Group Health Insurance for Plumbers

Tuesday, March 19, 2024 13:15 Posted by Admin

As a plumber, you know that when a pipe busts under a house or inside a wall, a person needs a professional to take care of the repair before major damage is done. When it comes to the health of you, as a private plumber or to the health of your employees, a professional is necessary to help ensure that your health stays good, that accidents at work are taken care of and that you, nor your employees will need to pay too much from your own wallet for the expense that comes with healthcare.

Whether you work as a private contractor in the plumbing business who has a small crew working for you, or you own or operate a large plumbing company that hires a dedicated team of plumbers to work for you, obtaining a good group health insurance policy can benefit you and your employees greatly over time. For many, it can be difficult to wade through the many options that one can have for health insurance. Let’s face it, for most people, health insurance is a confusing thing to buy because there are seemingly so many options to choose from, and with each option, it seems there are stipulations, criteria to be met, fees to pay and plenty of confusion about what is, or is not, covered by any given policy.

Plumbers and small businesses nationwide receive requests practically every week to apply for a group health insurance plan. Taking the necessary time to go through the paperwork and understand a policy can be exasperating to most. How can you choose the right plan for your plumbing company when there are so many to choose from? Taylor Benefits Insurance has the plan for you, and we also have the best information for choosing the plan that’s right for your plumbing company.

When choosing a group health insurance plan be sure to:

Look for the highest coverage limits

Healthcare cost has dramatically risen over the last five years, and if you or your employees need to see a doctor, the coverage limits on your plan need to be high enough to cover the vast amount of out of pocket expense that is associated with a healthcare visit. As you review the group health plans, be sure to check the dollar maximum per lifetime and the dollar maximum per claim amount shown on the plan. The higher dollar amount, the higher your coverage will be.

Limits on Coverage

Some plans have large limits that you need to check into before signing on the plan. For instance, your plan may have a limit for coverage of $3000 on a tonsillectomy, yet the procedure will cost $5000. This means you will need to pay $2000 out of pocket for the procedure. Before you agree to a plan, know what the limits are and if they seem low, steer clear of the plan unless you enjoy paying large amounts out of pocket for check-ups, surgery or other medical visits.

HMO, PPO or Total Freedom

Most group health plans will be HMO or PPO plans and it is not easy to find one that allows total freedom when it comes to choosing your own physician of the physician is not in the same network as the insurer.

An HMO requires you, the policy-holder, to see one individual physician and you will not be able to see a specialist or a different physician without prior authorization from the insurer. HMO policies can be very restrictive, but the cost may be lower than others and is beneficial to those who have no preference on the physician they see because they can save money on the insurance plan. HMO’s have, in the past, bene known to charge higher rates than doctors in a PPO network because they know they have no competition.

A PPO health plan is one of the most preferred group plans and with it, you will be able to choose your own in-network physician and will not need to have a referral or prior authorization to see a specialist. Most contractors, and small and large businesses, prefer offering a PPO plan to their employees because it allows more freedom of choice when choosing healthcare. Having a PPO health plan can also save money for your employees or yourself because PPO’s usually watch rates to be competitive with others and to be more accessible to their patients.

If you want total freedom to choose any doctor you prefer, buying a private policy is a choice, but it can be expensive to do so. On average, an individual who pays for a group plan will pay around $60 month for the group plan. A private policy can run more than $130 per month for an individual and the freedom of choice you have may not be much more, if any at all, than a PPO plan. With a group health plan, the employer covers a portion of the policy fee.

Some of the best plumbing companies, including plumbing companies such as Anytime Plumbing of Watsonville, started offering group health insurance plans to employees when the Affordable Care Act (ACA) took effect in 2014. Companies such as this, and others who employ at least 50 or more full-time employees, must provide health coverage or pay a tax penalty. Due to the cost of the penalty, most companies choose to offer the insurance. For more information on ACA requirements in California, you can check the California ACA Plans.

Per the ACA, a health plan must cover the following:

  • Lab Services and Testing
  • Pediatric Care
  • Emergency Care
  • Emergency Room Visits
  • Outpatient Care
  • Inpatient Care
  • Mental Health Care
  • Substance Abuse Treatment
  • Recovery and Rehab Services
  • Prescription Drug Coverage
  • Preventive Services (Vaccinations, screenings)
  • Maternity Care
  • Newborn Care

Companies that employ fewer than 50 full-time employees are not required by law to offer insurance coverage, but thanks to tax credits for businesses that many are eligible for, it may be a lucrative choice as well as one your employees with appreciate. While you are checking into a group health insurance plan, you may also want to check into dental or vision coverage for your plumbing crew as these, as well as short and long-term disability and retirement plans are also important coverage items for employers to offer.

Written by Todd Taylor

Todd Taylor

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.

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