GROUP MEDICAL INSURANCE

For companies with 1-50 employees

 

     The Affordable Care Act has radically changed how many smaller group employers offer medical insurance coverage.  Here are a few changes:

1.  For 2017 Small groups are defined as an employer having from 1-50 employees.  You need to have at least 2 eligible employees that are non-family members to qualify as a group.  (No family only groups)

2.  'Eligible' Employees who don't want to participate can waive coverage to another group or individual medical plan.   You need at least 75% of eligible employees (those not waiving coverage) to participate in the plan.

3.  Most companies now allow you to offer 2 different plans even to small groups.   If you have more than 5 employees Providence will let you pick 3 plans.  

WHY CONSIDER AN 'EMPLOYEE ONLY' PLAN?

    Employee-Only contracts are available.  This means that you do not offer coverage to the spouse & children.  If your employees are middle-income, their dependents can only use the Federal Marketplace and qualify for a tax credit if they are not being offered group health coverage.   Many employees also qualify for free coverage for their kids...but again, only if you are not offering them group health coverage.    This makes little sense, but we can discuss the best contract for your group.

MY ROLE AS YOUR INSURANCE BROKER

      Here's a few things about health insurance:  

1.  Prices are fixed by Law.  All Brokers and Online sellers offer the exact same rates. However, there may be a unique fix for your situation which another broker didn't consider.   We all have biases on the plans we like and show.   Find someone who seems to be looking out for your interests and listens to your concerns.

My four core group carriers include HealthNet, Kaiser, Providence, and Regence. Within these 4 companies you find the Legacy, Providence, and Kaiser healthcare systems.  

1.  After talking about your coverage desires the next step is to gather an accurate Census of your employees, and those that will be enrolling.   I'll quote the plans appropriate and present you all the options from that company for you to review.

2. Once you select the 1, 2 or 3 different plans you want to offer, I'll package the benefit summaries so that you can present them to your employees to choose which of the 2 or 3 they would like.

3.  I'll help you set up other benefits you want may want to offer such as voluntary Accident Insurance, Group Life, Dental, and Disability Income insurance.  

   

READY FOR ME TO PREPARE YOU A QUOTE?

 

1. REQUEST A CENSUS:   I need a Oregon Standard Group Profile form and a Census Form to get the info to provide you a good quote.  Click on the link below to download the form: 

2017_Small_Group_Profile_&_Census_Form.pdf  

 

Important Considersations

 

125 POP AND 105 HRA PLANS:

    If your employee's pay a portion of the medical premium, or you withdraw premiums for dependents, Section 125 of the tax code requires you to have a Section 125 Plan for your group, other known as a Premium Only Plan (POP), or Cafeteria Plan. This allows the employer to withhold the dependent premiums on a pre-tax basis.  

     To set up a Core125 plan for a one-time  $99.00 set up fee.  Simply visit the link below.  The people at Core Documents make this an easy process.

 http://www.coredocuments.com/core125.php

        Another valuable tool is a Health Reimbursement Arrangement (Section 105 HRA under the tax code).  You can set up an employer paid HRA that will reimburse employees a pre-set amount of medical, dental, and other unreimbursed expenses, say up to $500 per year.  Once you understand this tool you will be amazed, and your employees will be grateful. 

Learn more at www.coredocuments.com 

I look forward to being of service to you.

 

Best,

Dan Neils 503-650-4325   

 

 

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