Purchasing ‘group health coverage’ for your business is unique and entirely different from purchasing individual healthcare coverage. It is essential to work with a professional to find the best possible coverage that meets the requirements of your employees and your business.
What is Group Health Coverage?
Group Health Coverage is defined as one policy that is provided to a group of individual employees. Typically, this refers to a business or a not-for-profit organization with employees. Our team of agents at OceanPoint Insurance work with multiple insurance carriers to find you a group plan that fits your business’ budget and meets your needs. We understand that offering the right health coverage is a contributing factor to employee satisfaction and retention.
Am I Eligible for Group Health Coverage?
Any business with 2-50 full-time employees is guaranteed group coverage, regardless of the health status of the employees. Federal law states that small employers are assured group coverage if they choose to purchase it. It is important to note that a business owner is considered an employee. Therefore, sole proprietorships with one employee and partnerships are eligible for group health coverage.
How Are Group Health Coverage Rates Determined?
In the case of group coverage, premiums are determined differently than individual coverage. The premium is determined by way of the risk factors throughout the group as a whole. The following factors will be considered:
• Employees Age
• Employees Gender
What are the Benefits of Group Health Coverage?
You may be asking yourself, is group coverage the right choice for my business? Here are a few reasons to consider purchasing group coverage for your employees:
Access to Quality Care:
The health of the employees is instrumental to the success of a business. The better access to care, the more likely your employees will remain healthy. Providing group coverage affords the business owner the peace of mind that the employees have access to the medical attention and coverage they need.
Employee Retention, Recruitment, and Attendance:
Employers who offer group health coverage report a reduced amount of absenteeism in the workplace. This is due to the availability of medical attention when an employee is sick or injured. Immediate and available health care will typically reduce the length of absences due to sickness or injury.
Employees who are offered group insurance report overall higher job satisfaction. Satisfied employees are less likely to leave and will also contribute to the overall morale of the work environment. Group insurance shows that you care about the health and wellness of your employees and their families.
Job seekers often weigh their employment decisions on the availability of healthcare in the workplace. A job that offers group insurance is far more appealing than a position without healthcare. In fact, employees are more likely to accept slightly lower wages if coverage is provided.
Types of Group Insurance Plans:
There are several main types of plans. However, most plans include a combination or a blend of these available options.
Health Maintenance Organizations (HMOs)
HMO’s are considered to be more predictable, and they offer simplicity. However, they are also restrictive in that they often require patients to see predetermined providers. Employees are required to schedule appointments only with the providers within the HMO’s network. Employees may also pay a portion of the premium as well as a copay at the point of service. HMO’s will often deny coverage for a trip to the specialist unless the Primary Care Physician has referred the patient.
Preferred Provider Organizations (PPOs)
A PPO plan typically offers more flexibility to subscribers and is priced the same or a bit higher than the HMOs. With a PPO you can venture out of network to choose a provider. This can be done without a referral. PPO’s often have more out-of-pocket costs and can be a bit more complicated than the HMO.
Point-of-Service Plans (POS)
A POS plan is a blend of the HMO and the PPO which means that the insured can select from a network of providers. However, they may venture out of the network if they are prepared to incur most of the costs. If the primary care provider has provided a referral, the patient will not be responsible for the associated cost when leaving the network.
Health Savings Accounts (HSAs)
An HSA is a plan where both the employee and the employer can contribute to the coverage costs. These accounts are typically lower cost and carry a higher deductible. The employee will typically use this account for small health care expenses and routine visits. If the deductible is reached, the patient is covered by the policy.
As a business owner, you are asked to make important decisions daily. Let an OceanPoint agent walk you through the complicated decision of selecting group health insurance. We will find a policy that meets the needs of you, your business, and your valued employees!
Contact us today and get the healthcare coverage your employees can count on!