Montana relies on the federal healthcare exchange for its marketplace. Still, it has created a reinsurance program to assist state insurers with managing the cost of high individual claims. The reinsurance program levies a fee on all major medical and disability plans in Montana (excluding self-funded plans) to fund the program. Reinsurance has helped keep premiums down for those who purchase coverage through the exchange or independently.
The ACA requires large companies in Montana to offer health insurance to their full-time, eligible workers. ACA rules eliminated restrictions on coverage for pre-existing conditions, which previously prevented people from obtaining care in some circumstances. The ACA also requires insurance companies to allow dependents to remain on their parent’s policies until they reach the age of 26 and eliminate lifetime benefit caps. Policies issued in compliance with the ACA must be affordable, meaning the premium paid by the subscriber is limited to 9.6 percent of their gross income for individual coverage. In addition, every policy must include these essential benefits:
Small companies are exempt from the ACA requirement to provide health insurance coverage. Still, they have resources to assist them in doing so. For example, suppose your business employs one hundred or fewer workers. In that case, you may be able to qualify for programs through the SHOP (Small Business Health Options) structure. In addition, for even smaller employers, tax credits may ease the cost of administering new insurance coverage.
In Montana and elsewhere, small employers may choose to contribute to their workers’ healthcare costs by establishing a Qualified Small Employer Health Reimbursement Arrangement. These accounts can give small businesses a means to assist workers by facilitating their use of pre-tax funds for healthcare while avoiding the burden of administering a healthcare program. Talk to your Taylor Benefits Insurance specialist about how these QSEHRAs work.
Health insurance is considered a core benefit and is the most frequently provided, along with paid time off. Not surprisingly, these are the benefits most employees list first among priorities. However, a robust benefits program will include more. Many companies are adding to their packages to attract and retain top talent. The 2021 McKinsey & Company benefits survey reported a sizeable increase in employers citing benefits as very important in talent management (from 55 percent to 66 percent).
As a result, employers frequently add voluntary benefits, including dental coverage, vision insurance, short-and long-term disability plans, group life insurance, employee discounts, and more. In many cases, the company makes a minimal or even no contribution to the cost but can offer the employee a lower price due to the group affiliation.
When you’re looking for a comprehensive, low cost group health and employee benefit plan to offer those working for your Montana business, contact a reliable insurance broker. Here at Taylor Benefits Insurance Agency, we have formed connections with some of the leading insurance carriers in the nation. We have over 25 years of history in the insurance industry which has made it possible for us to cater to the more direct needs of our clients.
When you give us a call at our office, you’ll have the ability to talk with one of our experienced and licensed insurance brokers. They help you tailor the perfect plan and even start negotiating costs to try and earn you lower rates and premiums. We will work with multiple insurance carriers just to create a plan your find pleasing. By going through us, you’ll notice that you have way more options than you would going through an insurance carrier directly. Here are some of the options you’ll have:
As long as your plan is through us, we will conduct yearly audits to ensure that your plan always meets the standards set by the Affordable Care Act and other local, state and federal laws. When you are consistently abiding by the ever-changing act, your business will likely qualify for tax breaks and other perks. However, if your plan fails to meet the restrictions of the ACA, you may be subject to government issued penalties.
Taylor Benefits will make sure that your plan abides by the law. Our insurance brokers have the experience, knowledge and skillsets to handle healthcare reform and other issues that may arise throughout the duration of your health insurance and employee benefit plan. Give us a call today to learn more and after we help you come up with the perfect plan, we’ll provide you with a FREE quote!
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Below you will find concise answers to frequently asked questions about health insurance coverage in Montana:
A large group health insurance plan is the best choice for businesses with over 50 employees in Montana. The key benefit of large group health insurance plans is that they offer a significant discount when you purchase them.
Student health insurance plans are also available through large groups. People who cannot afford individual health insurance can benefit from this plan. Other benefits include:
What type of plan is right for you and your employees depends on what you and your employees want, and how much you are willing to spend. The following are four popular types of health insurance plans:
The “Health Maintenance Organizations” (HMOs) are health care organizations whose members receive health care services through a network of medical providers contracted with the organization. Most HMO plans require employees to select a primary care physician (“PCP”) to handle the majority of their health care and refer them to specialists as needed.
An HSA-qualified plan is typically a PPO plan designed specifically for use with a Health Savings Account (HSA). HSAs are special bank accounts that allow participants to save money at pre-tax rates to use for future medical expenses. Due to their advantages for employers, Section 105 Healthcare Reimbursement Plans (HRPs) are often used instead of HSAs.
PPOs or preferred provider organizations are the most common insurance plans. The insurance company will pay at full level if employees receive medical care from a doctor or hospital listed on the company’s preferred provider list.
With an indemnity plan, members can choose their own doctors and hospitals. Insurers cover the remaining charges. A company may require employees to pay up front for some services and then apply for reimbursement from an insurance company.
A number of medical treatments and equipment are covered by health insurance plans in Montana, including surgeries, doctor’s visits, prescription drugs.
However, some healthcare services, such as plastic surgery, for instance, are not covered by most companies because it is viewed as unnecessary. Vison or dental services are not covered by most healthcare plans, so they must be purchased separately.
No matter how much or how little an employee pays into company-sponsored health insurance, they all can contribute. In the United States, the average employee spends about three times as much on healthcare per year. On average, the employee pays $3240 a year, or $270 a month.
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