Vermont Group Health Insurance & Employee Benefit Plans

Vermont Group Health Insurance & Employee Benefit Plans

Taylor Benefits Insurance Agency is the leading insurance and employee benefit provider for business owners in Vermont.  As an independent broker, we have been providing businesses with comprehensive yet inexpensive health and benefit plans for nearly three decades. We give you more options and flexibility in your group health insurance and employee benefits to ensure you satisfy the needs of your employees and their families at home. Great coverage and employee perks will help your business thrive by attracting and retaining qualified, hardworking individuals.

Group & Employee Benefit Options

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Short and long term disability insurance
  • 401K plans
  • Retirement & pension plans
  • Section 125 cafeteria plans
  • Long term care
  • Life insurance
  • Worker’s compensation
  • Employee benefits and wellness plans
  • HMO & PPO
  • HSA & FSA

Your Basic Managed Care Health Coverage Options

  • Preferred Provider Organization (PPO)-Customers can choose between in-network providers for better coverage and cost savings or out of network which will have some coverage but higher personal costs.
  • Health Maintenance Organizations (HMO)-Customers much choose a Primary Care Physician (PCP) and use an in-network provider to receive coverage for care with the exception of emergency services.

Our licensed insurance brokers will discuss all your options with you before helping you tailor a group plan that meets everyone’s needs. We will not only create the right plan but we’ll negotiate the costs to find you the lowest possible rates and premiums. It is also the duty of our insurance brokers to conduct an annual audit to make sure your plan is changed as needed and still in compliance with the Affordable Care Act and all local, state and federal laws. Meeting these requirements will earn your company tax breaks and other advantages.

To learn more about Taylor Benefits and how we can best serve your Vermont business, give us a call today! Once you’ve discussed all our options with one of our insurance agents, you’ll be offered a FREE quote for your company’s future group health and benefit plan.

TOLM Taylor Vermont

Vermont Large Group Health Insurance Plans

For many employers, health insurance is a significant expense. However, large companies recognize that to compete for skilled employees they need to provide benefits that include a high-quality insurance plan. Also, the Affordable Care Act requires that employers meet affordability and coverage standards. The ACA rules stipulate that employees’ share of the premium can’t exceed 9.61 percent of their gross income. That limit only applies to coverage for the worker, leaving dependent coverage out of the equation.

The ACA also requires that coverage be demonstrably comprehensive by meeting these two criteria:

  1. The plan is intended to pay at least 60 percent of the total cost of medical services for a “standard” workforce population, and
  2. The benefits include substantial coverage of inpatient hospital and doctors’ professional services.

Finally, the act specifies ten services that any insurance plan must provide:

  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

In Vermont, the state added more required services for insurers. It’s important to remember that any self-funded plan is exempt from the state requirements, but not those in the ACA. Vermont has a slightly higher percentage of self-funded plans than the national average, at 63 percent. The Vermont requirements are as follows:

  • Chemotherapy
  • Clinical trials for cancer patients
  • Prescription drug coverage for cancer patients
  • Craniofacial disorders
  • Prosthetic devices
  • Diabetes care

Vermont Small Business Health Insurance Plans

Small employers in Vermont aren’t required to provide group health insurance for their employees. For many, the cost seems prohibitive. One reason is that per capita costs may be higher for small companies since insurers evaluate the risks in the employee pool to determine subscriber rates. However, small companies may find affordable plans through the SHOP (Small Business Health Options) program developed as part of the ACA. Your Taylor Benefits Insurance consultant can help you explore potential options. Since 85 percent of workers in Vermont have access to employer-sponsored coverage, that’s an indication that small companies are finding a way to provide the coverage. In Vermont, employers overall are paying 77 percent of the cost of workers’ health insurance premiums.

Vermont Employee Benefit Plans and Employee Benefit Packages

Vermont’s legislature passed the Green Mountain Secure Retirement Plan legislation to create a statewide multi-employer retirement plan to benefit Vermont residents. However, the implementation has been delayed, and the current status is unavailable, according to the state Treasurer’s office.

Vermont workers are eligible for paid sick leave, which they must accrue at a minimum rate of one hour per 52 hours worked. They must be allowed to use at least 40 accrued hours annually. Employees are entitled to unpaid family leave for pregnancy and birth or severe illness of a family member, with eligibility depending on the employer’s size.

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

Here are some concise answers to some of Vermont’s most common health insurance questions.

What Are the Benefits of Large Group Health Insurance Plans in Vermont?

Large group health insurance is ideal for companies with more than 50 employees. As you utilize this health insurance plan, you may discover that it provides you with coverage at an affordable price with a substantial discount. The following are some of the perks of large group health insurance plans:

  • Pre-existing conditions
  • Deductibles
  • Coinsurance
  • Employer-sponsored (funded) Medicare/Medicaid enrollment
  • Employee dental programs and coverage
  • Health Savings Accounts (HSAs)
  • Employee vision insurance and care
  • Employees’ drug coverage
  • Comprehensive healthcare strategy
  • Employees’ major medical expenses
  • Out-of-pocket expenses
  • Employee wellness initiatives

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

In Vermont, small businesses have five main types of health plans.

First, we have a traditional group health insurance plan. Employers pay a fixed healthcare insurance fee, a portion of which may be paid by employees, in exchange for providing health benefits to their employees and, in some cases, their employees’ families.

The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is another type of health insurance plan. Employers can offer employees a specified sum of money in benefits each month (at their discretion).

Group Coverage Health Reimbursement plan is also an option for your small business. The company offers group health insurance and a monthly stipend to cover deductibles, copays, and other expenses. 

Self-funded insurance plans are risky, which is one of the reasons why many people avoid them. Rather than paying monthly premiums, the employer pays the employee according to the cost of medications or medical bills.

Finally, Associate Health Plans (AHPs) are slightly risky health insurance plans for small organizations. There is only one way to obtain AHP coverage: a group of smaller businesses from the same industry or region band together to purchase large health insurance from an insurance provider.

What Benefits Can Employers Offer in Vermont?

Most workplaces in Vermont offer health insurance that covers a variety of medical treatments, including prescription meds, doctor’s appointments, and surgeries.

Since it is deemed unnecessary, the cost of plastic surgery, for example, is not covered. Furthermore, because most health insurance plans exclude dental and vision coverage, these two areas of health must be obtained individually.

How Much Do Employers Pay for Health Insurance?

Employees can contribute to group health insurance programs regardless of their income. The average employee pays around $3240 per year in healthcare, which is roughly three times cheaper than the average cost of healthcare in the United States.

We’re ready to help! Call today: 800-903-6066