Maine Group Health Insurance & Employee Benefits Plans

Maine group health benefits and employee insurance plans

Maine is one of the few states in the United States where small businesses don’t just operate to make a profit; they become an integral component of the communities they operate in. Due to this critical interdependency, it is important to ensure that small businesses are able to provide group health insurance plans and employee benefit packages that not only benefit their employees but also help keep their own profits stable.

Here are Taylor Benefits, we understand that our Maine business owners need to have affordable small group premiums. Fortunately, since we work with a wide network of insurance carriers nationwide, we can offer access to the best plans with a network of the most affordable healthcare providers and hospitals in Maine.

We not only offer group health insurance plans; we also have a full range of employer-sponsored benefits, including:

  • ACA (Affordable Care Act) compliance
  • Medical, dental, and vision insurance
  • Health savings plans (HSA)
  • Pension plans
  • Disability insurance (short and long-term)
  • Group life insurance and long-term care
  • Group retirement and 401(k) savings plans
  • Section 125 cafeteria plans
  • Employee benefits & wellness plans

For a FREE estimate today, be sure to fill out the easy quote form on this page.

Maine Large Group Health Insurance Plans

The state of Maine transitioned to a state-run health insurance marketplace in 2021, known as CoverME. All large group health insurance offered in Maine must meet ACA requirements for minimum essential benefits, elimination of lifetime benefit limits, and the prohibition of exclusion for pre-existing conditions. The requirement to offer health coverage to young adult dependents of covered employees until they reach age 26 is a significant expansion of coverage required by the ACA. However, employers can avoid this provision if they don’t include other dependents in their programs. If the health plan is available for dependents or family members, it must be extended to adult children under the age of 26 regardless of their marital or student status or even whether they have children of their own.

However, any insurer offering coverage within Maine must offer additional benefits above ACA requirements:

  • Hospice services
  • Adult dental care
  • Breast reduction and varicose vein surgery
  • Prosthetic devices
  • Reconstructive breast surgery (for breast cancer treatment)
  • Hearing aids
  • Access to clinical trials
  • Diabetes care management
  • Specified prescription coverage, including AIDS and HIV drugs

Maine Small Business Health Insurance Plans

The Maine Bureau of Insurance recommends that small companies in the state consult a qualified insurance broker like Taylor Benefits Insurance for assistance with selecting a health insurance program. Small employers have fifty or fewer full-time employees, but at least one in addition to the owner. Small employers choosing to offer a health plan through the Small Business Health Options Program can’t leave out eligible workers. However, they can opt not to cover family members or part-time employees.

Small employers can also opt for funding an ICHRA (individual coverage health reimbursement account) for workers instead of offering a specific health plan. The updated rules for small businesses also enable companies to provide both an eligible program and a limited HRA to help with employee premiums, copayments, deductibles, and other medical costs.

Maine Employee Benefit Plans and Employee Benefit Packages

Employees want to think that their employers care and are responsive to their needs. Providing more than just the essential benefits is one way companies can signal responsiveness. Smaller companies with limited benefits budgets may consider letting employees choose between a range of voluntary benefits options to pick the ones that mean more to them. For example, suppose a company has health insurance, a 401(k), and paid time off. Then, they add these choices:

  • Legal insurance coverage
  • Life insurance
  • Dental insurance coverage
  • Pet insurance coverage
  • Tuition assistance
  • Childcare assistance

The company could provide each worker with a maximum dollar amount and let them choose where to use it. Or allow each worker to select two or three from the list. These payments may be taxable income, but sometimes employees can pay the cost with the SHOP tax credit. According to the MetLife report, half of the employees in small companies, and more than half in larger organizations, are willing to pay a share of the cost for additional benefits.

Relevant Statistics

  • Over 90% of businesses in Maine offer group health insurance to their employees.
  • The average premium for a family plan in a Maine group health insurance is $9,500 per year.
  • Approximately 80% of Maine residents with employer-sponsored coverage have access to mental health services.
  • On average, Maine group health insurance plans cover 85% of prescription medication costs.
  • More than 70% of small businesses in Maine provide dental coverage as part of their group health insurance plans.

General Facts

  • Maine group health insurance refers to health insurance plans provided by employers or organizations to a group of people, such as employees or members.
  • These insurance plans typically offer coverage for medical services, including doctor visits, hospital stays, and prescription medications.
  • Group health insurance in Maine is regulated by state laws and may have specific requirements for coverage and eligibility.
  • Employers often contribute towards the cost of group health insurance premiums, making it more affordable for employees.
  • Maine residents who are not eligible for employer-sponsored group health insurance may be able to obtain coverage through public programs like Medicaid or the Affordable Care Act Marketplace.

Maine Group Health Insurance & The Affordable Care Act

The Affordable Care Act (ACA), also known as Obamacare, mandates that large employers and even some small business owners must provide access to health insurance coverage to their employees. As a top-rated company in the industry today, Taylor Benefits is here to help our clients better understand the insurance market in the state while procuring the most affordable coverage and retirement benefit plans for their Maine employees.

If you are a business owner or a manager in charge of insurance coverage for your business, be sure to fill out the FREE estimate form on this page to get started on the right small business health insurance adhering to the ACA today.

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

Here are some answers to common concerns regarding health insurance plans in Maine:

What Are Large Group Health Insurance Providers in Maine?

The market for large group health insurance providers in Maine is complex. There are so many providers competing for the same customers in the location it might be hard to differentiate between the offerings. Maine’s popular large health group insurance providers include Harvard Pilgrim Health Care, Tufts Health Plan, Anthem, and UnitedHealthcare. Your health insurance provider influences how much you spend on insurance, so it’s essential to pick the best.

In Maine, What Is Considered a Small Business Group for Health Insurance Plans?

The minimum employee threshold for a group insurance plan isn’t as high as most small business owners believe. To be eligible for a small business group health insurance package, you must have at least one worker as a small business owner. Some small companies may be eligible for tax credits, which the ACA established. However, if your company has more than 50 tax employees, you will instead be subject to the ACA’s large employer regulations.

In Maine, What is Normally Included in the Benefits Package?

The perks typically included in employee benefits offered in Maine include health coverage, retirement, paid leave, unemployment, and disability insurance. However, some companies choose to offer other benefits like vision and dental insurance, pet coverage, childcare, and fitness coverage. Employee benefits are one of the best ways to attract new employees to your business and retain old employees. Employers can choose an employee benefit plan that works for their business, no matter how large it is.

How Much Are Your Employee Benefits Worth?

Employee benefits accounted for 32% of employer compensation costs for workers in the United States. However, the worth of your benefits depends mainly on what perks your employer is offering. Health insurance is a significant component of all employee benefits, costing about $5000 to $30000 annually, depending on the type of plan and insurer. Retirement plans are also a popular perk that most employers offer, typically 2% to 6% of your salary in matching contributions. Disability insurance is also a very common employee benefit that can cost about $2000 to $5000 annually. The total worth of your employee benefits is based on what is included in the package.

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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