- Providing world class service and value for employee benefit group plans since 1987
Taylor Benefits has been revolutionizing the healthcare insurance industry in Pennsylvania for over 25 years. We offer group healthcare coverage and provide the most affordable and comprehensive employee benefits packages. Not only do we offer health benefits for your company, but we also offer around-the-clock, top-notch service, so you will always have an agent available to help with your insurance needs.
The ACA made many changes to healthcare insurance for staff of large companies. While most companies already provide medical coverage to their workers, the ACA ensures that all health plans meet specific standards for services and affordability. For example, the affordability requirement limits the number of employees’ premiums that subscribers can be required to pay.
The maximum is 9.12 percent of a subscriber’s gross income for individual coverage. That means that if a worker has a salary of $50,000, the maximum charge for their share is $4,560 annually.
Also, the ACA lists ten minimum essential coverage that all plans must cover:
Pennsylvania added to this list with the following medical insurance coverage requirements:
Employers can avoid those state-level requirements if they purchase their own healthcare benefits rather than purchasing insurance, but self-funding doesn’t grant an exemption from the ACA requirements.
Small employers aren’t required to provide health coverage for their employees. For many, the cost seems prohibitive. One reason is that per capita costs may be higher for small businesses since insurers evaluate the risks in the employee pool to determine subscriber rates.
Small businesses may find affordable small business medical insurance programs through the SHOP (Small Business Health Options) program developed as part of the Affordable Care Act (ACA). Your Taylor Benefits consultant can help you explore potential options. Further, small businesses with less than 25 workers may be eligible for small business healthcare benefits tax credit.
Pennsylvania does not require employers to offer paid or unpaid time off to workers. However, employees value their benefits packages, and many companies offer some time off to recruit and retain talent. In addition, paid time off and expanded family leave (often unpaid) are among the most requested benefits after health protection.
When possible, employers may add other benefits, like retirement savings plans, life and disability coverage, dental and vision coverage, and more. Many crew members value flexible scheduling, particularly if they are balancing family demands with work requirements. Companies may find it cost-effective to allow workers to shift their schedules or offer work-from-home options on request.
Taylor Benefits specializes in the following:
Taylor Benefits operates differently than most insurance providers by functioning as an independent agent. This allows us the unique ability to fully customize the perfect team package by drawing from any number of traditional protection providers in order to get you the best deal possible.
Taylor Benefits also recognizes that insurance requirements are in near-constant flux in Pennsylvania. Because we understand the local conditions and regulations, you can rest assured we offer group coverage to all businesses operating in this unique state.
Contact us today at the number on the top of the page for a FREE estimate and available group benefits options or complete the simple form on the right for a no-obligation, customized proposal for your Pennsylvania-based business.
The Affordable Care Act (ACA), casually called Obamacare, made it easier for the uninsured to receive comprehensive health protection, but it also threw a wrench in the workings of many businesses. Previously approved programs no longer met federally mandated minimums after the implementation, so companies found themselves scrambling to become compliant. Pennsylvania businesses were substantially affected due to the changes.
Taylor Benefits has been able to assist hundreds of businesses in Pennsylvania since the Affordable Care Act emerged, and we continue to be the industry leader in group policies and employee incentives programs. Our first-hand knowledge of the law, coupled with our diverse resources, consistently allows us to create packages that are ACA-compliant without adversely impacting the company’s bottom line.
If you need this type of attentive insurance assistance and are operating a PA-based business, please complete the form on the right or call the number at the top of the page for a FREE, customized proposal guaranteed to meet your needs exactly.
What are the most common group health insurance plans?
The most common group health insurance plans include Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Exclusive Provider Organization (EPO) plans, and Point of Service (POS) plans. Each type offers different levels of coverage, flexibility in choosing healthcare providers, and out-of-pocket costs.
What is the main advantage of group insurance?
The main advantage of group insurance is that it typically offers lower premiums and better coverage compared to individual insurance plans. This is because the risk is spread out among a larger group of people, making it more cost-effective for both the insurer and the insured individuals. Additionally, group insurance plans often have fewer restrictions and requirements for coverage, making them more accessible and convenient for participants.
Who splits the premiums in a group health insurance plan?
In a group health insurance plan, the premiums are typically split between the employer and the employees. The employer often pays a portion of the premium, while the employees pay the remaining amount, usually through payroll deductions. The exact split can vary depending on the employer’s policies and the specific insurance plan.
Which is better, group insurance or individual insurance?
Choosing between group insurance and individual insurance depends on various factors, including your specific health needs, financial situation, and whether you have access to a group plan through your employer or an association. Here’s a comparison to help determine which might be better for you:
Group Insurance:
How are premiums determined in group insurance?
Premiums in group insurance are determined based on several factors that assess the overall risk and expected healthcare costs of the group as a whole. Here are the primary factors that influence how premiums are set:
1. Risk Pool: The overall health, age, and demographics of the group members play a significant role. Insurers assess the collective risk profile to estimate the likely healthcare costs that the group will incur. A group with a younger, healthier demographic might see lower premiums compared to a group with an older, less healthy demographic.
2. Size of the Group: The size of the group can impact premiums. Larger groups often benefit from lower per-member premiums because the risk is spread over more individuals, reducing the insurer’s risk per capita.
3. Plan Design: The specifics of the insurance plan, such as deductibles, copayments, out-of-pocket maximums, and covered benefits, affect the premium. Plans with lower deductibles and more comprehensive coverage typically have higher premiums.
4. Geographic Location: The cost of healthcare services varies by location due to differences in cost of living, state regulations, and competition among providers. Insurers consider the geographic location of the group when setting premiums.
5. Industry: The industry in which the group operates can also influence premiums. Some industries are considered higher risk due to the nature of the work and the potential for more frequent or severe health claims.
6. Claims History: The historical claims data of the group, if available, can impact premiums. A history of high claims costs might lead to higher premiums, while a low claims history could result in more favorable rates.
7. Regulatory Factors: State and federal regulations can affect how premiums are calculated. For example, the Affordable Care Act (ACA) imposes certain requirements on how premiums can be set, including restrictions on varying premiums based on health status and limiting the premium variation based on age.
8. Tobacco Use: Some plans may charge higher premiums for members who use tobacco, within the limits set by regulations.
Insurers use actuarial data and statistical models to assess these factors and determine the appropriate premium for the group. The goal is to set a premium that covers the projected costs of the group’s healthcare needs, administrative costs, and allows for a reasonable profit margin. Employers often share the cost of premiums with employees, with the specific split varying by employer.
What health care coverage is called group health insurance?
Group health insurance is a type of health care coverage provided by an employer or an organization to its employees or members. It typically includes a range of medical, dental, and vision benefits. The cost of premiums for group health insurance is often shared between the employer and the employees, making it more affordable than individual health insurance plans. Group health insurance plans are designed to cover a group of people under a single policy, offering the same benefits to all members of the group. This type of insurance is advantageous for both employers and employees, as it provides comprehensive health coverage at a lower cost due to the risk being spread across a larger number of individuals.
Is group health insurance worth it?
Yes, group health insurance is often worth it. It typically offers lower premiums compared to individual plans, provides comprehensive coverage, and may include benefits for dependents. Employers often share the cost, making it more affordable. Additionally, it usually comes with simplified enrollment processes and broader coverage options.
What type of insurance is group health insurance?
Group health insurance is a type of health coverage provided by an employer or organization to its employees or members. It typically offers medical, dental, and vision benefits, and the cost of premiums is often shared between the employer and the employees, making it more affordable than individual health insurance plans.
What is PA state health insurance called?
In Pennsylvania, the state health insurance program for low-income individuals and families is called “Medical Assistance,” which is Pennsylvania’s Medicaid program. Additionally, the state offers the Children’s Health Insurance Program (CHIP) for uninsured children and teens who are not eligible for or enrolled in Medical Assistance. For individuals shopping for health insurance through the Affordable Care Act (ACA) marketplace, the state-run exchange is called “Pennie.” Pennie provides a platform for residents to shop for and enroll in individual health insurance plans and to see if they qualify for financial assistance.
In PA, as is the case elsewhere in the US, comprehensive medical protection coverage is a tremendous relief for employees who need health care. Pennsylvania created a state-run health protection exchange (Pennie) to assist employers and individual subscribers with accessing coverage and managing ACA compliance.
Below are some frequently asked questions about health insurance:
90 percent of Pennsylvania workers have employer-sponsored insurance available. For single coverage, the average employer contribution is $5,878, absorbing 81 percent of the premium expense.
Health protection for small businesses in Pennsylvania is offered by:
Among the health benefits an employee may expect to receive in Pennsylvania are:
These options will help to protect and care for your employees and may assist you in recruiting and retaining high-quality workers.
Benefits often add around 30 percent to the cost of each employee. The amount a company invests depends on the health protection package and the benefits it provides.
Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.
Todd Taylor with Taylor Benefits gives our small business the kind of personal service we need. Insurance benefits are important to our employees and Todd helps us find a balance between benefits and value. Todd responds immediately to my phone calls & e-mails. He has even gotten in touch with me on a Sunday when we were in need of coverage answers immediately. We are very pleased with the hands-on service Todd and his staff provide.”
-Ken and Linda Orvick, Orvick Management Group, Inc.
We’re ready to help! Call today: 800-903-6066