business man explain the basics of group health insurance in an office

Group Health Coverage Basics for Small Firms

Offering health insurance to your employees may sound like an overwhelming process — but it doesn’t need to be. Once you’ve identified your firm’s needs and know the basics of group health insurance, the rest is easy. So, what do you need to know first?

What’s the difference between group and individual health plans?

According to the U.S. Department of Labor, “A group health plan is an employee welfare benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or otherwise.”

In other words, a group health plan is designed to cover a group of employees, but each enrollee has their own plan with benefits – and the plan’s monthly premium is calculated differently than if it were purchased as an individual health plan.

The monthly premium for all health plans is determined by the perceived risk of the carrier in offering coverage. With a group health plan, the group seeking coverage has their risk pooled together as one, which in some cases, may lower the monthly cost.

Unlike individual plans, group health plans are also available in different types designed to help your business save the most money and make the best coverage decisions. To learn more about these different plan types and ways that your firm can save money on group health coverage, feel free to check out our latest group health webinar.

As a firm owner, do I have to offer group health insurance to my employees?

Depending on the size of your firm, the answer could be no. The Affordable Care Act (ACA) stated that businesses with fewer than 50 full-time employees are not legally obligated to provide health insurance to their employees — but many choose to regardless.

Looking for a better benefits package is one of the most common reasons people change jobs. And if your firm doesn’t offer a health insurance benefit, it may give current and prospective employees reason to look somewhere else for employment.

If you are federally mandated to offer health insurance to your employees, you will need to ensure you are following the rest of the ACA’s rules and regulations for small businesses.

Making The Right Group Health Decisions For Your Firm

Ready to take a look at your options? Our team of licensed benefits counselors is on hand to help you find the best group health solutions for your firm. Visit wsba.memberbenefits.com/employer-group-solutions/ or schedule an appointment with us today.

business person sitting at desk with calculator

What is a Level-Funded Health Plan?

According to the nonprofit National Business Group on Health (NBGH) survey 2019 Large Employers’ Health Care Strategy and Plan Design, the cost of employer-based health insurance is poised to reach roughly $15,000 per employee this year, a 5 percent increase from 2018. While this is not unusual, it is forcing businesses to get more creative with the employer group health benefits offered to their employees. In fact, NBGH president and CEO Brian Marcotte even went so far as to say that “Health care cost increases continue to outpace workers’ earnings and increases in inflation, making this trend unaffordable and unsustainable over the long term.”

51 percent of the companies that participated in the aforementioned survey also indicated that they would be taking steps to add more virtual care solutions to their benefits portfolio to help combat rising health insurance costs.

Another cost-saving tactic more companies are shifting toward is level-funded group health plans.

Level-Funded Health Plans

Level-funded health plans are ERISA compliant, partially self-insured plans designed to offer employers more flexibility and potential for 15%-30% cost savings. These plans are available to groups with two or more employees, have a wide range of industry-leading insurance companies to select plans from, and a nationwide network of hospitals and physicians that employees will be able to choose from.

Key components of these plans:

Claims Account

When a group signs up for a level-funded health plan, their insurance carrier can estimate the number of claims it will receive based on the group size. As each employee’s premium is paid, that money goes into a claims account. If at the end of the year there is a surplus of money remaining in the claims account, the employer will receive that money back.

Stop-Loss Insurance

If your group encounters higher-than-expected claims and your claims account is depleted, your Stop-Loss Insurance will step in to protect your finances and cover any overrun. This is included in your fixed cost along with taxes, commission, and administrative costs for level-funded health plans.

Plan Administration

A third-party administrator often handles the day-to-day functions of the program, allowing you to focus more on running daily operations.

Could a level-funded health plan be right for your firm?

What’s great about level-funding is that you simply pay your monthly premium and the insurance company does the rest. It walks, talks and feels exactly like a traditional health insurance plan.

If you’re wondering whether a level-funded health plan could be right for your business, our licensed Benefits Counselors are here to help. To learn more or to receive a quote, please visit https://wsba.memberbenefits.com/employer-group-solutions/.

employee benefits book on a wooden desk with glasses succulent coffee and notebooks

Trending Employee Benefits That Companies Should Be Aware Of

The U.S. unemployment rate is now at its lowest levels since 1969. This strengthening of the American job market has given many workers the confidence to reassess their employment situations in a way that they may not have felt comfortable doing ten years ago.

Employers are realizing that it is becoming harder to attract top talent and keep them. Previous benefits packages such as PTO and 401(k) offerings don’t seem to be enough anymore. So many businesses are now tasked with developing new ways to find and retain good staff.

While a comfortable salary is nice, a growing number of workers are placing a higher value on voluntary benefits. According to the Organization for Economic Co-operation and Development (OECD), the United States ranks 7th in the world for Countries With the Worst Work-Life Balance. So the more companies do to make their employees’ lives easier outside of the workplace, the more appealing and valuable those jobs become.

These are some of the most sought-after benefits right now:

Identity Theft Protection

According to Javelin’s 2019 Identity Fraud Study, over 14.4 million people fell victim to identity fraud in 2018 and over 23 percent of victims were not reimbursed for personal expenses. As technology continues to evolve, protecting your identity has never been more important. With new reports of data hacks every month, it’s at the forefront of many minds. Offering identity-theft protection could give employees an invaluable benefit: peace of mind.

Student Loan Refinancing

At the start of 2019, over 44 million U.S. citizens owed more than $1.56 trillion in student loan debt – signaling the highest amount ever recorded. According to Forbes, “Student loan debt is now the second highest consumer debt category – behind only mortgage debt – and higher than both credit cards and auto loans.” For the majority, this level of debt will continue to weigh them down for decades making this a crisis that impacts more than just recent college graduates.

This has led many businesses to begin offering student loan benefits to their employees in the form of refinancing options – or even help to pay down some of their debt (usually a set amount over a period of years). Some businesses who have implemented this approach have seen increased employee retention rates.

Wellness

Providing your employees with the tools they need to maintain their overall physical health can benefit not only them but your business as well. As a result, many employers are choosing to invest in everything from gym memberships to telemedicine options for their employees.

While exercise is a great way to relieve stress and improve overall cognitive abilities such as learning and concentration, sometimes that isn’t enough to fight off common depression and anxiety symptoms.

Roughly 1 million workers are absent from their jobs every day because of stress. According to The American Institute of Stress, “Unanticipated absenteeism is estimated to cost American companies $602.00/worker/year and the price tag for large employers could approach $3.5 million annually.”

Improving the access and affordability of mental health services is something that could greatly benefit businesses and employees alike. Many telemedicine services, such as Teladoc, have ventured into the realm of mental health counseling. This gives employees an additional benefit while allowing them to access crucial mental and physical health services wherever and whenever they need.

Moving Forward

Looking to refresh your voluntary benefits offerings to new and existing employees? Visit https://wsba.memberbenefits.com/ to learn about the voluntary ancillary products available to you as a valued member. Our licensed Benefits Counselors are standing by to help guide you to the best benefits for your business and budget. Contact us today!