Probably the least understood aspect of Health Care Reform is, “THERE IS NO EMPLOYER MANDATE FOR HEALTH INSURANCE IN THE SMALL GROUP MARKET”. In other words, there is no law that requires an employer with 2-49 employees to provide benefits. However it is commonly believed, if the employer offers health insurance benefits, their ability to attract and retain quality employees increases. Similar to the individual market, “Essential benefit plans” designed by the law will be Bronze plan (60% actuarial value), Silver plan (70% actuarial value), Gold plan (80% actuarial value) and Platinum with 90% actuarial value. “Actuarial Value”, what does this mean?
Rather than give you a definition, we believe it is easier to understand by example. For instance, if you choose to purchase the Silver plan with 70% “actuarial value”, you can generally expect to pay 30 % of the cost for services, and the insurance company will pay 70% (up to your annual out of pocket maximum). The Bronze, Gold, and Platinum work on the same principle.
The California Small Business Employer will have the option to purchase a group health insurance plan either inside the California exchange or outside the exchange. It is our understanding ALL small group enrollments in the small group exchange will be assisted through a broker, like us. If you do not have a relationship with a broker, a list of agents in your area will be provided. There are advantages and disadvantages for each. Please feel free to contact us for a better understanding of your choices. Feel free to click on the links below for additional information: