California small employers often find it challenging to manage a group health insurance plan and answer employee questions. Getting the accurate benefit and rate information to a newly hired employee; enrolling them in the plan; and, making sure they have their ID card can be daunting tasks for an office administrator who doesn’t do this sort of work frequently.
Also, potential job candidates may need guidance when selecting a medical insurance plan that your company offers. Some individuals have ongoing medical procedures and don’t want any disruptions while others are concerned about the price and don’t want to pay anything out of pocket for insurance. You’ll want to be prepared to confidently answer any questions potential employees have about your company’s insurance policy or have experts who can assist.
When you set up a group health insurance plan with Benefits Cafe, we will work with you so you can more efficiently manage your benefits. This includes sending you an Information Sheet, Administration Guide and scheduling a time to review it with you. Do you already have a plan set up? Not a problem, give us a call at 1-800-746-0045 and we can help you make Benefits Cafe the broker for your plan at no cost to you.
Below are 7 things to consider when adding a new employee to your insurance policy and how we make it simple.
1. What insurance plans are available to your employees?
Small Businesses in California can offer several plans including medical plans, dental plans, vision plans, life plans, and disability plans. This doesn’t mean that your company offers or will offer them all. We prepare an Information Sheet (PDF) that describes the plans your company offers. This is beneficial when you have multiple people in your office managing employee benefits.
Benefits Cafe makes it simple. We facilitate the plan choice options for your employees by providing a worksheet (PDF) that includes a comparison of the plans, cost per pay period, and an active hyperlink to a detailed benefit description of the plan, which we refer to as a Summary of Benefits and Coverage (SBC).
If your company has more than 10 employees enrolled, we will set up an online enrollment portal at no cost to you in lieu of worksheets. The portal will allow employees to log in and view the different plan and cost options from their computer, tablet, or phone.
2. Who is eligible to enroll in your company’s insurance?
Your company may have full-time employees, part-time employees, seasonal employees, paid interns, etc. It is important to know the difference between these employees and whether they are eligible to enroll. You may want to take a look at page 4 of The Rules for Small Business Health Insurance for more information.
Benefits Cafe makes it simple. When you set up a plan with us, we’ll explain the eligibility rules to you and ensure you are aware of who can enroll in your insurance plan.
3. Can I ask employees to pay a part of their insurance?
Insurance in California has the reputation of being very expensive. Employees are aware of this and one of the first questions they may ask is “Do I have to pay for insurance?” In California, employers are required to pay a certain amount of the employee’s monthly cost and are not required to pay any amount for dependents. In addition, companies with 1-100 employees are considered “Small Group” which means that the cost for each employee is based on their age. You may hire two employees at the same time, but if they are not the same age their monthly cost will differ. You can learn more about the way rates are calculated and about the employer contribution requirements on pages 1 and 4 of The Rules for Small Business Health Insurance.
Benefits Cafe makes it simple. We will send you a customized worksheet (PDF) with the employee’s per pay period cost to enroll. If you have 10 or more employees enrolled in the plan, we will make this information available via an online portal.
We will also prepare a Section 125 for your company at no cost to you. This allows your employees to make their contribution toward the medical, dental and vision plans on a pre-tax basis.
4. If I hire a new employee, when will their insurance start?
When you set up a plan, most insurance companies require that you list your new hire waiting period on the Employer Application before they approve your policy. When the employees enroll, the insurance companies use the waiting period you selected and the date of hire of the employee to determine when the employee will be enrolled on the plan. There are some companies, like Kaiser, that don’t keep track of the waiting period for you and instead require that the employee’s enrollment date be listed on the employee’s enrollment application.
However, all insurance companies, in compliance with the Affordable Care ACT (ACA) require that you don’t apply a waiting period longer than 90 days. The waiting period must be the same for all employees although there are some exceptions to this.
Benefits Cafe makes it simple. We will send you an Information Sheet (PDF) that includes your company’s new hire waiting period. When you have a new hire, we will include their effective date on the worksheet (PDF) we send you with their plan options.
If your company has more than 10 employees enrolled, we will set up an online enrollment portal at no cost to you. When you add a new employee onto the portal and add their date of hire, the system will determine their effective date based on your company’s new hire waiting period. When the employees go through the enrollment process online, they will have access to this information.
5. How do I enroll an employee on my company’s insurance plan?
Employees need to complete an enrollment form that will include, their address, plan choice, dependent information, and (most importantly) their signature. You may ask yourself “What if the employee has other coverage and doesn’t want to enroll?” In this case, the employee would need to sign a waiver that you would keep for your records as evidence that you gave the employee the opportunity to enroll in the plan. The forms vary by insurance company and by the effective date of your plan.
Benefits Cafe makes it simple. We will create a customized Admin Guide for your company and schedule a time to review it with you. The Admin Guide will list the steps you need to take to add a new employee to the plan and the steps Benefits Cafe will take to assist.
Additionally, we will send you the enrollment material the employees need to complete. You will send us the completed forms and we will work with the insurance company to enroll the new hire in a timely manner. In fact, we schedule a task to follow up within a week to ensure everything was received and input into the system. If employees have a question about the status of their enrollment, they can give us a call.
If you have 10 or more employees enrolled in the plan, the only difference is that the employees will complete the enrollment forms via an online portal.
6. How can employees access their plan information?
Once the insurance company has processed the employee’s enrollment, it can take anywhere from 7-10 business days for the medical ID cards to arrive in the mail. You may ask yourself “what if an employee needs to see their doctor and hasn’t received their ID card?” You’ll be happy to hear that most insurance companies grant online access to ID cards via an online portal or mobile app.
Benefits Cafe makes it simple. Some insurance companies require that the employees have their ID number to register online. We understand that’s a bit difficult to do when the employee hasn’t received their ID card in the mail. Instead of having employees call the insurance company and wait on hold, they can reach out to us. We will help them find the information they need to register and send them an informational flyer. Below are some examples of the mobile apps that are available.
Aetna Mobile App
Anthem Mobile App
Blue Shield Mobile App
HealthNet Online and Mobile App
Kaiser Permanente Mobile App
United Healthcare Mobile App
7. Who should employees reach out to if they have questions about the insurance?
Employees should not feel forced to disclose private health information to employers simply because they are having difficulty with their health insurance. We believe employees should have a resource to help answer their questions and make insurance easy. Also, a federal law called “HIPAA” prevents employers from requesting private health information and it’s best not to share your personal medical information with your employer. The fear is that an employer may discriminate against an employee if they know that the employee has a serious medical condition. So, employees can contact the insurance company directly, or their benefits broker, such as Benefits Cafe.
Benefits Cafe makes it simple. When you set up a plan with Benefits Cafe as your broker, your employees will have 3 account managers they can reach out to with any questions via email or by phone. We can help find the answer to any questions they have about the plans, pricing, enrollment process, claims, and more. All they must do is let us know they are an employee of your company and we’re happy to help.