What You Need to Know About Group Health Insurance for Small Businesses (Part II)

Group Health Insurance for Small Businesses

Group-Health-InsuranceIn part one of this blog, we discussed the difference between a small-group and a large-group when it comes to determining what health insurance plan is right for your business and employees. We also discussed the importance of group health plans along with some of the different types of health insurance plans that could be offered by small businesses.

Now, in part II of this blog, Bernardini & Donovan will discuss employer-sponsored health plans (and things to consider) in addition to how to find an appropriate health insurance agent for you and your small business.

Employer-Sponsored Health Plans for Small Businesses

According to health insurance laws, small group health insurance must be made available to be sold to any small business that qualifies for group insurance.

As a small business, your group must be able to prove that you are a viable business by providing some basic business documentation. All insurers generally have the same requirements, but occasionally they will relax the qualifying guidelines in an effort to acquire new business.

Once a group is deemed qualified, they have hundreds of health insurance plan options from which to choose. It is important to have a knowledgeable broker like Bernardini & Donovan Insurance Services, Inc. at your side to help you determine qualification and assist in selecting a plan that meets your coverage needs and budget.

The insurance companies generally require that a certain percentage of employees participate in the employer plan and this percentage varies based on group size and the insurance company selected. Now, to ensure your business stays competitive within the job market, here are three things to take into consideration to guide your decision when choosing employer-sponsored healthcare:

  • Preventative care coverage: Most health plans must cover a set of preventive services like shots and screening tests at no cost to you. 10 essential health benefits required by the  Affordable Care Act (ACA) for small businesses (1-100 employees) and individual health insurance plans.

Know what coverage matters. First, the top coverages employees look for are preventative care, hospitalization, and copays. Understanding these coverages is your first step to choosing policies that keep your workforce healthy and happy. Talk to our team of specialists to help you balance the cost against these critical needs.

○     Ambulatory patient services (outpatient services)

○     Emergency services

○     Hospitalization

○     Maternity and newborn care

○     Mental Health and substance use disorders, including behavioral health treatment

○     Prescription drug coverage

○     Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and related devices

○     Laboratory services

○     Preventive and wellness services and chronic disease management

○     Pediatric services, including oral and vision care

Large and small group health insurance policies are designed to provide the best possible coverage for individuals who are part of a specific group.

  • Hospitalization coverage: The cost of medical care, especially hospital stays, can quickly add up. This plan can either a) help you prepare your budget for unexpected medical costs resulting from a hospital stay or b) pay your benefits for other medical services depending on the policy when you are confined to a hospital, whether the reasons are planned or unplanned, and can cover short or long term stays.
  • Copay coverage: A copayment or copay is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. Copayments can vary for different services within the same plan, like drugs, lab tests, and visits to specialists.
  • Generally, plans with lower monthly premiums have higher copayments. Plans with higher monthly premiums usually have lower copayments.

Choose who gets covered. Second, you need to decide if everyone will qualify for the same policy. Will you offer coverage to part-time employees? How will you treat their dependents? The amazing thing is that you do not need to choose a “one size fits all” policy. Your insurance agent will help you understand your workforce and choose policies that comply with the ACA while meeting your needs and those of your employees.

Decide how much you will contribute. Third, you will decide how much of these policies you choose to subsidize. Some employers opt to pay for the entire policy, others offer a sliding cost scale based on coverage, and some only cover a flat percentage of the employee’s total health care costs. It’s important that you offer “affordable” coverage to avoid any fines associated with the ACA, so work with your provider to understand median policy costs in your region and how these costs stack up against your employees’ wages and cost of living.

Things to Consider with an Employer Health Plan

When you own a small business with less than 50 total employees, you are not required by law to offer a health plan for your employees; however, you may still want to. Before choosing a group health plan for your employees, there are a few things to consider.

First, you need to keep both your business goals as well as the benefit of your employees in mind. This is a careful balance, but it can be done with the right considerations along the way. Use this list as your guide through the process:

❏    How much can your business pay and how much can your employees pay? In general terms, plans come in terms of premiums. The higher the premium, the lower the costs out of pocket and vice-versa. Something to consider is how much both your business and your employees can afford in terms of premiums and out of pocket costs when they use the insurance. You will want to find a happy medium that makes both you and your employees happy.

❏    Will you offer one plan or a choice of plans? There are many plans for you to choose from and your biggest decision will be whether you want to offer one or a choice of a few for your employees. You will want to explore all of the options available for your area. One main reason employers offer more than one plan is because some employees want a better plan than the most basic plan and others just want something to meet legal requirements.

❏    Will you offer other plans, like dental and vision? You are not just limited to medical plan offerings. If you want, you can offer your employees both vision and dental offering as well.

❏    How much will you pay for? As a business, you MUST pay a portion of the premiums on behalf of your employees, but are not required to pay for dependent cost. You will want to determine what you will pay for before as a company.

When it comes to evaluating group health plans, health plans vary tremendously. The basic comparison factors are relatively simple, though: analyze benefits, price, and providers of any plan.

Providers – This is an important area you should investigate. Traditional insurance plans allow you to choose your own doctor but managed care plans include preferred provider organizations (PPOs), health maintenance organizations (HMOs), and point of service (POS) plans. These plans often restrict your choices of medical services providers to an approved list. The list could prove crucial in deciding whether to enroll in a given plan.

Price – Compare plans with similar benefits to determine which plan offers the best value for your money. Your employer might offer several options from which you could choose. Keep in mind that a) some companies offer a choice between two insurance plans b) some employers can also provide a basic insurance plan, but they allow employees to purchase more comprehensive insurance as a personal option c) and some companies offer multiple insurance plans.

Benefits – You should research the benefits of various plans to find what each cover. Assessing the following benefits will provide practical help in evaluating policies: find out what co-payments are required for outpatient care and inpatient treatment; find out what kind of copayments are required for generic or name brand prescriptions; understand what your deductible options are and how they will affect the insurance premium.

If you live or operate a small business in Redlands or the Inland Empire and want to learn more about health insurance options, contact the health insurance specialists at Bernardini & Donovan Insurance.

Finding an Agent for Small Business Health Insurance Plans

The value of an agent is not an easy thing to summarize. For starters, an agent sells insurance plans for multiple insurance companies, which means they have a variety of options at their disposal. Agents can help ensure that you pick the right small group health insurance in regards to cost, the plan itself, and more.

The value of an agent is likewise apparent when you need answers to questions concerning group health insurance plans and policies. A reputable agent doesn’t just sell you a policy; they explain it in the finest detail so you understand exactly what you are getting for your money. Your agent is the one you contact when you have to file a claim or if you need to update your policy. When the insurance company has questions concerning an accident or health claim, your agent is the one who acts on your behalf to make sure all of your insurance needs are meant.

If you have any questions concerning insurance coverage for a small group of individuals, we at Bernardini & Donovan can answer your questions and help you get the coverage you need.

What You Need to Know About Group Health Insurance for Small Businesses (Part I)

Group Health Insurance

Group Health InsurancePurchasing group health insurance as a small business owner can be a rather intimidating task. This is especially true when you try to do it all on your own without any help. However, the process can be made a lot easier and less daunting if you let a professional agent assist you in choosing the right group health insurance plan for your small business.

In this two-part article, Bernardini & Donovan Insurance Services will break down what you need to know about group health insurance for small businesses. We’ll discuss what a small business is considered, why group health plans are important, some of the types of health insurance plans offered by small businesses, employer-sponsored health plans and things to consider, and finding an appropriate health insurance agent for you and your business.

There are a number of variables to consider when purchasing group health insurance. While there are many business insurance options available, your selection will be determined by your needs. That’s why we’re going to discuss important variables such as: determining whether your business is considered a small business or a large business; the health insurance plans available for small businesses; ideal plans based on your business; and more.

In this first part, we’ll be focusing on small businesses versus large businesses, why group health plans are important, and the types of health insurance plans offered to small businesses. In the next article, we’ll address employer-sponsored health plans (and things to consider) and how to find an appropriate health insurance agent for you and your small business.

Small-Group Employer vs. Large-Group Employer

As a small business owner, one of the most important considerations that you have to make will deal with the type of insurance that you offer to your employees. But, how do you know if your business is considered a small group employer or a large group employer?

The Affordable Care Act divided employers into two categories: small group and large group. There is a general dividing line at 50 full-time employees or equivalents, although there are some benefits specifically aimed at businesses with 25 or fewer full-time employees. A business that employs 50 or less full-time employees falls under the small group category. However, the full-time employee doesn’t necessarily have to be one individual.

A business can have as many part-time employees as it wants as long as the equivalent number does not exceed 50. In other words, an employer can have four part-time employees working ten hours a week for a total of 40 hours worked. These four people working a total of 40 hours collectively, is calculated as one employee. There can be any variation on this theme to qualify for the small group coverage as long as the sum total is no more than 50 full-time employees.

A full-time employee or equivalent is an employee who averages at least 30 hours per week or 130 hours in a calendar month. You must calculate your hourly worker’s service hours based on hours worked and hours of earned paid leave.

If you run a small business with two to 20 employees and are looking for guidance for your small business’ group health insurance, Bernardini & Donovan Insurance Services can offer the best and most cost-effective business insurance plans around. We’ll help cut through all of the confusion and unnecessary information so that you can have the peace of mind that comes with knowing that your employees are well protected in the event that something unfortunate should unexpectedly happen.

The Importance of Group Health Plans

In our healthcare perks article, the B&D team talked about how small businesses can attract talented employees through better healthcare perks. It’s no surprise that modern employees are extremely savvy about the bonuses that come with a job. Gone are the days when salary used to be the major competing factor in attracting new talent! Today, it’s as if everything is about healthcare, child care, continued education, retirement accounts, and other related perks.

This is great for both employees and employers. For employees, they can acquire more value than they could in a straight cash salary. For employers, companies can take advantage of a variety of tax incentives and breaks to provide these bonuses and remain competitive.

When it comes to establishing the ideal health insurance plan for your small business, consider how your plans benefit your employees.

  • Vision, Dental and Prescription Services. Though they may be optional, offering vision, dental and prescription services is not expensive and will go a long way towards showing employees that your business is concerned about their health. There’s also another benefit — providing vision, dental and prescription service makes it less likely that employees will go without care, damaging both their own health and their productivity. Mental health services and substance abuse services offer similar benefits.
  • Flexible Spending Accounts. Both health care flexible spending accounts and dependent care flexible spending accounts are extremely important perks for modern businesses. Employees will be able to set aside money in a tax-advantaged account, much like an IRA, to be used on both their own medical expenses and their child’s or other dependents. Many executive employees and other financially savvy employees specifically look for the flexible spending account option, as it makes more sense to them and will result in more money being acquired by them overall, as they can put tax-advantaged funds towards their medical costs.
  • Employee Health Programs. In addition to health insurance, employers can create health programs that promote good health to their employees. Many employees specifically look for these programs when they are learning about a job opportunity. Employee health programs can include everything from healthy provided snacks to an on-site gym, depending on your company’s budget.

Employers can look to their health insurance agency to find out more about what they can do to attract the best up-and-coming talent to their business.

Types of Health Insurance Plans for Small Businesses

  • Business Health Insurance Don’t: The “One Size Fits All” Plan. No two employees are the same, this has never been more true than when you begin to take their health into consideration.

Each employee (and their respective family members) will have their own unique considerations, which is why it is important to not opt for a “one size fits all” plan. Instead, engage your employees and take their feedback into consideration.

Try to find a plan that you can customize to fit the needs of the group instead of trying to force the needs of the group to work within the confines of the plan that you’ve selected after the fact.

  • Health Savings Accounts. One type of business insurance that has become increasingly popular over the last two decades is the health savings account (or HSA).

For individuals who are enrolled in an HDHP (or “high deductible health plan”) they can open a medical savings account with a number of tax advantages that they wouldn’t get from other types of plans.

Deposits into the account can be made by either the employee in question or by the employer and can be made on a pre-tax basis. The money in the account is then to be used to pay for things like medical bills and other unforeseen expenses related to their health.

One of the primary advantages is that the money continues to roll over each year and does not “expire” in the event that it goes unused for any specific period of time.

Finding Affordable Health Plans for Small Businesses: Bernardini & Donovan

When it comes to educating one’s self on group health insurance for small businesses, there’s a lot of information to consider. Remember that this is the first of a two-part article geared towards group health insurance plans. The goal is for small businesses to feel more confident when it comes to finding a service that suits them and their employees.

Just because you own a business doesn’t mean you should lose money trying to pay group health insurance for your employees. You can find the insurance coverage that works for your company’s budget while letting your employees have the health insurance program they need to stay healthy. If you want to jumpstart the process, feel free to browse the insurance products offered through Bernardini & Donovan Insurance Services.

The B&D team is here to help you find a suitable and affordable healthcare plan as a small business owner. We believe that you should find a healthcare plan that suits you and your budget, and we want to help.

Contact Bernardini & Donovan Insurance Services if you’d like guidance through the process of selecting the appropriate group health insurance for your business. We can help you make the right decision, and we have the right tools to help you find the perfect plan(s) for your employees as well as for your business.

We discussed the difference between a small-group and a large-group, the importance of group health plans, and some of the different types of health insurance plans that could be offered by small businesses. On the next blog, we’ll consider employer-sponsored health plans and how to find an appropriate health insurance agent.

How Obamacare Will Affect Your Small Business

As the various insurance implications surrounding Obamacare continue to affect both individuals and small businesses, it is important that you make sure that you are complying with the Affordable Care Act. Depending on the size of your small business and the amount of full-time employees that you have, you may be required to offer them health insurance. As we observe how recent health care reform is affecting our California small businesses, there are some trends that are worthy of acknowledgement:

  • Obamacare has contributed to the growth of consumer-driven health care. As a consumer-driven industry, employees and patients are acting as medical consumers and controlling how their health care allowances are spent. Since the responsibility of controlling health care choices is transferred to the employees, small business employers benefit from consumer-driven health care.
  • As a small business employer, it is important that you educate yourself of the various health insurance options available to you. When it comes to small businesses and health insurance, you have the luxury of offering your employees tax-free money so that they can make their own health insurance purchase.
  • The entire way employee benefits work is altered by recent health care reform. Rather than providing your employees with a group health insurance plan, you now have the luxury of offering your employees a health care allowance instead. If you have experienced the inability to offer your employees group health insurance in the past due to failure to meet minimum requirements, you can now offer employees this commodity, tax-free!

Contact Bernardini & Donovan Insurance Services for all of your California business’ health insurance needs. We understand that the various implications surrounding Covered California may have you confused, and that is why we are available to dispel any myths and reveal only the truth.

Does Your Business Qualify For SHOP Tax Credits?

Did you know that as a small business owner with fewer than 25 employees you may be eligible to receive a tax credit? This is only of course if you qualify to offer your employees health coverage through the Small Business Health Options Program, also known as SHOP.

The Small Business Health Care Tax Credit is typically awarded to small businesses whose full time employees make an average of $50,000 or less annually. In order to qualify, you must be willing to pay at least 50% of the premium costs of your full time employee’s health care. You will not be required to offer health coverage to your part time employees or to the dependents of your full time employees. If you have fewer than 10 employees, expect to receive the ultimate benefits. The smaller your business, the larger tax credit you can expect to receive.

Employers abiding by the SHOP qualifications can receive up to 50% of their contribution towards employees’ premium costs. As a tax-exempt employer, you can receive up to 35 percent of your contribution towards employees’ premium costs in tax credits. Remember, this tax credit is only available for those employers who have provided their employees’ health coverage through the SHOP Marketplace.

How to Qualify for the Benefits of the Small Business Health Tax Credit:

  • You must have 50 or fewer full time employees in order to offer health coverage through the SHOP Marketplace.
  • As a SHOP member, you must offer health coverage to each full time employee.
  • In order to qualify, about 70% of your employees must enroll in your SHOP plan.
  • You will need to be relatively close to a SHOP service area in order to take advantage of this program.

Bernardini & Donovan Insurance Services strives to provide Redlands, California residents with excellent insurance services custom tailored to meet your unique needs. Contact us today and allow us customize a unique health insurance package for your family based on your needs.


SHOP: How It Can Benefit Your Small Business

With all the confusion surrounding the implications of the Affordable Care Act, it is imperative that you utilize all the available options as a business owner. The Small Business Health Options Program has been put in place to guide small businesses through the process of offering health coverage to their employees.

As a small business owner with 50 or fewer full-time employees, you are given the opportunity to take advantage of the Small Business Health Options Program Marketplace, also known as SHOP. If you are a small business owner with less than 25 employees, you may be eligible to receive tax credits when purchasing health coverage for your employees through the Small Business Health Options Program.

Benefits of The Small Business Health Options Program, Include:

  • You are in control of what coverage you offer your employees and how much you pay toward employee premiums.
  • Your business’ needs and your employees’ needs can be met by choosing between 4 different levels of coverage.
  • You can choose to begin coverage at any time. As long as you enroll by the 15th of the month, coverage will begin on the 1st of the following month.
  • As previously mentioned, as a small business with fewer than 25 employees, you may be eligible to receive a tax credit.

Qualifying Terms for The Small Business Health Options Program, Include:

  • Any business with 50 or less full time employees may be qualified to offer employees coverage through SHOP.
  • If you are interested in using SHOP, you must offer coverage to every single one of your full time employees.
  • If you are looking to use SHOP, you may be required to have a large majority your employees enroll in your SHOP plan. This percentage is typically around 70 percent.
  • You must be within the boundaries of a SHOP service area to utilize the service.

Bernardini & Donovan Insurance Services strives to provide Redlands, California residents with excellent insurance services custom tailored to meet your unique needs. Contact us today and allow us customize a unique health insurance package for your family based on your needs.

How the SHOP Works

When a business gets started there are a number of things that need to happen in order to attract employees. One of the benefits that needs to be in place is health insurance. The Covered California SHOP Exchange is a way for small businesses to provide group health insurance for their employees. Here is how Shop works for small businesses:

How Shop Works

  • Each participant in the plan completes a profile and receives a group ID.
  • The employee of the company enters the SHOP program and they are then issued an ID of their own. In order for them to      access their plan they are also issued a password.
  • Once inside the plan the employee enrolls in the health plan that they need for themselves.
  • Once the employee has made their selections the employer then verifies that they work there.
  • All information is taken care of by the SHOP and then from there it is given over to the insurance carriers.

Any small business owners who have questions about the SHOP in California, should contact Bernardini & Donovan Insurance Services. They can help answer all of your questions about Covered California SHOP.


Covered California SHOP Exchange: What this means for employers

In California small businesses that are struggling to provide health care coverage for their employees now have hope. The Covered California SHOP (Small Business Health Options Program) Exchange will provide a greater selection of group health insurance coverage, previously only offered to businesses with larger numbers of employees. Small business owners who are interested in joining the Covered California SHOP Exchange can do so just as long as they have less than 50 employees, for the time being.

As part of this revolutionary program, small businesses with fewer than 25 employees, as well as an annual earning that is less than $50,000, can earn a 50 percent federal tax credit for any health care coverage that is purchased via SHOP. To date 375,000 small business employers in the state of California are eligible for this small business tax credit.

Here at Bernardini & Donovan Insurance Services we offer additional information regarding the Covered California SHOP Exchange. If you would like assistance in determining if you are eligible or how to be a part of the SHOP program, contact the insurance professionals at Bernardini & Donovan Insurance Services, located in Redlands, CA today.


What Every Small Business Owner Needs to Know about the Affordable Care Act in 2014

New policies related to healthcare have many small business owners concerned of what is to come in 2014. News reports are tossing around penalty figures of $2000 per person per year. And that is just the start of the penalty scale. Bernardini & Donovan Insurance Services explains what a small business owner needs to know about his or her responsibilities under the Affordable Care Act:

  • Small businesses won’t be penalized. Businesses that employ less than 50 full-time employees will not be held to the employer responsibilities outlined in the Affordable Care Act.
  • However, you can qualify for a tax credit. A small business that pays average yearly wages of less than $50K, has less than 25 full-time employees and offers affordable health insurance could receive incentives in the form of a small business tax credit. Beginning in 2014, this credit could be up to 50 percent and will help offset group health insurance costs.
  • You may have more buying power than you think. According to HealthCare.gov, the average small business pays  18 percent more for group health insurance than a larger company would. Small businesses that employ less than 100 people on average will have access to the Health Insurance Marketplace, reducing costs by giving access to plans seen by larger corporation.

Contact Bernardini & Donovan Insurance Services at 877-251-2447 today for more information on group health insurance for small businesses.

Make the Right Decision About Becoming A Part Of Your Employer’s Health Insurance Program

You’ve finally found the dream job position you always wanted. It will offer a great salary and bonuses throughout your career. As you fill out the employee paperwork, you are asked on whether you want to participate in the employer’s health insurance program.

Joining Group Health Insurance Plans

Many employers who hire a certain number of employees will offer health insurance programs through the company. There are many benefits on why you should participate in one. While you will have a portion of your wages go into the health plan, your employer will also pay toward the costs. In addition, the insurance is group rated, which means you will have more opportunities of being placed on a good plan.

Most employers will give you the opportunity to choose the plan you want. Also, you may be able to place your spouse and your children on the same plan. Make sure you read about all the benefits and coverage you will get when you are asked to participate in it.

Find Affordable Health Plans Through Bernardini & Donovan Insurance Services

Just because you own a business doesn’t mean you should go broke trying to pay group health insurance for your employees. Find the insurance coverage that works for your company’s budget while letting your employees have the health insurance program they need to stay healthy by looking at the insurance products offered through Bernardini & Donovan Insurance Services. For more information about Bernardini & Donovan Insurance Services in the Redlands area, and throughout California, contact Bernardini & Donovan Insurance Services at 877-251-2447.

5 Steps to Get the Group Health Insurance Everyone Is Happy With

Your business has grown to the point where you can hire as many employees that you need to handle operations. You’ve developed the employee positions and hired the qualified workers. There is just one other thing you need to do: find the right employer’s health insurance plan that you can afford.

5 Steps Business Owners Can Take To Find the Right Group Health Insurance           

Finding the right health insurance and employee benefits does not have to be a long and arduous process. You can find the insurance you want and the one that your employees will be happy with by following these 5 steps.

Step #1: Research the Insurance Industry

Never purchase a product without finding out more about it. This includes health insurance. Find out about the industry and how it personally affects you as you can make smart decisions when it comes to buying group health insurance.

Step #2: Talk With Your Employees about Benefits

While you don’t have to ask your employees about health insurance, it is a good idea to get their opinion about it. Create a survey and ask them about the types of employee benefits they would like to have. In this manner, you can look for insurance that will cover their needs.

Step #3: Get Quotes

Ask your agent or broker to prepare different quotes so you can get a general idea on how much the insurance will cost.

Step #4: Compare Plans

Once you get the quotes, you can now compare the insurance plans so you are getting the most affordable prices with the best offered coverage. Now is the time to pull out the questionnaires your employees filled out so you can use their opinions to help with the decision-making.

Step #5: Commit To the Policy

Once you choose the policy, you need to commit to it without second-guessing yourself. Just move forward with your choice with the full knowledge that your employees are properly protected.

Bernardini & Donovan Insurance Services Provides the Quotes You Need

Choosing insurance is never easy, but it can be done if you are using the right company who offers affordable insurance products. Bernardini & Donovan Insurance Services offers premium group health insurance at the quotes you can afford. For more information about Bernardini & Donovan Insurance Services in the Redlands area, and throughout California, contact Bernardini & Donovan Insurance Services at 877-251-2447.

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