Benefits Of A Group Health Insurance Plan
The primary advantage of a group plan is that it spreads risk across a pool of insured individuals. This benefits the group members by keeping premiums low, and insurers can better manage risk when they have a clearer idea of who they are covering. Insurers can exert even greater control over costs through health maintenance organizations , in which providers contract with insurers to provide care to members.
The HMO model tends to keep costs low, at the cost of restrictions on the flexibility of care afforded to individuals. Preferred provider organizations offer the patient a greater choice of doctors and easier access to specialists but tend to charge higher premiums than HMOs.
Do Small Businesses Have To Provide Health Insurance To Employees
While employers with less than 50 full-time employees arent legally required to offer health insurance, many still choose to do so. Offering health benefits is a great way to improve recruitment and retention, which is essential for an employer of any size.
The Society of Human Resource Management reported that 92% of employees say benefits are essential to their overall job satisfaction. In fact, a Fractl survey found that 84% of employees put health insurance at the top of their most desired benefit list.
This data proves that health benefits contribute positively to talent acquisition and retention. Happy and healthy employees tend to be loyal, productive, and satisfied with your business.
While its true that a health insurance plan can be costly, with so many small businesses offering health insurance benefits, can you really afford not to while still staying competitive?
How Does Group Insurance Differ From Individual Insurance
You can purchase an individual insurance plan for yourself or one of your family members. All costs of this chosen plan are being paid by you directly. When it comes to group health benefits, your employer/company provides a plan that you and your immediate family members can partake in and pay only a small percentage as agreed on beforehand.
The pros can be considered cons, depending on your viewpoint:
- Your employer can pay some of your monthly premiums
- Your employer can help you choose an appropriate plan
- Your employer can provide plan documents
Some people want to be personally involved in all aspects of the health insurance plan they rely on, which is why all of these points might pose problems.
Note that you can always purchase an individual plan alongside your group plan.
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Information On Private Plans
Private prescription drug insurance plans are group insurance plans or employee benefit plans that cover the cost of medications. They are managed by private companies, unlike the Public Prescription Drug Insurance Plan, which is administered by RAMQ. Anyone who has taken up residence permanently in Québec and any child temporarily staying for more than 6 month must have prescription drug insurance coverage, as required under the Health Insurance Act.
Which Health Plan Is Best For You
Heres a round-up of different health insurance options and who might be interested in each one:
- Association health plan Youre self-employed or a small business owner who belongs to an organization that offers an AHP.
- Employer-sponsored health insurance Your spouse has health insurance through his/her company and youre looking for a health insurance plan that offers full protection and youre not as concerned about costs.
- Individual market/ACA plan You want more coverage than what an AHP offers and dont mind higher premiums. This could also be an option if your household income is less than 400% of the federal povery level, since you can benefit from tax breaks and subsidies.
- Short-term health plan You want low costs and dont expect to need much health care.
- COBRA You lost your job within the past 60 days and you want to keep your employer-sponosred health plan. You also dont mind paying for all of the health insurance costs.
- Medicaid You qualify for coverage and want a low-cost option with full coverage.
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How Group Health Insurance Works
Group health insurance plans are purchased by companies and organizations and then offered to their members or employees. Plans can only be purchased by groups, which means individuals cannot purchase coverage through these plans. Plans usually require at least 70% participation in the plan to be valid. Because of the many differencesinsurers, plan types, costs, and terms and conditionsbetween plans, no two are ever the same.
Group plans cannot be purchased by individuals and require at least 70% participation by group members.
Once the organization chooses a plan, group members are given the option to accept or decline coverage. In certain areas, plans may come in tiers, where insured parties have the option of taking basic coverage or advanced insurance with add-ons. The premiums are split between the organization and its members based on the plan. Health insurance coverage may also be extended to the immediate family and/or other dependents of group members for an extra cost.
The cost of group health insurance is usually much lower than individual plans because the risk is spread across a higher number of people. Simply put, this type of insurance is cheaper and more affordable than individual plans available on the market because more people buy into the plan.
Private Plan Eligibility Criteria
Your employer or professional association or order may have eligibility criteria. For instance:
- Participation in the plan after a waiting period of 3 months for a new employee or new member
- Restricted access depending on a minimum number of hours worked per week or a minimum income threshold
- Exclusions applying to part-time, casual, contract, laid-off or retired employees
You must register with another plan if you do not qualify for the plan offered by your employer or professional association or order.
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Renew Enrolment In Msp
Most B.C. residents 18.5 years of age and over will be sent a notification letter instructing them to renew enrolment in MSP by completing identity-proofing at an ICBC driver licensing office. If the persons name on the notification letter is different than their current name, they will need to contact HIBC before visiting an ICBC driver licensing office.
Residents can book an appointment to visit an ICBC driver licensing office at a location and time that suits them. For more information, please visit icbc.com/appointment.
- At the ICBC driver licensing office, the individual will need to
- Provide two pieces of identification one of which must be primary ID
- Have their photo taken
They should also bring their CareCard or expired/expiring BC Services Card with them.
After meeting these requirements, the applicant will receive a BC Services Card Statement of Declaration which, in most cases, will include their PHN. The member can use this interim document to access insured health care benefits until their BC Services Card arrives in the mail.
Children under the age of 19 have no obligation to renew their enrolment. Children under 18.5 will automatically be issued a new BC Services Card when their cards expire.
Beneficiaries 75 years of age or over are not required to renew enrolment in MSP. To obtain a Photo BC Services Card, they may visit an ICBC driver licensing office. To obtain a Non-Photo BC Services Card, they may contact HIBC.
How Many People Do I Need To Enroll In A Group Health Plan
If you have your own small business and employ at least one full-time employee that will also be covered by the plan, that may be all you need to get coverage by enrolling in a group health insurance plan. The rules and qualifications for enrolling in a group health insurance plan may differ based on the insurance company or the specific plan.
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Is Group Insurance Taxable
Life insurance premiums are not taxable in most cases, meaning that no sales tax is charged or added. An employer can pay insurance premiums on behalf of their employee, which counts as a deductible. This means that you as an employer can deduct your employees premium cost from their paycheck before the deductible of any federal taxes.
The result is that your employees have lower taxable income meaning that their take-home pay increases, which essentially means that this kind of insurance plan also benefits the financial situation of your employees and ensures greater satisfaction.
How You Can Obtain A Reimbursement From Your Insurer
You must check with your insurer to find out how it reimburses you its portion of the cost of your medications. You may be reimbursed at the time of purchase or afterwards. You may or may not have to submit a claim.
At the time of purchase
You only pay your contribution toward the cost of the medication when you purchase it at a pharmacy. Your insurer then pays its portion to the pharmacist.
After your purchase, no claim necessary
You pay the pharmacy the full cost of the medication. Next, the pharmacist submits a claim to your insurer on your behalf. You then receive the reimbursement, for example, by cheque or direct deposit.
After your purchase, claim necessary
You pay the pharmacy the full cost of the medication. Next, you submit a claim to your insurer, attaching the invoice or receipt for the medications purchased. You then receive the reimbursement, for example, by cheque or direct deposit.
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Guide To Association Health Plans
Self-employed people, sole proprietors and those who work for small businesses can band together and create an association health plan to help them get better health insurance rates.
The federal government also loosened regulations involving AHPs geographic locations and the Affordable Care Acts AHP requirements. The result is that AHPs are once again a lower-cost option for Americans and now have added consumer protections.
Lets take a look at AHPs, how they compare with other health plans, and how to sign up:
Where To Find Group Health Insurance Plans
The most common way to get group health insurance coverage is through an employer. If your employer doesnt offer health insurance due to the small size of the company or if youre unsatisfied with your employers coverage options, look into coverage through a membership organization. If you belong to a membership organization offering a group health plan, such as AARP, the National Association of Female Executives, the Writers Guild of America or the Freelancers Union, you may be able to get health insurance coverage through your membership.
Be wary of plans offered by some membership organizations, as many offer a health services discount plan, which may save you money on prescriptions but isnt a true health insurance plan.
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Where To Find The Best Group Health Insurance Plans
Plans vary drastically among and between insurance providers, independent insurance agencies, and the state and federal exchanges. To learn how many employees you need, it is best to follow up with the insurance providers and independent insurance agencies in your area, as well as the state and federal exchanges. Start locally and expand your search if you are unsatisfied with the plans you are being offered.
Benefits Of Group Health Insurance Plans
Group health insurance policies have a number of advantages and benefits over individual plans. Many employers provide supplemental health plans, which include dental coverage, vision coverage and pharmacy coverage, either separately or as a bundle.
The main benefit group plans offer is lower premiums. According to 2018 research conducted by eHealth, a private online marketplace for health insurance, the average premium cost per individual in a group health insurance plan was $409 a month compared to $440 for an individual plan. In the same study, small group health plans had an average deductible of $3,140 a year compared to $4,578 for individual plans.
Additionally, family members and dependents can be added to group plans at an additional cost to members, which can assist families with sole providers or whose alternative or individual health plan options carry significantly higher prices.
Group health insurance plans provide numerous tax benefits to both the employer and employee. The money employers pay towards monthly premiums is tax-deductible, and employees premium payments can be made pre-tax, which may reduce their total taxable income.
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What Is The Small Business Health Care Tax Credit
The business health care tax credit is another tax benefit for employers but has certain requirements. To be eligible for the tax credit, employers must have fewer than 25 full-time employees, pay less than $50,000 a year on average per employee and, offer a qualified health plan to its employees through a Small Business Health Options Program Marketplace. You must also pay at least 50 percent of the cost of employee-only not family or dependent health care coverage for each employee
Full Time Vs Part Time Employees
Not every part-time employee qualifies for health insurance. While you can use part-time employees to pad your numbers if you need 50 group members for your plan , part-time employees are sometimes not offered health insurance. In 2014, Staples was accused of reducing employees hours, transitioning full-time workers to part-time status, to avoid having to pay for their Obamacare coverage. Their behavior prompted a response from then-President Barack Obama.
Legally, part-time employees work less than 35 hours per week. This is the prime distinction between part-time and full-time employees. This distinction often leads, however, to reduced benefits packages for part-time employees. It is common for full-time employees to receive better health insurance than part-time employees, if they receive it at all.
Consider Group Insurance in the Workplace
While not every employer provides health insurance to their part-time employees, or provides employer sponsored health insurance at all, every employer should consider offering group insurance to their employees. Group insurance is more affordable than individual or family plans for employees, and improves productivity in the workplace. Rewarding your employees is a great way to ensure they remain loyal, happy, and dedicated to their workplace.
How Employees Determine Group Insurance Plans
What Should I Do Next?
What Are Your Insurance Needs?
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Two Steps To Enrol In Msp
Enrolment in MSP is a two-step process for persons 19 years of age or over who have Canadian citizenship or permanent resident status in Canada.
Step 1:
New and returning residents that are to be added to an MSP group account need to identity proof by visiting an Insurance Corporation of BC driver licensing office, and requesting a Photo BC Services Card. The BC Services Card provides access to insured provincial health care benefits for eligible BC residents.
Residents can book an appointment to visit an ICBC driver licensing office at a location and time that suits them. For more information, please visit icbc.com/appointment.
At the ICBC driver licensing office, residents will need to:
- Provide two pieces of identification one of which must be primary ID
- Have their photo taken
Step 2:
New and returning B.C. residents will need to submit an application for MSP enrolment to HIBC, along with supporting documentation.
Visit: gov.bc.ca/mspgroupplanadministratorforms for the Application for Group Enrolment.
Account holders and/or spouses who have not completed both steps for MSP enrolment will be added to your group account with pending coverage status. These individuals will not be able to claim MSP benefits. Once each individual has completed both enrolment steps, their coverage will become active and they will be able to claim MSP benefits.
Note: children will be placed on your group with active coverage status, at the time of their parent’s/guardian’s registration.
Insurance Options For Uninsured Individuals
Not everyone is covered by a group health insurance plan. For many decades, these uninsured people were forced to bear the cost of healthcare on their own. But that has changed.
Government-sponsored health plans continue to provide care to those left out of employer-sponsored group health insurance plans. As national health expenditures have climbed past 17.7% of gross domestic product , the Affordable Care Act of 2010 substituted a nationwide mandate that each taxpayer join a group plan for the sort of single-payer solution that has faced stiff opposition since the 1930s. According to government data, roughly 23 million Americans are taking advantage of health insurance under the ACA, according to the most recent set of numbers from 2019.
Under the Obama administration, people who remained uninsured under the ACA were required to pay a health insurance mandate. This was repealed by the Trump administration, which stated it penalized people unnecessarily.
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Whats The Executive Order Concerning Association Health Plans
An executive order, issued October 2017, wants to allow greater access to Association Health Plans, so that more employers to form associations. The order suggests that measures should be taken to promote the formation of AHPs on the basis of both proximity and common industry.
In other words, if you are a small business or sole proprietor who formerly had no access to an AHP, or did not qualify to be part of one, this executive order could potentially make forming or joining one possible.
Ichras Are Relatively New
Because ICHRAs are a new benefit model, employers are likely to need to set aside time and resources to fully understand how ICHRAs work, decide whether the business will administer an ICHRA in-house or hire an outside administrator, consider employee circumstances and needs in relation to health coverage, decide whether the ICHRA is offered to all or certain classes of employees, and set a budget.
Then, employers must set aside time and resources to explain how the ICHRA works to employees.
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