Depending on whose information you take a look at, the United States is dwelling to thousands and thousands of small companies. In truth, in response to the Small Business Administration, there are at the moment 32,540,953 million small companies within the nation and small enterprise medical health insurance is a significant concern for them.
And there are over 4 million small companies within the state of California alone.
Of course, these numbers could fluctuate relying on the standards used to outline a “small business”, such because the variety of workers, annual income, or trade classification.
For instance, underneath the Affordable Care Act (ACA), small companies are outlined as these with 50 or fewer full-time equal (FTE) workers. And a full-time equal worker is an worker who works a mean of 30 hours per week or extra.
With so many small companies within the nation, it’s nearly sure that some homeowners usually are not fully accustomed to the fundamentals of small enterprise medical health insurance.
SMALL BUSINESS HEALTH INSURANCE: A 33,000 FOOT VIEW
First and foremost, it’s important for any small enterprise proprietor to grasp that companies with fewer than 50 full-time equal (FTE) workers usually are not required to offer medical health insurance to their workers underneath the ACA.
On the opposite hand, they’re definitely in a position to and may derive a number of advantages by doing so. For instance, the ACA gives well being care tax credit to small companies that do select to supply medical health insurance plans to their full-time workers.
Small companies could also be eligible for a tax credit score of as much as 50 p.c of the price of the medical health insurance premiums they pay for his or her workers. However, there are stipulations. To qualify for the tax credit score, all the following standards should be met:
You have fewer than 25 full-time equal (FTE) workers
Your common worker wage is about $56,000 per yr or much less
You pay at the least 50 p.c of your full-time workers’ premium prices
You supply SHOP protection to your whole full-time workers. (Note: protection does not must be supplied to dependents or workers working fewer than 30 hours per week to qualify for the tax credit score.)
So, you could be questioning at this level what “SHOP” is. The ACA established Small Business Health Options Programs – individually generally known as SHOP – to assist small companies buy medical health insurance for his or her workers.
SHOPs are primarily on-line well being care marketplaces the place small companies can evaluate and buy medical health insurance plans from totally different insurance coverage firms.
The main good thing about going by means of a SHOP is that it may be simpler for you as a small enterprise proprietor to offer medical health insurance to your workers and qualify for well being care tax credit. And, by offering entry to medical health insurance, you possibly can assist your workers keep wholesome and productive, which might profit each your workers and your corporation.
UNDERSTANDING SMALL BUSINESS HEALTH INSURANCE TERMS
Simply put, small enterprise medical health insurance is a sort of medical health insurance that gives protection for small companies and their workers. It also can embrace medical, dental, and imaginative and prescient protection for homeowners and workers.
Small enterprise medical health insurance premiums are the quantity you and your staff pay on a month-to-month foundation to buy protection for medical, dental, and imaginative and prescient plans, though some plans make use of quarterly or annual foundation .
Deductibles are the quantity you pay earlier than your insurance coverage begins protecting prices. These are sometimes factored as out-of-pocket maximums that are essentially the most you’ll pay throughout a coverage interval (often one yr) earlier than the medical health insurance begins protecting 100% of the price of well being care.
Co-pays are mounted quantities you pay for lined companies on the time of care.
Co-insurance is the share of prices you pay after you’ve met your deductible.
Lifetime limits are the utmost quantity your insurance coverage pays for lined companies throughout your lifetime.
Drug formulary is a listing of pharmaceuticals lined by your plan.
TYPES OF SMALL BUSINESS HEALTH INSURANCE
When searching for small enterprise medical health insurance, there are 4 foremost parts you need to be conscious of regarding small enterprise medical health insurance:
Coverage
Number of workers
Employee premiums
Shopping for protection
Small enterprise medical health insurance plans are designed particularly for small companies.
There are a number of varieties of small enterprise medical health insurance plans obtainable out there. The most typical varieties embrace small group medical health insurance plans, well being financial savings accounts (HSAs), and well being reimbursement preparations (HRAs).
Small group medical health insurance plans are the commonest sort of small enterprise medical health insurance.
These plans are designed to cowl a bunch of individuals, reminiscent of workers of a small enterprise, and their dependents. These insurance policy are usually extra reasonably priced than particular person medical health insurance plans as a result of the danger is unfold throughout a bigger group of individuals. Small group medical health insurance additionally gives a wider vary of advantages, together with preventative care, emergency companies, prescription drug protection, and psychological well being companies.
Health financial savings accounts (HSAs) are a sort of financial savings account that can be utilized to pay for medical bills. HSAs are paired with high-deductible well being plans (HDHPs), that are medical health insurance plans with excessive deductibles however supply decrease premiums. HSAs enable workers to economize on a tax-free foundation to pay for medical bills.
Health reimbursement preparations (HRAs) are just like HSAs in that they’re used to pay for medical bills. However, HRAs are funded solely by the employer and can be utilized to reimburse workers for certified medical bills.
FACTORS IN CHOOSING SMALL BUSINESS HEALTH INSURANCE
When deciding on a small enterprise medical health insurance plan, there are a number of elements to contemplate. These embrace the price of the plan, the advantages supplied, the community of healthcare suppliers, and the extent of customer support offered by the insurance coverage firm.
The value of small enterprise medical health insurance plans will fluctuate based mostly on a number of issues, together with the dimensions of your corporation, its location, and the age and well being of your workers. It is vital to match the prices of various plans to seek out one that matches your price range. Keep in thoughts, too, that prices contain greater than the month-to-month premium.
The advantages supplied by a specific small enterprise medical health insurance plan also can fluctuate so it is very important think about the particular healthcare wants of your workers when deciding on a plan. For instance, if a number of of your workers have continual circumstances, contemplating a plan with complete protection for pharmaceuticals and specialist care could also be extra acceptable.
Also, the geographic protection of a well being plan’s healthcare supplier community is a crucial issue to contemplate. Some plans could restrict the variety of healthcare suppliers which are lined, whereas others supply a wider community of suppliers.
Often missed, the extent of customer support offered by the insurance coverage firm is vital to contemplate. Small enterprise homeowners ought to look for an organization that gives responsive and high quality customer support to assist workers navigate the healthcare system. Customer service is important for enterprise homeowners and their HR employees, as nicely.
J.C. LEWIS INSURANCE SERVICES – YOUR SMALL BUSINESS HEALTH INSURANCE EXPERTS
Another “basic” truth of medical health insurance is which you can cut back prices and lower your expenses by working with an skilled dealer. And working with J.C. Lewis means we’re working for you, not the insurance coverage firms. That means we’re in a position to evaluate the protection of varied insurers in order to seek out you the most effective charges and protection out there.
In different phrases, we are able to offer you unbiased, cost-effective, and best-fit well being protection coverage suggestions.
J.C. Lewis Insurance, a family-owned agency that has been based mostly in Sonoma County since 1979, is made up of professional brokers who supply small enterprise insurance policy. For the final 4 many years our mission has been to offer professional recommendation and help to small enterprise homeowners for group medical health insurance and group medical plans.
In addition, our agency solely supplies small enterprise medical health insurance plans from the main medical health insurance carriers licensed to do enterprise within the states the place we function.
We are licensed and authorized by every insurance coverage service to supply protection to small-group employers along with Medicare supplemental and prescription drug plans for seniors.
We’re joyful to reply all of your questions on medical health insurance protectionat J.C. Lewis Insurance Services, and you’ll be assured that we’ll assist you discover the correct answer.
