Finding the right group health insurance and employee benefits plan isn’t necessarily simple. It requires a detailed understanding of your options as well as knowledge of the ACA requirements and other laws regarding employee benefits and insurance. Of course, you could go straight to an insurance carrier, but if you do, you may end up with fewer health insurance options and higher premiums.
There is a balancing act between cost and coverage for large employers working to ensure compliance with the Affordable Care Act. Health insurance must meet the Affordable Care Act standards of essential health benefits and affordability. The affordability provision limits the subscriber’s premium for individual health insurance coverage to no more than 9.12 percent of their gross income. That rule means a worker earning $50,000 annually can pay up to $4,560, which equals slightly less than $400 per month.
As an employee’s earnings increase, the allowable premium can rise also. Of course, the employer can offer more than one plan option. Other choices can have a higher premium cost if they have a correspondingly better value. For that reason, every qualifying health plan is identified by a metal tier (bronze, silver, gold, or platinum) that describes the value.
A bronze plan is designed to cover sixty percent of the cost of the subscriber’s healthcare, with the remaining forty percent to be paid by the individual. In contrast, a silver plan will have a higher monthly premium but cover seventy percent of the expected charges. So, a worker can choose to pay a higher premium if they expect higher service usage.
Employers with over fifty workers who either don’t purchase health insurance or offer coverage that doesn’t meet the affordability or minimum benefits standard are non-compliant. In that case, they are subject to a penalty called the employer-shared responsibility payment.
Offering healthcare insurance is often a challenge for small companies due to the high per capita cost. Still, over half of the small companies provide the benefit to their workers, with some also offering family health insurance to their dependents.
The Affordable Care Act supports these efforts through SHOP (Small Business Health Insurance Options Program), which provides an accessible platform for smaller businesses. Small companies may also be eligible for tax credits to absorb some of the administrative costs of developing and managing the plans.
The tax credit is available for small businesses (with fewer than 25 full-time or full-time equivalent workers) if the employees have average wages of less than$53,000 annually and the employer is paying at least half the premium expense. However, the company doesn’t have to include a subsidy for dependents to qualify for the tax credit. Talk to your Taylor Benefits Insurance consultant for more information about small business insurance programs and tax credits.
Whether you call it the Great Resignation or the New Attrition, employers in Nebraska feel the effects of employees’ willingness to change jobs quickly or even leave their current role without a new one lined up. In addition to increasing compensation, companies enhance benefits packages to recruit and retain the workers they want and need.
The effort may pay off. According to MetLife’s 2022 Benefits Survey, nearly three-quarters of responding employees say that better benefits would keep them from leaving their current company. Notably, the MetLife survey said that employees satisfied with their benefits are twice as likely to be happy with their jobs and seventy percent more likely to express loyalty to their company.
Employers typically try to design a benefits package to help their eligible employees maintain financial stability and plan for the future. That could mean offering health insurance, life insurance, contributions to a retirement savings plan like a 401(k), and perhaps assistance finding or paying for childcare.
Call 800-903-6066 for a free consultation on Nebraska Group Health Insurance & Employee Benefit Plans.
If you want to find the best possible group health and benefits plan to offer your employees, contact a licensed insurance broker at Taylor Benefits Insurance Agency. With nearly three decades in the industry, we have formed a large network of reliable carriers that we work with. This diverse pool of policy issuers gives us the freedom to modify plans, plus room to negotiate costs. We try our best to get our clients’ optimal coverage at the lowest costs.
Contact Taylor Benefits today to learn more about how we can serve your business and its employees. We will create the right plan and make sure you are completely satisfied before we offer group coverage and individual health insurance for free.
Here are answers to some frequently asked questions about health insurance in Nebraska:
For large organizations with more than 50 employees in Nebraska, a large group health insurance program is the best option. By taking advantage of the discount that comes with a group coverage plan, you can have affordable health insurance.
Since the ACA requires that large employer coverage be available for dependents up to age 26, young adults may have better access to high-quality healthcare insurance than they did previously. The ACA also eliminated the practice of excluding coverage for pre-existing health conditions, improving benefits for any subscribers with chronic illness.
There are various types of health plans available, and the best selection for your small company depends on the needs of your workers. The four most common types of health insurance policies are:
An HMO is a health maintenance organization that provides a wide range of health care services through a network of providers that either contract exclusively with the HMO or agree to deliver services. When enrolling in an HMO, employees need to choose a primary care physician (“PCP”) to provide the majority of their health care and to refer them to HMO specialists when necessary. Subscribers may typically not use unaffiliated service providers except in an emergency.
The most common plans are PPOs, or “Preferred Provider Organizations.”. An employee who is covered by a PPO plan must seek medical treatment from providers on the insurance company’s preferred provider list to receive the highest benefit. However, subscribers have the option of using outside providers if they agree to lower reimbursement.
Indemnity plans allow members to handle their own health care and typically visit any doctor or hospital. The insurance company then pays a predetermined part of the overall expenses. Employees may be expected to pay for some treatments up front and then seek reimbursement from their insurance carrier.
Health Savings Accounts (HSAs) are offered along with high-deductible health insurance plans that are specifically designed to be used with HSAs. Health Savings Accounts allow individuals to save pre-tax money for medical expenses. The health insurance plan must meet the IRS’ established deductible to qualify.
Business owners in Nebraska typically offer health insurance that covers most medical equipment and treatments, such as prescription medications, doctor’s appointments, and surgeries.
Employers may also provide other benefits that their workers want, including retirement savings, paid time off, flexible scheduling, and other perks.
Group health insurance plans are available to employees of all income levels. The cost the company pays varies widely, depending on the location, the group size, and the breadth of coverage. The minimum essential coverage as per the ACA compliance limits the employee’s share of the premium to no more than 9.12 percent of their income.
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