Small Business Health Insurance - An Employer's Guide to Getting Small Business Health Insurance

Saving on your small business health insurance canthe potential for a small number of doctor's visits
be a challenge. But there are ways to overcometo cost thousands, these plans can become
the financial obstacles and get the coverageincredibly expensive.
necessary for your business. There are twoFlexible Spending Account (FSA)
major benefits of employer-based coverage. FirstA flexible spending account is a savings account
these plans, although expensive, usually carry theto be used for medical expenses, and is funded
best all around protection for you and yourby pre-tax dollars. Using pre-tax dollars means
employees. Second, providing benefits plays a keythat your employees will actually show that they
role in attracting and retaining quality employees.have less income, and will therefore have less
Why is coverage for small businesses so muchtaxes withheld. As an employer, you set the limit
more than for large corporations?on contributions to the account per year. In
Health insurance for small businesses cost soaddition to the employee contribution, you can
much because of the high quality coveragealso credit the account, or fund it completely
concentrated among a small group of people.from your general assets.
Every individual within the group represents aAn FSA, especially if combined with an HDHP, can
different level of financial risk to an insurancesignificantly reduce the costs of small business
company, and this risk is added up and spread outhealth insurance.
among the group. Large corporations payYou should be forewarned, money from FSA
considerably less because the risk is spread toaccounts cannot be rolled over. They are,
such a large group, where small business ownershowever, available to use for two years and two
can see unreasonably high increases in premiumsand half months after the benefit year. A
due to one or two members. Small businessesterminated employee won't be able to use
also have to insure their employees under stateleftover funds, unless there is a positive remaining
mandates, which can require the policies to coverbalance and COBRA is elected.
some specific health conditions and treatments.Small business health insurance providers have
Large corporations' policies are under federal law,made significant improvements in their services to
usually self-insured, and with fewer mandatedsimplify the administration of your plan. With
benefits. The Erisa Act of 1974 officiallyHRAs, FSAs, and HSAs, your employees can use
exempted self-funded insurance policies fromdebit cards for medical transactions. Be sure to
state mandates, lessening the financial burdens ofresearch this thoroughly. You will want to be sure
larger firms.your debit card plan is IRS compliant, and that
Isn't the Health Care Reform Bill going to fix this?you can use a large number of pharmacies. You
This remains to be seen. There will be benefitsshould also pick a plan that can verify eligibility on
for small business owners in the form ofthe spot. Talk with your agent about linking
insurance exchanges, pools, tax credits, subsidiestransit, parking fees, and prescriptions to the
etc. But you can't rely on a bill that is still in thesame card. When picking the debit card options,
works, and you can't wait for a bill where theplease be sure to clarify the details of the
policies set forth won't take effect until aboutsubstantion process. This is IMPORTANT! With
2013. Additionally, the bill will help you with costs,other plans, the provider may assign someone to
but still won't prevent those costs from continuallymanage your plan. Or you may have to hire
rising. You, as a business owner, will need to besomeone. Still, you should be able to login to your
fully aware of what you can do to maintain youraccount and print insurance cards, important
bottom line.papers etc.
What can I do?The next thing you can do is thoroughly assess
First you need to understand the plan options outyour needs. Being that every member of your
there. So here they are.small business plays a key role in its success, it is
PPOvital that their needs are met. And understanding
A preferred provider option (PPO) is a plan wherethese needs is crucial to finding the right plan. Find
your insurance provider uses a network ofout about chronic illnesses, and additional
doctors and specialists. Whoever provides yourinformation related to past health issues. Know
care will file the claim with your insurancewhat your employees think about health
provider, and you pay the co-pay.insurance, and get them involved in the process.
Who am I allowed to visit?Hiring an agent or a broker
Your provider will cover any visit to a doctor orFinding and understanding small business health
specialist within their network. Any care you seekinsurance can be a daunting task. While some
outside the network will not be covered. Unlike anchoose to go it alone, others need some
HMO, you don't have to get your chosen doctorprofessional assistance. You need to understand
registered or approved by your PPO provider. Tothe difference between an agent and a broker,
find out which doctors are in your network,and how you can get the most from either of
simply ask your doctor's office or visit yourthem.
insurance company's website.A broker
Where Can I Get it?Brokers function independently and usually work
Most providers offer it as an option in your plan.for several different companies. Since they have
Your employees will have the option to get ita variety of resources, they can usually provide
when they sign their employment paperwork.more options and a better overall view of the
They generally decide on their elections during themarketplace. Brokers will assist you by evaluating
open enrollment period, because altering the planthe costs and designs of plans from your local
after this time period won't be easy.major carriers. The cost isn't everything, you
And Finally, What Does It Cover?want to get the coverage that you need.
Any basic office visit, within the network that is,Ask the broker how he or she is getting paid for
will be covered under the PPO insurance. Theretheir services. They should readily divulge that
will be the standard co-pay, and dependent uponinformation. Some brokers may charge you a flat
your particular plan, other types of care may befree. Some receive a fee from an employer,
covered. The reimbursement for emergencywhile others receive a commission from the
room visits generally range from sixty to seventyinsurance provider. Any commissions could be
percent of the total costs. And if it is necessaryreflected in your premiums, but not to the point
for you to be hospitalized, there could be athat you should worry.
change in the reimbursement. Visits to specialistsAn agent
will be covered, but you will need a referral fromAgents typically provide services for one
your doctor, and the specialist must be within thecompany. They have a closer relationship to the
network.insurance company than a broker would, giving
A PPO is an expensive, yet flexible option forthem more leverage to make alterations to your
your small business health insurance. It providesplan. In some cases they can offer a particular
great coverage though, and you should inquireplan for less than a broker, and may have access
with your provider to find out how you canto additional services like worker's compensation.
reduce the costs.To find out what different providers have to
HMO (Health Maintenance Organization)offer, talk to more than one agent. It may be
Health Maintenance Organizations (HMOs) are thetime-consuming, but it could bring you closer to
most popular small business health insurance plans.the most cost-effective solution for your small
Under an HMO plan you will have to register yourbusiness health insurance.
primary care physician, as well as any referredOne of the common options presented by agents
specialists and physicians. Plan participants are freeis the employee-elect option. This is an
to choose specialists and medical groups as longarrangement where employees pick the plan they
as they are covered under the plan. And becauseprefer. Those who don't need as much coverage
HMOs are geographically driven, the options maywon't be forced to pay so much, and those who
be limited outside of a specific area.do need it can get it without increasing the
Health maintenance organizations help to containfinancial burden of the company as a whole.
employer's costs by using a wide variety ofHow to Save On Your Small Business Health
prevention methods like wellness programs, nurseInsurance Plan
hotlines, physicals, and baby-care to name a few.What's important to remember is that there really
Placing a heavy emphasis on prevention cutsis no inexpensive solution to health care. Even if
costs by stopping unnecessary visits and medicalyour initial premiums are reasonably low, they
procedures.could rise significantly at your next renewal. So
When someone does fall ill, however, thesaving money on small business health insurance is
insurance provider manages care by working withabout doing a combination of things simultaneously
health care providers to figure out whatto get good rates, and to then maintain those
procedures are necessary. Usually a patient will berates.. And it will require a consistent effort from
required to have pre-certification for surgicalyou, your employees, and your insurance
procedures that aren't considered essential, orprovider.
that may be harmful.First, you can save yourself money by reading
HMOs are less expensive than PPOs, and thisthe fine print. You need to know exactly what
preventative approach to health care theoreticallyyour plan does and DOESN'T cover. There are
does keep costs down. The downside, however,also state mandated coverages. For example, in
is that employees may not pursue help when it isstates like Illinois, your insurance must cover
needed for fear of denial. That aside, it is amammograms. Also, understanding the ins and
popular and affordable plan for your small businessouts of your plan will give you and your
health insurance.employees a better idea of how to deal with your
POS (Point of Service)insurance.
A Point of Service plan is a managed careNext, you should shave unnecessary benefits.
insurance similar to both an HMO and a PPO. POSAfter reading all about your plan, you will find
plans require members to pick a primary healthcoverage for things you may not need. Eliminating
care provider. In order to get reimbursed forthese benefits can significantly drop monthly small
out-of-network visits, you will need to have abusiness health insurance premiums. For example,
referral from the primary provider. If you don't,eliminating coverage for brand name medications
however, your reimbursement for the visit couldcan reduce costs by more than 25 percent.
be substantially less. Out-of-network visits will alsoWellness program have worked wonders for small
require you to handle the paperwork, meaningbusinesses. A wellness program is any program
submit the claim to the insurance provider.designed to promote healthy living within the
POSs provide more freedom and flexibility thanorganization. Weight loss competitions benefit
HMOs. But this increased freedom results in higherevery participant. Add a financial incentive for
premiums. Also, this type of plan can put a strainfurther motivation. Stock the work fridge with
on employee finances when non-network visitswater, and leave literature about healthy living
start to pile up. Assess your needs and weigh alllying around. Search the internet for calorie
your options before making a decision.counting charts. Raising awareness entice workers
EPOto make positive changes. Active, exercising,
An Exclusive Provider Organization Plan is anotherdiet-conscious employees have stronger immune
network-based managed care plan. Members ofsystems, more vitality, and more productive
this plan must choose from a health care providerworkplaces. They also don't deal with as many
within the network, but exceptions can be madehealth issues. Fewer doctor visits and
due to medical emergencies. Like HMOs, EPOshospitilizations will help maintain lower annual
focus on preventative care and healthy living. Andpremiums, because it will prove to your insurance
price wise, they fall between HMOs and PPOs.provider that your business is a low financial risk.
The differences between an EPO and the otherIncreasing your co-pay and deductible can go a
two organization plans are small, but important.long way towards cutting costs. For instance,
While certain HMO and PPO plans offerraising co-pays by just ten dollars has saved
reimbursement for out-of-network usage, an EPOcompanies as much as thirteen percent on their
does not allow its members to file a claim forpremiums. A higher deductible will significantly
doctor visits out its network. EPO plans are morereduce your monthly premium. To lessen the
restrictive in this respect, but are also able tofinancial burden of high-deductible health plans
negotiate lower fees by guaranteeing health care(HDHPs), combine them with an HSA.
providers that it's members will use in-networkCombinations like these have saved both business
doctors. These plans are also negotiated on aowners and employees bundles of cash.
fee-for-services basis, whereas HMOs are on aCheck into getting a nurse hotline. A nurse hotline
per-person basis.is a toll free, 24-hour-a-day, seven-day-a-week
HSA (Health Savings Account)service. Employees can get medical advice from
An HSA is a tax-advantaged account used to payqualified, registered nurses. This method has
existing and future medical expenses. HSAs aredeterred a large number of people from
used in conjunction with high-deductible healthemergency visits, and it can also be used for
plans (HDHP), which will make some withpreventative care as well. Insurers like Nationwide
pre-existing conditions ineligible. Also, HSAs musthave them, or you may have to purchase from a
be funded with cash. Communicating the terms ofthird-party provider.
this account to your employees is important, as aIncrease the size of your group to reduce your
large number of HSAs are underfunded ormonthly small business health insurance premiums.
improperly funded. The health savings accountsIn a survey by America's Health Insurance Plans,
were signed into the law by George Bush in 2003,small businesses who employed ten people or less
and have become an affordable alternative to apaid forty three more dollars on average than
group health plan.businesses with twenty six to fifty employees.
When inquiring about an HSA, there will be a fewCheck around with other businesses owners, or
things you will want to clarify. While HSAsfellow members of business organizations. Some
generally cover routine medical expenses andstates also have small business groups and pools
copays, some can provide dental and vision carefor this purpose. Check with your state Chamber
as well. And since HSAs can be combined withof Commerce and Department of Insurance.
certain compatible plans, it is important toBeware of heavily discounted plans. First, there
understand how money from the account will beare numerous scammers trying to get your
allocated. And finally, you will want to know aboutmoney. They promise low rates, and usually
cashing out your HSA balance. The amount iscover little to nothing at all. The internet is
taxable and could be subject to a ten percentnotorious for swindlers trying to hustle you out of
excise tax.a buck. If you are going with a company you
HRA (Health Reimbursement Arrangement)aren't familiar with, please do your research. On
An HRA is exactly what it sounds like. Theanother note, even reputable companies present
employer reimburses the employee for healthproblems. In an attempt to gain market share,
care. As an employer, you will usually have theBlue Cross offered small businesses discounted
option to contribute to a reimbursement fund, orrates in 2008. For 2009, some of these same
to pay fees as they are incurred. Thesebusinesses were set to see increases of as much
reimbursements can be deducted from youras 47% in their premiums. As the costs of
taxes, and are tax-free for your employees,medical care increases, the costs are shifted from
saving you both money.the insurer to the insured, and discount plans
Some providers empower employers by givingbecome overpriced plans quickly.
them more options. HRAs, unlike HSAs, don'tShop around. As mentioned before, talking to
have to be funded with cash money, placing adifferent agents will expose you to the best that
book keeping entry on your balance sheet isinsurance providers have to offer. Ask other small
enough. You can usually control aspects of yourbusiness owners about their providers. You can
arrangement such as reimbursement limits,use trusted online resources like Netquote and
whether you or your employee pays first, and ifEhealthinsurance to shop around instantly. These
the previous year's funds roll over.services also let you compare plans side by side,
HRAs are becoming a more popular optionand allow you to purchase your plan online. Even
because of the control it has given smallafter you get your initial plan, it's good to annually
businesses. Combined with a high deductible healthreevaluate your coverage. This will keep you on
plan (HDHP), an HRA could be the mostthe up-and-up about what the market is offering.
cost-effective solution to your small businessKeeping costs down is an ongoing effort,
health insurance problems. It's always best toespecially with rates and plans changing all the
compare these plans to PPOs, HMOs, and EPOs totime from company to company.
know what works best.Share some of the costs with your employees.
Fee for Service (FFS) or Traditional IndemnityRaising employee contributions isn't a popular
A fee for service plan is the most flexible smalloption, but it may be one of the only ways to
business health insurance option. You choose yourabsorb costs and maintain small business health
doctor, and your hospital. You can see a specialistinsurance coverage. Communicate with your
without a referral. This flexibility, however, comesemployees about how to keep costs down, and
with more out-of-pocket expenses and higherremind them that their increase is your increase
insurance premiums.as well.
The typical FFS plan has a deductible rangingThe sad truth is that, no matter how many
anywhere from five to fifteen hundred dollars.cost-cutting methods you apply, your insurance
After this amount is reached, the provider will pickpremiums are expected to continually rise. In
up eighty percent of your medical bills, and requireaddition to this, you can't prevent every health
you to pay the remaining twenty percent.problem with exercise and higher co-pays.
Because of the rising costs of health care, and