Vermont Group Health Insurance & Employee Benefits Plans

Vermont Group Health Insurance

Taylor Benefits Insurance Agency is the leading insurance and employee benefits 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 an overview of the Vermont health insurance marketplace (Vermont Health Connect) and flexibility in your group health insurance and employee benefits to help you satisfy the needs of your employees and their families.

Great health insurance coverage and employee perks will help your business thrive by attracting and retaining qualified, hardworking individuals.

Group & Employee Benefits 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 Health Coverage Options

  • Preferred Provider Organization (PPO). With a PPO plan, subscribers can choose to obtain their Vermont health insurance plan from in-network providers for better coverage and cost savings. However, they can also seek services from outside the network. Doing so will typically mean that they pay a higher charge unless the need is an emergency.  

  • Health Maintenance Organizations (HMO). With this structure, subscribers choose a Primary Care Physician (PCP) and use an in-network provider to receive coverage for all health care, with the exception of emergency services.

Our licensed insurance brokers will discuss all your options with you and then recommend a group plan your business qualifies. We will not only create the right plan, but we’ll negotiate the costs to find you the lowest possible rates and premiums.

Taylor Benefits will conduct an annual audit to make sure your plan is always up-to-date and remains in compliance with the Affordable Care Act, as well as local, state, and federal laws. Ensuring that your plan is compliant helps you qualify for potential tax credits and avoid penalties. 

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 benefits plan.

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 provide policies that meet the affordability and coverage standards. The ACA rules stipulate that an employee’s share of the premium can’t exceed 9.12 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 businesses since insurers evaluate the risks in the employee pool to determine subscriber rates. However, small businesses 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 businesses are finding a way to provide the coverage. In Vermont, employers overall are paying 77 percent of the cost of workers’ health insurance premiums.

Relevant Statistics

  • Over 90% of small businesses in Vermont offer group health insurance to their employees.
  • The average annual premium for group health insurance in Vermont is $5,600 per employee.
  • More than 80% of Vermont residents with employer-sponsored group health insurance are satisfied with their coverage.
  • Group health insurance covers approximately 98% of the population in Vermont.
  • Employers who offer group health insurance in Vermont experience a 20% decrease in employee turnover compared to those who do not offer it.

General Facts

  • Vermont offers group health insurance plans for businesses and organizations.
  • Group health insurance provides coverage for a group of people, such as employees of a company or members of an organization.
  • Employers in Vermont are required to offer group health insurance to eligible employees.
  • Group health insurance plans in Vermont typically cover a range of medical services, including doctor visits, hospital stays, and prescription medications.
  • Premiums for group health insurance are often shared between the employer and the employees, helping to make healthcare more affordable.

Vermont Employee Benefits Plans and Employee Benefits 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 family health insurance for pregnancy and birth or severe illness of a family member, with eligibility depending on the employer’s size.

Learn more about employee benefit plans in Vermont.

Frequently Asked Questions About Health Insurance And Employee Benefits 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. One advantage is the lower cost that a sponsor can obtain. The employer can decide what benefits to offer and how much of the premium to pass along to the subscriber as long as they comply with the ACA requirements.

Some key attributes of large group plans include these:

  • 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
  • Coverage for employees’ major medical expenses
  • Out-of-pocket expense limits
  • Employee wellness initiatives

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

In Vermont, small businesses can choose from several viable plan structures to sponsor health insurance for their employees:

First, traditional group health insurance plans are an option. The employer offers one or more coverage choices while typically sharing the cost with the subscriber. This option might include an indemnity, Point-of-Service, HMO, or PPO plan.

If a small business is reluctant to administer and pay for traditional health insurance, it may consider a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). With this option, the employer contributes funds to each employee’s account. The employee can use the money to pay for expenses related to a qualified health plan.

Another choice is a Group Coverage Health Reimbursement plan. With this approach, the company offers both health insurance and a monthly stipend to cover deductibles, copays, and other expenses. 

Some small companies opt for self-funded plans, but these are riskier for small businesses. With self-funding, the company directly pays for employees’ medical costs instead of buying an insurance policy. While self-funding may offer an opportunity for both reduced expenses and better cash flow, the exposure to catastrophic claims precludes many companies from adopting this method.

Finally, Associate Health Plans (AHPs) are also slightly risky but may offer an opportunity for savings. With this approach, several smaller businesses from the same industry or region band together to purchase large health insurance from an insurance provider.

How Much Do Employers Pay for Health Insurance?

Employers in Vermont contribute an average of 77 percent of the cost of health insurance for each worker. That equals an annual payment of over $6000 per employee..

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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