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Are You a Small Business Owner?

Choosing a Group Health Plan for Yourself and Your Employees Can Be Difficult

Pfeifer Insurance Brokers Can Help

Are you obligated to provided health insurance to your employees? If you own a small business, you already realize that you are not obligated to provide health insurance for your employees or their dependents. The cut-off under the Affordable Care Act (the ACA, commonly called ObamaCare) is 100 employees -- if you employ 100 or more "full time equivalents" (generally employees who work more than 30 hours per week on average) you are required to offer eligible health insurance coverage to your employees, and if your company is smaller - less than 100 employees - you are not.

What are the advantages of providing health insurance? But even without a legal obligation, there are several reasons why a small business owner might  want to provide health insurance for employees and perhaps for their dependents. First, providing group coverage for employees may be a cost effective way of providing health insurance for the owner and his or her family. Of course, an owner could choose not to obtain employee coverage and purchase insurance for himself and his family in the individual insurance market. However, a group policy will typically have lower premiums (for otherwise comparable coverage) and there may be tax advantages to the group policy as premiums are generally treated as deductible. Second, employers are often able to hire better employees when they offer health insurance, and are in a better position to retain them. Third, a healthier work force is often a more productive work force. And finally, many employers simply feel better about themselves and their businesses when they provide health insurance and the peace of mind that goes with it to their employees.

What factors do you need to consider? There are a number of factors to consider in selecting an insurance program and carrier. Among them are:

          Health benefits and care. What sort of health requirements do you and your employees have? Is it a younger work force? Older? Generally healthy? Are you primarily interested in protecting against catastrophic costs as a result of serious illness or in covering recurring and regular expenses? Will you and your employees be better served by a PPO or an HMO program?

          Costs. How much are you and you employees willing to pay in premiums, deductibles, copays, and coinsurance (the portion of medical expenses not covered by the insurer)? Obviously, the general rule is that the higher the premium the greater the coverage provided by the insurance policy. But how do you balance cost against coverage? How do you assess the premium, deductibility, copay and coinsurance costs of a given policy against its coverage?

          Brands and Industry Ratings.  You may have an interest particular insurance carriers and their reputations in the market. You may also have questions about the financial capacity of certain insurers to meet coverage obligations. How do you assess those concerns?

          Dependent Coverage. Should you offer coverage to the dependents of your employees, and if so, what additional costs and administrative burdens will be involved?

          Coverage Add-ons. What about additional coverages such as dental and vision care? Should you allow employees the option of including such coverages? Is that possible in all cases or only with certain insurance carriers and programs?

          Employer Contribution. What percentage of the premium costs should you as the employer be willing to bear? What are your options? Is there a minimum employer contribution that is required by law? How can you best manage your long and short term health care budget?

          Covered California and The Private Market. The group policy market in California for small businesses has been radically changed in the last three years by the introduction of the Affordable Care Act and of Covered California's Small Business Health Options Program (SHOP). Pfeifer Insurance Brokers is a an authorized agent for Covered California, the state authorized health insurance exchange in California, and are completely familiar with its programs and policies. However, as an independent agent we are also able to access private insurers operating outside of SHOP.

These are all critical questions. The answers require an understanding both of your business and of the health care market. Pfeifer Insurance Brokers is willing to spend the time with you to come to an appropriate understanding of your business's capabilities and desires where health insurance is concerned. We will help you answer the preceding questions and others that you may have in a way that takes your specific requirements and situation into account. And we know the health insurance market place and in most cases will be able to obtain multiple quotes on group policies that satisfy your requirements. We will assist you with helpful comparisons of various plan rates and benefits. As a licensed agent operating independently of the insurers, we can offer unbiased and experienced advice. And when you have chosen a program, we can help you with the application and enrollment processes. We have done it for others, let us do it for you.

Alex Pfeifer
Pfeifer Insurance Brokers
650 762-8070

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