California Group Health Insurance

Finding the best plans for your business.

A question we get a lot from people searching for affordable group health plans is how the Affordable Care Act (Obamacare) has changed group health insurance in California. They want to know:

  • Who classifies as a “small business employer.”
  • What determines the “premium?” (a.k.a, the price).
  • How can I compare plans? (cost of doctor visits, in-hospital services, prescriptions).
  • What sort of tax benefits does group medical insurance offer employers and employees?

To answer common questions about the ACA and help demystify group health insurance in general, we’ve created a few easy-to-digest graphics to break things down. You’ll also find a list of resources covering California group medical insurance and tips for selecting the right plan for your employee health benefits.

Running a business is hard enough without navigating the ins and outs of group health insurance. We’re expert benefit advisors with decades of experience and we’re ready to help at no additional charge. Contact us here or give us a call at (800)746-0045.

Rules for California Small Business Health Insurance

Rules for California Small Business Health Insurance

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5 Things You Should Know About Small Group Medical Insurance & Obamacare

1. Insurance Companies Calculate Rates Differently

Before Obamacare, small group health plans rates were based on age ranges of employees — less than 30 years old; 30-39, 40-49, and so on. It didn’t matter if the employee’s spouse was young or old, or if they had one child or ten children. There was a single rate for families based on the employee’s age. But not anymore.

With the introduction of the ACA in 2014, the rate for small group health insurance is based on the exact age of an employee, as well as the age of each dependent spouse and child.

Affordable Care Act Change

Affordable Care Act Change

2. Health Plans Are Rated in “Metallic Levels”

Health insurance is as complicated as it is expensive. To help people understand benefits and compare plans, the federal government uses a process to separate plans into four groups — platinum, gold, silver, and bronze.

Just like the Olympics, gold is better than silver which is better than bronze. A platinum plan is the best, meaning the insurance company pays the most and the patient pays the least. Under the ACA, all plans must cover at least 60 percent of medical expenses.

The Affordable Care Act Uses Metallic Levels to Compare Plan Benefits

The Affordable Care Act Uses Metallic Levels to Compare Plan Benefits

3. You Can Save on Plans by Excluding Pricey Providers & Doctors

The price of medical care varies dramatically between doctors and hospitals. By enrolling in a plan that excludes expensive doctors and medical facilities, employees can obtain comprehensive benefits (e.g., platinum level) at a low cost.

So, when you evaluate a medical insurance plan for your employees, keep in mind that you can offer a “narrow” or “medium” provider network and spend less than if you offer a “full” network.

Narrow to Full Provider Networks

Narrow to Full Provider Networks

4. Small Companies Can Offer a Range of Plans

Some employees never get sick and only want catastrophic coverage. Others have chronic illnesses and want a plan that covers doctor visits with little contribution. The good news is the ACA gives small businesses the chance to offer a range of options for all types of employees.

How many options? Insurance companies allow small employers to offer 20 or more plans to their employees — while controlling the cost to the employer. However, we’ve found that offering more than six or seven plans can get overwhelming for employees.

What Employees Want from their Employer-sponsored Plans

What Employees Want from their Employer-sponsored Plans

5. Small Companies Can Share the Cost of Employee Benefits

Group medical insurance is extremely tax favored, which is one of the reasons companies offer employee benefits. Unlike wages, employer-sponsored health coverage is not subject to state and federal income taxation — for the employer or the employee.

All California health insurance companies require employers to contribute a minimum of 50 percent of the monthly cost of an employee-only plan. Most insurance companies also allow an employer to contribute as little as $100 per employee per month. The catch is that if an employer pushes too much cost on to the employee, employees won’t sign up and a group plan needs a minimum percent of the employees to be viable.

BenefitsCafe.com can assist you with all the above and more. Give us a call at 800-746-0045 or complete this contact form.

What Business Owners Want from their Group Benefits

What Business Owners Want from their Group Benefits

Advice when Selecting a California Group Health Plan

5 Ways to Spend Less and Give Your Employees More – Employers have hundreds of medical insurance plans.  Here are 5 ideas that may help you meet the needs of your employees while also helping to meet your company’s bottom line.

Benefits of using a Small Group Health Insurance Broker – Learn the advantages of using a small group health insurance broker to assist with your group policy. Seeking out an employee-benefits adviser can significantly help, and by California law, is at no additional cost to you.

How to Evaluate a Health Plan – Health care plans can appear to be convoluted to the untrained eye. Learn how we simplify the process of comparing different plans by focusing on three factors: benefits, price, and providers.

California Small Group Health Insurance Eligibility – Learn about comprehensive legislation to regulate small business health insurance in California and how to determine an eligible employer/employee and what that entails.

Myth Busters: Employee Participation and Employer Contribution – Small business owners often find it financially difficult to start group health plan for their employees without bankrupting the company. Here we set out to dispel common myths of small group health insurance.

California Small Group Rules protect small businesses that purchase health insurance for their employees. This document describes the rights and obligations of small businesses that purchase coverage for small business health insurance in California.

Tax Considerations of Group Health Insurance in California

Tax Incentives for Group Health, Dental, and Life Insurance – Learn how State and Federal tax treatment of employee benefits provides a valuable incentive to employers to pay for employee health, dental, and life insurance plans.

The Problem with Paying for Insurance through a Salary Bonus – Find out how the strategy of paying employees a salary bonus to purchase their own insurance costs employer and employee a lot of money compared to a California small group health insurance plan.

Section 125 Plans – When an employee pays a portion of the premium for his or her health, dental, or vision insurance, we can help you set up a Section 125 plan (a.k.a. Cafeteria Plans). Learn how this type of plan saves the employer and employees a significant amount of money.

Specific Small Group Health Plan Information

Learn about the small group plans from Anthem Blue Cross of California, Aetna of California, Blue Shield, Kaiser Permanente and others, and the benefits and drawbacks of these plans in our California small group health plans section.

For those turning 65, read this helpful guide to help determine if you should stay on your employer’s group plan or enroll in a Medicare Supplemental plan.

Need personalized advice? Feel free to give us a call at 1-800-746-0045 and we can help you find the best California small group health plan based on your specific needs and requirements.

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