Arizona Group Health Insurance & Employment Benefit Plans

Arizona Group health benefits and employee insurance plans

Go through a reliable and licensed insurance agent in Arizona if you are looking for low cost premiums on health insurance plans for your local business. Here at Taylor Benefits Insurance Agency, we provide inexpensive health insurance plans and benefit options for companies of all sizes, from Mom and Pop businesses to large corporations. Throughout our history and experience, we’ve had the pleasure of forming relationships with the absolute best Arizona group health insurance carriers throughout the state. We offer health insurance and benefit plans for your business while negotiating costs.

Arizona Large Group Health Insurance Plans

Under the Affordable Care Act provisions, employers with more than fifty employees are obligated to provide health insurance to full-time workers. The insurance must meet specific requirements, or the business will pay the penalty for noncompliance. While most of these regulated organizations already offered health insurance coverage before the ACA passed, they must now report information to demonstrate compliance with the statute. The main provisions for compliance are affordability and minimum essential components.

While the regulations require that coverage be affordable for the employee, no such requirement protects family member dependents. Affordability is set at 9.6 percent of gross income for individual coverage. Further, all plans must cap out-of-pocket costs for subscribers and may not limit the amount of any claims with annual or lifetime benefit maximums for any of the required components. The minimum essential benefits include:

  1. Ambulatory patient services (outpatient care)
  2. Emergency services
  3. Hospitalization, including surgical and medical
  4. Maternity and newborn care, including delivery
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Preventative and wellness services, including chronic disease management
  10. Pediatric services, including dental and vision care for children under the age of 19

Health insurance can take many forms, including traditional point-of-service plans, preferred provider organizations (PPO), health maintenance organizations (HMO), and HDHPs (high deductible health plans), which are frequently paired with HSAs (health savings accounts).

Arizona Small Business Health Insurance Plans

In Arizona and elsewhere, small companies are constantly reviewing their health insurance offerings in an effort to save money and continue to provide coverage for their workers. One attractive option may be a high deductible health plan with a health savings option. The IRS defines a high deductible health plan as having a deductible of at least $1,400 for individual coverage and $2,800 for a family. If the deductible is lower, the plan does not qualify for an HSA. Also, the maximum out-of-pocket expense can’t exceed $7,050 for an individual or $14,100 for a family.

The basic idea behind this kind of coverage is twofold. First, the subscriber pays a lower premium in return for accepting a higher deductible. The subscriber can direct some of what they save in premium payments toward the HSA, which is a tax-advantaged account to pay for medical expenses, including deductibles and copayments. While the minimum deductible is $1,400, many of the current HD plans have much higher amounts, often at or near the maximum out-of-pocket figures allowed.

If the subscriber doesn’t use the money they direct into the HSA by year-end, the deposits can accrue. This element is an essential difference between the HSA and flexible spending accounts, which have a use it or lose it provision. Instead, the money can continue to grow, and the subscriber can continue contributing to more significant expenses that may occur later. Even more notable is that this account can follow the subscriber into retirement. At that time, the account owner could use the funds for non-medical expenses. Many employers partially fund the HSAs for their employees, but that isn’t necessary.

Arizona Employee Benefit Plans and Employee Benefit Packages

Creating the best employee benefits package for your company in Arizona depends on a couple of variables. One is your workers, and what matters to them, and another is your budget. Whether the business is large or small, many companies prioritize health insurance when crafting their benefits program because employees value it. If you can add dental and vision insurance coverage, that’s a great portfolio of health-related offerings.

Next on the incentive list, employees usually want paid time off. In Arizona, an employer with fifteen or more workers must provide up to forty paid sick leave hours per year. Smaller companies must grant up to twenty-four paid sick time hours. Employees can use the time for their own or a family member’s injury or illness or to seek care and treatment. In addition, there are other allowable uses, such as school closure and domestic violence. Arizona employers don’t have to provide paid holidays or vacation time, but many do.

What is the Importance of Offering Group Health Insurance?

Group Health Plans cover eligible employees working together in a company. The premium paid for group health insurance is much lower than individual health insurance plans. Being an employer, you can simply extend the coverage to the dependents and family members of eligible employees.

Buying group health insurance is beneficial for both employers and employees. There are various advantages associated with buying group health insurance. Let’s take a look at them.

Increases Employee Productivity

An employee’s productivity largely depends on factors, such as financial security, working culture, health protection, and job security. Most employers provide financial coverage to their employees under the Arizona Large Group Health Insurance against unexpected emergencies or hospital expenses.

It will make the employees choose your company over your competitors as they feel valued. So, both large employers and small employers will be able to reap the benefits of having a productive workforce.

Creates Good Reputation in the Industry

Creating a good business reputation helps in building long-term relationships with customers. When businesses conduct CSR (Corporate Social Responsibility) activity, it will create a good impression not only among the employees but also among the customer. This, in turn, will increase brand loyalty in the individual market.

When employers provide group plans to the employees, it reflects the employer’s goodwill. The employees tend to become more loyal to the company. It serves as an additional benefit when it comes to retaining an employee.

Helps Retain Employees

Group insurance plays a significant role when it comes to retaining employees in small businesses. With group health plans, employees can take care of their physical and mental health. When employees feel that their employer cares about them, they are more inclined to be loyal to the company.

Tax Savings

Small businesses offer group insurance to enjoy tax incentives. When your company pays a premium for health insurance, it is tax-deductible. You can get a federal tax credit worth up to 50% of the employees premiums paid by you. So, you get tax credits to provide health insurance options to your employees.

How Group Health Insurance Coverage Help Employees?

As we said, health plans are also beneficial for employees. Let’s take a quick look at what benefits it has to offer.

Group Coverage at Low Cost

The benefit of group insurance is that you will b able to enjoy healthcare group coverage at a low cost. You might have been pretty healthy but you may need to be hospitalized or get a surgery done.

In such a scenario, the group coverage will cover the healthcare costs. The health plan can pay at least up to 70% of the hospital and medical underwriting cost, based on the terms and conditions of the group plan.

Coverage Options for Family Members

According to some group health insurance plans, you can add your family members to the health plan, such as your parents, spouse, or children. This way your family members also get health coverage options in one plan.

No Waiting Period

Individual health insurance plan comes with a waiting period for pre-existing conditions and illnesses as per the medical history of the person.

For instance, in most cases, there is a waiting period to offer coverage for maternity. It ranges from 2-4 years among various health insurers. But as group health plans are equal for all the full time employees in an organization, it doesn’t have any waiting periods to get patient protection against pre-existing conditions.

So, you can save time on the waiting period. As long as you are a part of the company offering health insurance coverage, you can get health coverage.

No Pre-Medical Test Needed

Just as the waiting period, usually, individual coverage comes with many pre-medical condition tests that help in determining if a person has any pre-existing illness. But in a group health plan, a person doesn’t have to get any pre-medical test done to enjoy the benefits of health insurance coverage.

Easy Claims

Claims for health insurance for small businesses become a lot simpler as you have someone in-house to help out through the process and its key aspects. The enrollment process is explained by HR and the company reimburses employees for the hospital bills.

Things to Consider Before Getting Group Health Insurance Coverage

It’s the employer’s responsibility to take care of the health of the employees. So, employers need to make sure they offer a health plan to every employee in the company. This will not only offer financial protection to employees but also serves as an important factor for the satisfaction of the employees.

But before you get group health insurance for your employees, here are a few things that you need to consider.

Know the Requirements

The first thing you should do when you are buying a product or service is to know the requirements. Sure, saving on the premium amount might be your requirement but you should also know what your employee’s needs are. It is ultimately your employees who are going to benefit from the health insurance plan.

But you also have to be realistic with the amount you will pay as a premium. Remember the premium will increase with the number of employees you have. Furthermore, the premium is going to increase with time.

Thus, you have to strike a balance between the amount you are paying and the benefits the employees enjoy. But make sure that you take feedback from your employees. Small business health insurance should benefit them.

Coverage of the Plan

By coverage, we mean the amount offered by the employer to every employee in the small business health insurance. Based on the size of the organization, average annual wages, and the average age of the employees, you may or may not have to get certain covers.

For instance, if all the employees are unmarried and travel a lot, you might have to get a personal accident cover. But if almost all your employees are married, you might have to get maternity benefits.

So, you have to pay attention to what is being covered under the health care plan.

Network Hospitals Covered

It’s good to have a small business health insurance plan as the insurance company offers a plethora of network hospitals on the list. With these network hospitals, an employee with group plan can enjoy cashless hospitalization. So, they don’t need to wait for any prior coverage requirements for hospital bills and then wait for the insurance company to reimburse them.

Often, employers don’t pay attention to it but if an employee is sick, they would prefer getting treatment from a hospital providing medical facilities without having to bother about arranging finances. Hence, make sure that the network hospitals offer good health care facilities, services, and treatment.

Claim Settlement Ratio

The number of claim settlement requests settled by an insurance company out of the claims received is called the claim settlement ratio. Small business owners should choose a health insurance company having a claim settlement ratio of 90% or more.

Don’t forget to check if the company’s claim settlement process is easy and quick so that the employees participating in your small business health insurance plan have a smooth experience.

Waiting Periods

The time employees have to wait to get the reimbursement for some treatment is called the waiting period. There are mainly three types of waiting periods for affordable health insurance.

Specific Disease Waiting Period: The insurance company offers a list of diseases, which are usually covered under the policy after a 2-years waiting period.

Initial Waiting Period: When you get the policy, there is generally a waiting period of 30-days to consult a primary care physician. Hence, during the waiting period, you can just make claim associated with hospitalization due to an accident.

Pre-existing Diseases Waiting Period: Existing medical conditions, which you have before you get the policy is called a pre-existing disease. The conditions are known to be covered within 3-4 years of a waiting period.

Legal Implications

Make sure that you talk to your legal team if the insurance is mandatory for your small business and if yes, ask them what should be covered in the group health insurance. For instance, if you are a small business owner in the manufacturing industry, you might have to ensure the factory workers follow the Employee State Insurance Act 1948.

The Fine Print of the Plan

Every small business health insurance plan comes with its sets of terms and conditions. It includes the illnesses and situations, which are covered or not covered under the policy. Hence, before you get the group health insurance plan for your employees make sure that you go through all the terms and conditions.

If relevant situations or illnesses are not put under the policy, it will be of no use for eligible small businesses.

What are the Limitations of Group Health Insurance?

Just as everything, even a group health insurance plan comes with its own drawbacks. We believe in being transparent about everything. Let’s take a look at the limitations before you buy the small business health plan.

Limited Benefits

A group health insurance plan and an individual health insurance plan differ a little in terms of coverage and benefits they offer. The reason behind this is that the group health insurance plans have been created for at least two employees. Hence, it just covers the standard features for full time employees.

Individual health insurance plans can be more customized as per the benefiter’s healthcare requirements.

But as an employer, you should always get group plans for your full time employees. If required, you can get an additional health insurance plan. The premium and operating costs depend on how many employees you have in your company.

Coverage Ends When an Employee Leaves the Job

In case you are an employee, one of the primary restrictions of a group health insurance policy is that when you leave the company, the coverage will cease.

But that won’t be a problem if your new company is offering you a fully insured group health insurance policy, too. Thus, make sure you have family health insurance and separate health insurance as a backup.

Employees Don’t Enjoy Tax Benefits

It is another drawback for the employee. When small groups or large groups provide fully insured group health insurance plans, they get tax credit. But you as an employee won’t be able to enjoy the tax benefits unless you have your own health insurance that you pay for.

Factors to Keep in Mind While Getting Group Health Insurance

Here are a few points that you need to keep in as a large employer when you are getting group health insurance plans.

  • Plan the Budget: As an employer, you have to decide on a budget before you get a group health insurance plan for the company. As per the budget, an employer will have complete control over the spending and take care of the expenses.
  • Benefits of the Coverage and Plan: Before you purchase any PPO plans, know the benefits it has offer, the inclusions, exclusions, and coverage provided to the employees.
  • Types of Insurance Plan: You have to find out the kind of insurance plan the organization needs. Being a large employer, you have to decide if would like to extend the standard policy coverage for the dependents or not.
  • Premium Amount Deduction from Salary: Several companies as a part of the compensation to the employees are going to deduct the premium from the salary of the employee. Hence, an employer has to decide if the premium is going to be paid just by the employee or the employee will pay a share of it.

Group Plan Options for Arizona Businesses

  • Group health insurance
  • Group dental insurance
  • Group vision insurance
  • Group life insurance & long term care
  • Group retirement & employee 401(k) plans
  • Group pension plans
  • Prescription drug coverage
  • HSA and FSA
  • HMO and PPO
  • Medicare options
  • Cafeteria plans (section 125)
  • COBRA and continuation of coverage
  • Group short and long term disability
  • Worker’s compensation insurance

Information Regarding the Affordable Care Act

It is required that all small businesses in Arizona remain in compliance with the Affordable Care Act. This is a government issued law that changes often yet it sets the standards and minimum requirements of the insurance industry. Your business can qualify for annual tax credit breaks when it remains in constant compliance with the requirements of the ACA and other relevant laws.

At Taylor Benefits Agency, our brokers make sure your plan obeys the laws of the Affordable Care Act. Our licensed and experienced insurance brokers are educated and trained to remain on top of the changes made to the act. They’ll even audit your health insurance plan during its duration to assure that it keeps up with the ever-changing requirements listed in the act.

Give Taylor Benefits a call now to learn more and to discuss the future of your group health and employee benefit plan. We will even provide you with a FREE quote!

Frequently Asked Questions About Health Insurance And Employee Benefit Plans in Arizona

Here are some answers to common questions regarding Arizona health insurance coverage.

Which Large Group Health Insurance Providers Are in Arizona?

Taylor Benefits Insurance can connect you with some of the country’s leading group health insurance companies. Years of reliable service have demonstrated that you can always rely on us to get you a great deal on large group coverage plans.

We work collaboratively with the following insurance companies:

  • Blue Cross
  • Blue Shield
  • eHealthInsurance
  • Humana Group
  • Kaiser Foundation Group
  • Unitedhealth Group
  • State Farm
  • Coventry Corp. Group
  • HIP Insurance Group
  • Carefirst Inc. Group
  • UHC of California
  • Metropolitan Group
  • HCSC Group

How Do Small Business Group Health Insurance Plans Work in Arizona?

Small business health insurance can benefit small business owners in five ways.

The first strategy is a generally applicable group health insurance plan for small businesses. Employers pay a health coverage premium to give health benefits to their employees and, in some situations, their employees’ families. However, the employee may pay a portion of this sum.

The second option to explore is the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). Employers can provide employees with a certain amount of money in benefits each month (at their discretion).

The third option is a Group Coverage Health Reimbursement plan. This implies that the company would provide both group health insurance and a monthly allowance to offset deductibles, copays, as well as other expenses.

For smaller businesses, self-funded health insurance plans are a riskier option. Instead of paying monthly premiums, employees present their medical bills or prescriptions, and employers compensate them accordingly.

This last option, known as Associate Health Plans (AHPs), is a slightly risky financial option for small businesses. This is basically when smaller businesses within an industry or location join together to purchase a large group health plan from an insurance provider.

What Are the Different Types of Health Benefits Offered in Arizona?

Taylor Benefits Insurance Agency offers benefit plans for companies and employees in Arizona for the following:

  • health coverage
  • dental coverage
  • vision insurance
  • Disability insurance, both short and long term
  • 401k
  • retirement & pension
  • section 125 cafeteria
  • HSA
  • life insurance
  • long term care
  • ACA (Affordable Care Act)
  • Corporate health insurance & employee benefits
  • large groups

How Much Do Employers Pay for Health Insurance?

Group health insurance programs allow employees to make any amount of contributions. An employee’s expenses start at about $270 per month or $3240 per year. By comparison, employee contributions are more than three times less than the average American’s annual healthcare costs.

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