Employer Group Health Plans

GROUP HEALTH PLANS/EMPLOYER PLANS

There are several approaches to providing employer group plans.

FULLY FUNDED

Direct billing with the insurer (All Group Sizes)

These types of health plans are designed to meet the benefit needs for employers in size from two employees and up. Unlike individual & family health plans that are limited in design and networks via ACA/Obamacare mandates, group coverage has more options.

Network Provider options can be PPO, EPO, HMO, POS. In addition, multiple plan designs can be offered, and deductible can be offered to meet an employee’s financial needs. With employee retention becoming a mantra, having benefit plans has become an effective retention tool.

GROUP HEALTH PLANS/EMPLOYER PLANS

There are several approaches to providing employer group plans.

FULLY FUNDED

Direct billing with the insurer (All Group Sizes)

WHAT’S THE LAW ON PROVIDING GROUP COVERAGE?

A business or organization with 2 to 49 Employee – Not required to provide coverage. However, by not doing so, it can result on the loss of valued employees.
A business with 50 or more employees must provide health insurance coverage.
If the employer offers a group plan to employees, it must cover fifty percent of the employee’s monthly contribution.
Please Note: The employer’s share is based on 50% the lowest cost plan offered.
Doing a thorough fact find of both employer and employee needs can yield the best direction for coverage and cost with a fully funded plan.

WHAT’S THE LAW ON PROVIDING GROUP COVERAGE?

A business or organization with 2 to 49 Employee – Not required to provide coverage. However, by not doing so, it can result on the loss of valued employees.
A business with 50 or more employees must provide health insurance coverage.
If the employer offers a group plan to employees, it must cover fifty percent of the employee’s monthly contribution.
Please Note: The employer’s share is based on 50% the lowest cost plan offered.
Doing a thorough fact find of both employer and employee needs can yield the best direction for coverage and cost with a fully funded plan.

PARTIAL AND FULLY SELF FUNDED PLANS

The Employer Sizes below are generalized and fluid.

Partial Employee Sizes for developing rates
5 to 20 Employees
20 to 50 Employees
51 to 200 Employees
Fully Funded or Partial Funded
200 + Employees

Please Note: These plans are third party administered plans and based on a medical platform under the Federal ARISA Benefit Law. Rates and risk are dependent upon different factors. These plans do provide an opportunity to create savings for both the employer and employee. It requires a deeper evaluation of the employer and employees to develop rates and possible savings. In essence these can be considered custom plans.

COLLAPSING GROUP

For Employer Groups 2 to 49 Employees Only

A way to provide coverage to employees with no direct participation from the employer, with the use of ACA/Obamacare Plans. It helps to provide a retention tool for employers who cannot financially compete with larger or better funded competitors.

PARTIAL AND FULLY SELF FUNDED PLANS

The Employer Sizes below are generalized and fluid.

Partial Employee Sizes for developing rates
5 to 20 Employees
20 to 50 Employees
51 to 200 Employees
Fully Funded or Partial Funded
200 + Employees

COLLAPSING GROUP

For Employer Groups 2 to 49 Employees Only

A call to our offices to set up a consultation can be the first step to savings and simplification for your group health insurance requirements. Let’s talk.