As a small business owner, you want to provide the best for your employees. That includes offering group health insurance that will not break the bank. When researching group health plans for your employees, you’ve probably come across the terms “group health” and “blanket health”. Both are different in what type of coverage they provide your employees, so you need to understand how each type of plan works in order to determine which might be right for your employees and your business.
Group health insurance provides health benefits to your employees, their spouses, and any other eligible dependents. With a group health plan, they will have coverage for visits to the doctor, hospital, or any urgent care facility. If you choose to offer a group health plan, you can also include coverage for prescription drugs and vision and dental care.
Blanket Health Insurance
Blanket health insurance is similar to group health insurance, except it is less comprehensive. It is meant to cover a group of individuals engaged in a specific activity. This type of insurance is often referred to as an accident-only policy, because it provides only basic coverage in the event that your employee is involved in an accident or is injured. The benefit of this kind of insurance is that you don’t have to purchase multiple individual policies to get coverage; the coverage you purchase is a “blanket” policy that covers all of your employees.
You can purchase blanket health coverage to provide health benefits in connection with accidental injury, but the policy usually has a limit on the type of procedures and services that are covered.
How They Are Different
While both offer some type of healthcare coverage, group health insurance and blanket health insurance have many key differences. Group health insurance:
Covers the 10 essential health benefits that are required to be covered by the Affordable Care Act.
Does not have a dollar limit on what it will pay for care received by your employees.
Is more comprehensive in what it covers and has more coverage optionsthan blanket health.
Has policy terms of a full year.
Blanket health insurance:
Does not have to cover the 10 essential benefits; these plans usually are limited in the types of procedures, tests, and services they offer.
Usually has a maximum covered benefit amount for each person covered.
Has a limited term duration.
If you choose group health insurance, you can tailor your plan to your employees’ financial and medical needs. Blanket health insurance is more cost-effective, but you will not be providing full-coverage health insurance for your employees. You need to consider your employees’ different needs, which a single policy, like blanket health, might not be able to meet.
It can be difficult and time-consuming to compare all the different group health insurance plans in your area, but with the help of an EZ.Insure agent, you are guaranteed to find a group health plan that meets your employees’ needs and saves you money. Our agent will assess your business and employees, and will research and compare all available plans in your area, for free. No hassle and no obligation, just free quotes! Easily compare plans now by entering the zip code in the bar above, or to speak directly to an agent, call 888-998-2027.
If you own a business that employs fewer than 50 people, then you are not required to offer your workforce group health insurance – but that doesn’t mean that you can’t, or that you shouldn’t. Many small business owners find that having healthier and happier employees is worth the cost and the administrative headaches of providing a healthcare plan, some go even further: they offer multiple plan options for their workers to choose from. Going this route may not be right for every small business, but if you’re looking to keep a diverse workforce satisfied, then it might be right for you.
Offering Health Insurance: The Stats
If you’re not currently offering a healthcare plan to your employees, you may want to take a look at a few stats:
40%: The percentage of workers that say that healthcare is their number one priority when it comes to benefits.
88%:The percentage of job seekers who say that they would give health benefits “some consideration” or “heavy consideration” when choosing a job. 46% said it was a deciding factor.
56%: The percentage of people with employer-sponsored health benefits who say that whether or not they like their health coverage is a key factor in deciding to stay at their current job.
50-60%of a worker’s annual salary: The amount it can cost to find a direct replacement for them if they leave their position.
$4,000: The average amount it takes to hire an employee.
The numbers above should give you an idea of how important offering group insurance to your employees can be to recruiting, retention, and to your bottom line. Adding flexibility to your plan options can only increase those benefits.
If you are currently offering one type of insurance plan to your employees, then you’re not alone. According to the Kaiser Family Foundation 2019 Health Benefits Survey:
76% of small businesses offer one plan type
20% offer two plan types
4% offer three or more plan types
If you’re choosing between plan types, you might want to take a look at a breakdown of what other small employers are choosing:
Point of Service (POS) plans: almost half of small employers – 47% – chose this option, according to a recent survey. POS plans are a hybrid of PPOs and HMOs: they have the lower premiums and primary care physician requirement of HMOs, but are slightly more flexible.
HMOs:This type of plan, which requires that employees choose a primary care physician, get referrals to see specialists, and stay within a narrow network, accounted for 26% of small business plans
PPOs: 15% of plans were this more flexible type, which have larger networks and fewer requirements than an HMO, but also have higher premiums.
Offering Plan Options: The Factors
Now that you know all the relevant facts and figures, and we’ve established that offering at least one plan is a good idea, let’s take a look at the factors that should go into determining whether you decide to offer more than one plan type.
The ages and health needs of your employees: If you’ve got a workforce completely populated by Millennials or X-ennials who are single, childless, and healthy, then offering a one-size-fits-all high deductible health plan might be a great choice for you. You and your young, healthy employees could both save money on premiums, and they could contribute money tax-free to an HSA. But if you have some older employees, or employees who need to visit their doctor often, then they would probably prefer a plan with a higher premium and lower deductible. Adding a PPO into the mix would probably work for them, especially because they might not want to have to see their primary care physician every time they need to visit a specialist.
Location: If your employees all live and work in one small area, then they might not need to pay extra for a PPO with a wide network. However, if you have a lot of commuters who are spread out over a large area, they may prefer the flexibility of a plan with a larger network.
Budget:You need to think about what both you and your employees can afford when it comes to choosing a plan. If you really can’t find it in your budget to contribute to higher premiums plans, then stick with offering a cheaper option – it’s better to offer one plan than no plan! On the other hand, if most of your employees are older and/or have families and are willing to pay for a more full-coverage plan, but you have a few younger, more budget-conscious employees, consider offering them a second, cheaper option.
There’s always a lot to consider when choosing whether – and how – to offer health insurance to your small business’s employees. If you need more input, turn to your employees themselves – you can always offer an anonymous employee healthcare survey so that they can tell you exactly what they want. And if you need still more help, turn to EZ! We can answer all of your questions about offering multiple plans (or anything else!), find you the best plan options, and get you super fast, accurate quotes, and we’ll do it all for free. To get started with us today, simply enter your zip code in the bar above, or to speak with an agent directly, call 888-350-1890.
If there’s one thing that we can all agree on, it’s that 2020 has been an unusual year, especially when it comes to healthcare. We’ve seen a once-in-a-lifetime pandemic, and we still don’t know what all the effects of it will be. Take, for example, costs for employer-based healthcare. If you’re an employer, you’re right to be wondering where your health costs are headed in 2021 – will they skyrocket? Level off? Maybe even go down? Unfortunately, the answers to these questions are not as clear-cut this year as they have been in previous years, but we can take a look at what some experts are projecting, as well as what you can do to help keep costs down.
This Year’s Cost of Care
To get a better idea of why predicting healthcare costs for 2021 has been so difficult, we need to take a look at what healthcare costs have been like this year. As you might expect, dealing with the coronavirus is expensive: California’s state ACA Marketplace, Covered California, estimated that the costs to test, treat, and care for coronavirus patients this year will be between $34 billion and $251 billion; America’s Health Insurance Plans predicts the cost will total $56 billion to $556 billion over a two-year period.
Even with those astronomical numbers, we can’t simply jump to the conclusion that insurance costs are going to skyrocket next year. It looks like the total costs of healthcare in the U.S. are actually down this year; in fact, one estimate is projecting that we will have spent anywhere from $75 billion to $575 billion less than expected on healthcare by year’s end. One actuarial firm is even saying that some self-insured employers could see a 4% drop in healthcare costs in 2021. How can that be? While the coronavirus has been an unexpected expense, in some cases, it has been balanced out – or even cancelled out – by the fact that many people are postponing or cancelling regular clinical care and elective treatments due to coronavirus.
But before we get too excited about a possible drop in healthcare costs, we need to look at what the experts are predicting. And, like everything else this year, it’s unusual: there are multiple possible scenarios for how much employer healthcare costs will rise.
Multiple Scenarios
Medical costs are one of the most vital bits of information for insurance companies as they figure out plan costs for the coming year. With this year being so much in flux, it is unclear what insurers are going to do; in fact, business advisory giant PricewaterhouseCoopers (PwC) has taken the unusual step of offering multiple scenarios for what could happen to employer healthcare costs in 2021. “This is an unprecedented report for us,” said Ben Isgur, leader of PwC’s Health Research Institute. “In the 13 years we have been doing this, we made a projection of the coming year and never felt the need to do scenarios.” Their 3 scenarios for 2021 are as follows:
Medical spending continues to stay low, with people opting out of non-coronavirus related care. In this scenario, costs would only rise by about 4%, which would be one-third lower than the average growth over the last five years.
Medical spending could be “medium,” and costs would rise at the same rate as they did from 2014 – 2020: around 6%.
Spending could be very high and result in a 10% increase in costs.
These numbers might not be across the board for all businesses in all areas: it might depend on where they are located and how much the coronavirus has affected their area. For example, businesses in an area that has been relatively unaffected by coronavirus will most likely see the usual increase of about 6%, while those with a surge in the virus, but a drop in people seeking care for other things, could see a rise closer to 4%. But if all of this other medical care gets pushed into next year? Then we could see a rise in healthcare costs of around 10%, which would mean the highest rate of medical-cost inflation since 2007.
For now, it does look as if some insurers are raising rates, and these increases seem to vary by plan type. For example, recent filings with the District of Columbia’s Department of Insurance, Securities and Banking related to small groups for 2021 show that Aetna filed for an average increase of 7.4% for health maintenance organization (HMO) plans and 38% for preferred provider organization (PPO) plans, while UnitedHealth proposed an average increase of 17.4% for its two HMOs and 11.4% for its PPO plans. They may be anticipating a surge in claims as 2021 gets underway.
A Surge Next Year?
What many employers are concerned about now is that final, high-spending scenario. With so many people putting off necessary treatments, insurance claims could skyrocket in 2021 as people get sicker. Skipping out on preventive care could also present a large problem, as people may miss out on being diagnosed with underlying issues. “[Employers are] worried that some of these elective procedures will simply be bunched up next year and some people will be sicker next year … because certain things weren’t detected earlier,” said James Klein, American Benefits Council president.
Other things that could drive up costs? Increased coronavirus testing as employees return to work, prescription drug cost increases as pharmaceutical companies work on coronavirus treatments, and higher operating costs for hospitals and physicians as they try to keep up with the need for protective gear. Finally, let’s not forget that, as people struggle with isolation and anxiety, mental health costs will probably continue to rise – and now is certainly not the time to skimp on mental health care benefits for your employees.
What You Can Do
If costs do end up rising significantly, it might seem like the best thing to do would be to choose plans with higher deductibles or contribute less to employees’ premiums, which would pass some of the costs onto them. This may help to reduce your spending in the short-term, but it’s probably not the best long-term strategy. Studies show that putting more of the cost of healthcare onto your employees actually discourages them from seeking preventive care: for example, families with a higher deductible are less likely to take their children to see the doctor, even if the visit is free. In the long run, this could mean that your employees and their families will be less healthy, which could mean higher healthcare costs.
So what should you be doing to help manage healthcare costs and keep your employees healthy? Here are a few strategies:
Probably the best thing that you can do right now – and continue to do in the future – is to offer telemedicine as an option to your employees. Virtual healthcare exploded in popularity during the pandemic, and many patients love its convenience, while many employers love how cost-effective it is. Speak with your insurance company and make sure that they will continue to cover it – and encourage your employees to take full advantage of it.
Healthcare technology doesn’t have to end with telemedicine. You can offer “virtual chronic care solutions,” which can reduce the need for regular doctor visits. This could include things like Bluetooth-enabled glucose monitors that link with smartphone apps.
Instead of raising costs for your employees, try narrowing the network included in your plan. If your employees are already happy with their covered doctors, it may not be necessary to include a wider range of providers.
Speak to your insurance company, or one of our knowledgeable agents, and have them help you examine your employees’ healthcare costs. For example, are their providers jumping right to expensive tests and surgeries, or are they more likely to start with effective preventive measures?
The only thing we know right now about 2021 healthcare costs for employers is that we don’t know a whole lot. Right now all you can do is move forward on the assumption that costs will go up, as they do every year, and try to find ways to keep costs down. The best way to do that? Contact EZ, and speak with one of our agents. They can give you cost-saving tips, and can also find you a great plan at a great price – and they’ll do it all for free. To get started, enter your zip code in the bar above, or to speak with an agent directly, call 888-350-1890.
Thanks to modern technology, anywhere can be an office or a workspace, and you can have meetings with people you’ve never actually met in person. You might employ people in different parts of the country, and your only contact with them might be through email and Zoom, but they are still part of your team, and should be treated as such. Offering healthcare to your employees – wherever they are – is a great way to show you value them. It is also a way to attract the best candidates for your remote positions. Figuring out a group health plan can be hard enough, but adding employees from different states into the mix can make it feel impossible. But there are ways to make it happen!
Why Offer a Healthcare Plan and Where to Start
If you’re running a small business with a handful of employees working remotely, you might be questioning whether it’s worth it to even look into a group healthcare plan. Rest assured, it is worth it. There are multiple studies that show that offering healthcare boosts retention rates, employee satisfaction, and productivity.
If you’re looking to find – and keep – the right people for your remote positions, then consider what employees told a Willis Towers Watson study. 45% said that their employers’ healthcare benefits were a reason they chose their job, and 55% said their healthcare benefits were a reason they stayed at their job.
Everyone loves to have days off, but it turns out that employees love not having to worry about huge medical bills even more. According to a survey done by Glassdoor, 40% of employees chose healthcare as their number one most desired benefit, edging out more vacation time and performance bonuses. Glassdoor also found that having healthcare increased employees’ satisfaction with their jobs more than did perks like extra vacation time, retirement benefits, or even parental leave. And remember, satisfied (and healthy!) employees are more present and productive when they’re working.
It is important to note that you can’t just throw any old cookie-cutter plan at your employees, especially those who are working remotely and who you don’t know very well. Studies have shown that 80% of employees say that having health benefits customized to meet their needs is important to them. So the best way to start when looking to cover your far-off employees is to simply ask them what they want. Anonymous health surveys are great for finding out about employees that you don’t know well; include questions about how much coverage they want/need, whether they have dependents they want covered, etc.
The Obstacles
So the benefits of offering healthcare to employees are clear, but if they’re in different states, it’s not necessarily an easy thing to do. There are some obstacles that might limit your options. For example:
Some insurance companies won’t cover out-of-state employees. Others might, but will require a majority of the employees to be located in the same state.
Your state might have specific insurance requirements that make it difficult for you to find an insurance company (which are regulated at the state level) that can offer the same plan to all of your employees.
Your employees might want to choose their own plans, but have you help out with costs.
If you qualify for an ACA SHOP plan, you may be put off by the process of getting plans in multiple states.
Don’t get discouraged by these difficulties! It can be done, and we can take you through the ways that you can successfully navigate the process of choosing coverage.
Your Options
Covering out-of-state employees basically boils down to four options, all of which have their pros and cons.
1. Separate state plans – You can actually offer different plans to different employees in different states, which would allow everyone to get the right plan for them. If you qualify for an ACA SHOP marketplace, there is an option to choose a plan that operates in different states, and you might be able to qualify for the small business healthcare tax credit.
On the downside, though, if you decide to offer different plans to different employees, you might find the whole process of choosing and managing separate plans overwhelming. In addition, if you go through SHOP and your state has its own exchange, you’ll be stuck making separate accounts for each marketplace, instead of being able to use a single account with the federal exchange. And if you have the option through SHOP to offer a single plan, you may find that it doesn’t work for all of your employees.
2. A national plan – If the idea of multiple plans in multiple states gives you a headache, you can also look into a national plan. Some insurance companies, such as Aetna, Humana, and United Healthcare now offer the option of healthcare plans that are accessible from multiple states. With a national plan, you don’t have to keep track of multiple states’ rules and can offer everyone the same plan, although again, this can be a downside if your employees are diverse. National plans can also be much more expensive than other plans, such as those offered through SHOP, so they may be out of reach for some smaller businesses.
3. A self-funded plan – With self-funded plans, you basically take on the responsibility of paying for your employees’ healthcare costs using a pool of money that everyone pays into. This might work well for employees that are diverse and spread out over multiple states, but there are downsides to this type of plan, as well. Typically, smaller businesses have been wary of self-funding because of the risks of major claims wiping out a large chunk of their finances.
4. A health reimbursement arrangement – This might just be the best option for small businesses looking to ensure employees in multiple states. With a health reimbursement arrangement (HRA), like a QSEHRA or ICHRA, you set aside a fixed monthly amount for your employees (QSEHRAs have a limit, while ICHRAs do not) and employees can choose and purchase their own plans and then come to you for reimbursement. They can also get reimbursed for other qualified health expenses. So, employees get the plan that they want, you save money on payroll taxes by putting aside tax-free money for reimbursement, and you save yourself the headache of picking a one-size-fits-all plan that you need to manage over multiple states. You also get to keep any money that is not claimed at the end of the year. It’s certainly something to consider.
Whatever options you are looking into to do right by your far away employees, EZ can help cut through the jargon and make the whole process a lot less confusing. When you come to us, we’ll set you up with your own personal agent who can answer all of your insurance questions, give you fast and accurate quotes, and even sign you up when you’re ready – all for free! So stop wondering what’s possible when it comes to insuring your remote workforce and get started with us today! Simply enter your zip code in the bar above, or to speak with an agent directly, call 888-350-1890. No hassle, no obligation!
Silver or gold? If given the option, which would you choose? You’d probably be tempted to immediately answer gold. But when it comes to group health insurance, it’s not that easy. It turns out that the group health plans known as “Silver plans” are far more popular than “Gold plans.” So when is it worth it to go for gold?
The ACA Marketplace
The Affordable Care Act, otherwise known as the ACA or Obamacare, was signed into law in 2010. It mandated that health insurance exchanges be created in each state. It changed the way insurance worked. People can now go to this “marketplace” and shop for the plan that is right for them, choosing between different metal tiers of coverage (Bronze, Silver, Gold, and Platinum).
Under the ACA, small employers (businesses with 1- 50 employees) can also benefit from this marketplace. In the past, it could be challenging for small business owners to find multiple options for group insurance. But now they can shop around to choose between the same metal tiers as individuals can.
What is a “Metal Tier”?
Just like with individual plans, the metal tier options available to small businesses are Bronze, Silver, Gold, and Platinum. While it may sound like it, the different tiers do not indicate different levels of care.. After all, under the ACA, all plans must cover at least the 10 essential health benefits. What the metal tier actually represents is the cost-sharing split between the employee and the insurance company, meaning how much they will pay versus how much the insurance company will pay for medical care.
Employees with Bronze plans will pay the lowest monthly premiums, while those with Platinum plans will pay the highest premiums. However, premiums are not the only cost to consider: there are cost-sharing requirements, as well, including:
Deductibles– the amount you need to pay for medical care before insurance “kicks in”
Coinsurance – the percentage the insurance company will pay for services after you have met your deductible
Copays – the amount of money you are responsible for, over and above what your insurance company pays – for example, it may cost you a flat copay of $35 to visit your doctor
Because Bronze plans are the lowest tier and have the lowest monthly premiums, they have the highest cost-sharing requirements, while Platinum plans, on the other hand, have the lowest out-of-pocket costs. The cost of premiums and these cost-sharing requirements varies between the metal tiers: for example, with a Bronze plan, employees will pay 40% of costs (with the insurance company paying 60%), while with a Platinum plan, the split is 10% / 90%. That being said, there is an out-of-pocket limit for every plan, which for 2020 is $8,200 for individuals and $16,400 for families. The out-of-pocket limit varies and will probably be highest for those with Bronze plans.
Silver Versus Gold Plans
The most popular plan among employers is the Silver plan, around 50% of employers choose this type of plan. Coming in second is the Gold plan, with almost 30% of employers choosing that type of plan. Leaving out Bronze plans with their high out-of-pocket costs, and Platinum plans, with their high premiums, let’s look at Silver and Gold plans.
With a Silver plan, employees will pay 30% of costs, and with a Gold plan they will pay 20%. These numbers are really dependent on how much healthcare they need throughout the year. For example, if an employee only uses their plan to see the doctor for an annual visit plus one or two other minor visits, they will be paying far less than 20% or 30%. But if they end up with a serious illness and need hospitalization or long-term care, they will be paying far more.
It is understandable, then, that many employers choose Silver plans as a one-size-fits-all option. The premiums are lower, and you might be banking on an able-bodied, working-age group of employees who will use medical services an “average” amount. In this case, the 30% cost sharing doesn’t seem too daunting.
When to Go for Gold
If lower monthly premiums are important to you as a small business owner in order to attract employees, then Silver may be the way to go. But when is Gold worth it?
Simply stated, a Gold plan is worth it for people who expect to use their health insurance. They are perfect for people with (or who have dependents with) chronic conditions or are in higher risk categories for things like the flu – or even those with very young children or children who play sports.
Remember, because of HIPAA (Health Insurance and Portability Act), you cannot directly ask employees about any specific health conditions they may have. You can, however, send out an anonymous survey and ask your employees what they are looking for generally in a healthcare plan. You may find that they are willing to pay more for premiums in order to lower their out-of-pocket costs. If they are worried about being faced with high bills when they need care, then a gold plan might be the right option.
Remember, if you are at a loss at where to begin in choosing group health insurance, EZ.Insure can help. You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at Replies@Ez.Insure or call 888-998-2027.
What comes to mind when you hear the term “cafeteria plan”? Lunch! Well, these plans have nothing to do with what’s on the menu. “Cafeteria plan” is the informal name for Section 125 of the Internal Revenue Code, which allows employers to offer a la carte benefit options to employees. Employees can choose which of the offered benefits are right for them, and pay for them pre-tax.
What Are Cafeteria Plans?
Just like walking through a cafeteria and choosing dishes, with a cafeteria plan, employees can decide which healthcare options they want. Examples include vision, dental, or HSAs/FSAs. It is important to note that cafeteria plans are not a type of health insurance. They are a way to let employees use pre-tax money to pay for the types of coverage they choose.
To qualify as a cafeteria plan, the plan must include:
At least one qualified pre-tax benefit – these can include things like HSAs and FSAs, which allow employees to put aside pre-tax money to pay for medical expenses throughout the year
At least one qualified taxable benefit – for example, an employer may allow employees who don’t want any of the offered benefits to choose a cash alternative as part of their salary. This is in contrast to traditional group plans, in which an employee isn’t compensated for opting out of coverage. This cash will, however, be taxed.
The Advantages of a Cafeteria Plan
Cafeteria plans are an attractive option for a diverse workforce that is used to having choices. For employees, not only do they get to choose only the benefits that are right for them, but they also get significant tax advantages. They can contribute pre-tax, thus saving money. Because they are taking pre-tax money out of their pay, their paychecks will be smaller, and they will end up paying less in taxes.
For employers, there are a few main advantages:
Employees with smaller paychecks mean paying less in payroll taxes.
Employers may be able to attract and keep staff with a personalized benefits plan.
Unused FSA funds remain with the employer.
The Disadvantages of Cafeteria Plan
For employees, there aren’t many big disadvantages to having a Section 125 cafeteria plan, but there are a few things for them to remember:
Employees are locked into the plan they choose for the entire year – with only a few exceptions,
employees must wait until the next enrollment season to make any changes
If employees choose a benefit like cash in place of coverage, they will incur a tax penalty.
Any funds put aside but not spent by the employee are forfeited – employees need to decide how much money to put aside at the beginning of the year, and they may not always get it right.
For employers, the main disadvantage of offering this type of plan to employees is the hassle. Because they are so individualized, they can take a lot of time and expense to manage.
Remember, whatever plan you’re considering offering to your employees, we can help sort through the mess. EZ.Insure is here to connect you to your own personal agent who can steer you in the right direction – for free! You will never be hounded by endless calls and you will always get the most accurate information. We promise everything will be quick, easy – and did we mention, free? To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing replies@ez.insure or calling 888-998-2027.