All About Open Enrollment: Qualified Health Plan Checklist

Before you apply for a Qualified Health Plan (QHP), you should gather the necessary information to make your application process go more smoothly. Gather these things before open enrollment to make your application experience quicker and easier! Keep in mind that if you are applying for a QHP, but not subsidies, you may not need all of this information on hand during open enrollment. However it’s a good idea to make sure you have all of this information if you do end up qualifying for cost saving subsidies.

Basic household information

When you apply for a QHP during open enrollment you will be asked for basic information, such as your name and date of birth. You should know this information for yourself and each person in your household, even if they are not applying for coverage.

Your household typically includes your tax filers and dependents. However, there are exceptions, sometimes the marketplace may include people you live with who aren’t in your tax household.

You can expect to include the following people on your application in addition to yourself:

  • Your spouse
  • Your children – even if they file a tax return
  • Anyone you include on your tax return as a dependent, even if they don’t live with you (a common example of this is an adult child)
  • Anyone else under 21 that you take care of
  • Your unmarried partner if they are your dependent for tax purposes or if they are the parent of your child.

Addresses

Your address is very important to determine what QHP you are eligible for, so make sure that you have your home address – and your mailing address if it is different – on hand as open enrollment approaches.

If anyone on your application has a different address, you may need to provide that information as well.

Social Security Numbers

When applying for a QHP, you will be asked to supply a Social Security Number (SSN) for everyone on your application. Make sure that you have each person on your applications 9-digit SSN available before you being applying.

If you choose to not supply an SSN on your application during open enrollment, you will be asked to supply more information at a later time.

Keep in mind that your SSN will only be used to determine your eligibility for a QHP.

Immigration documents

You will only need to supply immigration information if you are applying for health insurance as a lawfully present immigrant.

If you or anyone on your application is a lawfully present immigrant you will need to supply immigration document information to qualify for a QHP during the open enrollment period.

Tax information

Before you apply for a Qualified Health Plan, you will need to have both tax and income information readily available. Firstly, you will need to know how you file taxes. If you are married, you will need to let the Marketplace or broker know if you are filing separately or jointly. You will also be asked about who you claim as a dependent.

Employer and income information

You will also be asked about income and expenses. You will need to have income, expense, and deduction information for yourself and everyone in your household – even those who are not applying for insurance.

You will need to know the following income information for both yourself and everyone else in your household:

  • Wages and salaries, as reported on W-2 forms and pay stubs
  • Tips
  • Net income from any self-employment
  • Unemployment compensation
  • Social Security payment – including disability payments but not Supplemental Security Income (SSI)
  • Rental Income
  • All other taxable income

You will have to supply the best estimate of your household income for the year for which you are applying for coverage. Keep in mind that this will be an estimate you make during open enrollment for the following year.

This estimate is typically what is used to determine if you qualify for Affordable Care Act (ACA) subsidies. These subsidies help those who typically have a yearly income between 100% and 400% of the Federal Poverty Line (FPL) afford the monthly premiums – and in some cases out-of-pocket costs – of your QHP.

Changes to income

If you experience a change in income that differs from the estimate you reported during open enrollment, make sure to report that to your marketplace as soon as possible. If you experience a drop in income, you may end up qualifying for subsidies even if you previously did not qualify.

However, if you experience an increase in income you may no longer qualify for subsidies. If you do not report this change in income, you may end up having to pay back the subsidies for the months you no longer qualified during tax season.

Make sure to report any changes in your income that differ from what you reported during open enrollment so that you don’t miss out on savings you may qualify for or so you don’t end up with an unexpectedly large tax bill at the end of the coverage year.

If you have more questions about subsidies, read our article that answers ACA Subsidy FAQs!

A note on data matching issues

During open Enrollment, after completing your application to enroll in a QHP you may be asked to submit documents to verify your information – such as your income or citizen status. This is sometimes called a data matching issue or inconsistency. To resolve this issue and enroll in a QHP, you must submit copies of certain documents.

A data matching issue is when there is some sort of difference between the information that you put on your health insurance application and the information received available from other resources.

These issues may relate to your annual income, citizenship or immigration status. You will receive a notice about a data matching issue; once you receive the notice, you’ll have to verify the information by sending certain documents by a due date. If you do not meet the deadline, you could lose your health insurance or savings.

The kind of documents you need to submit to resolve a data matching issue, depend on what kind of data matching issue you have.

Common things insurers need to verify are:

  • Yearly income estimate
  • Immigration status
  • Citizenship
  • Adoption, foster care placement, or court order

If you expect that there may be a data matching issue concerning any of these or other pieces of information, it may be a good idea to gather documents that can resolve the issue before the open enrollment period.

Common documents that may resolve a yearly income estimate data matching issues are

  • A 1040 federal or state tax return
  • A W-2 or 1099
  • A Pay Stub
  • Or self-employment ledger documentation

Keep in mind that all of these documents must contain your first and last name as well as other important information such as income amount, frequency of pay, or net income.

Common documents that may confirm your immigration status are

  • A Permanent Resident Card – also known as a “green card”
  • A Reentry permit
  • A Refugee Travel Document
  • Or a machine readable Immigrant Visa

Common documents that may confirm your U.S. citizenship status are

  • A U.S. passport
  • A Certificate of Naturalization
  • A Certificate of Citizenship
  • Or a State-Issued enhanced driver’s license

Common documents that may confirm an adoption, foster care placement, or court order are

  • An adoption letter or record
  • Foster care papers
  • Or another court order

Make sure that if you are asked to submit documents to resolve a data matching issue that you do not send in the original document.

You can visit healthcare.gov for more information on how to resolve data matching issues.

What You Need to Know About the Changes to California Health Insurance

There are two major changes coming to California health insurance in 2020:

  • there will be a new state subsidy program that is expected to help 235,000 Californians who previously did not qualify for federal assistance
  • the individual mandate tax penalty will be reinstated which means Californians who choose not to buy qualified health insurance, will face a penalty of either $695 per adult ($347.50 per child) or 2.5% of their annual income

The restoration of the individual mandate

While the individual mandate penalty is no more at the federal level, California lawmakers have chosen to enact legislation to restore the individual mandate penalty in 2020. The penalty was nixed out by the Tax Cuts and Jobs Act of 2017, which gave way to higher premiums in 2019.

California is joining 4 other states – Massachusetts, New Jersey, Vermont, and Washington, D.C. – that have put state individual mandate laws into place.

According to Covered California, restoring the individual mandate for California is a factor in driving premiums to be, on average, 3.2% lower for the upcoming year. Additionally, Covered California estimates that this will lead to Californians saving an average of $167 per year on their premiums during the 2020 coverage year.

However, customers who can afford health insurance but choose not to purchase coverage may be subjected to a tax penalty, which will be a part of their annual state tax filing. The penalty could be 2.5 percent of household income or $696 per adult (this number will rise every year with inflation), whichever amount is larger.

The money raise from the penalties – which is expected to be about $1 billion over the next three years – will be used to fund the new subsidy program that state is putting into place in 2020.

The new subsidy program

In 2020, there will be a new state subsidy program that will help lower the cost of health insurance for low and middle-income Californians.

Previously, those who made above 400% of the federal poverty line (FPL) were not eligible for premium tax credits. In 2020, those who make between 400 to 600% of the FPL will newly be eligible for subsidies. This means that a family of four with an annual income of around $150,000 per year will be eligible for subsidies.

This program is meant to limit how much a Californian will pay for their health insurance premium as a percentage of their income, according to Covered California. For example, older individuals living in areas with high health care costs could receive large amounts of financial help.

How can I avoid the tax penalty?

In order to avoid the tax penalty, you must have the minimum essential coverage. If you go without health insurance during the upcoming coverage year – even if it’s only for a few months and not the full year – you may be subject to the tax penalty.

The best way to avoid this penalty is to purchase health insurance during the open enrollment period for the 2020 coverage year – which for California runs from October 15th 2018 through January 15th, 2020. Start shopping for individual or family coverage on eHealth.com!

How do I know if I qualify for a subsidy?

Typically, you will qualify for a subsidy in California if you make between 100% and 600% of the FPL. If you make less than 100% of the FPL, you may qualify for Medi-Cal. If you make more than 600% of the FPL you may not be eligible for government subsidies to help pay for your health insurance.

In order to find out if you qualify for subsidies under the new California subsidy program, you can use eHealth’s subsidy calculator while shopping for health insurance.

Subsidies are based off of the estimated amount of income that you expect to make in the upcoming coverage year.

Keep in mind that you should report changes in income throughout the year. This way if you’ve received a subsidy and experience an increase in income that disqualifies you for that subsidy, you will not have to pay that amount back at the end of the year. Additionally, if you believe that you experienced a change in income that could make you qualified for a subsidy, make sure to report it so that you don’t miss out on savings.

Health Insurance Options for Students

Going to college is stressful enough without worrying about the costs of healthcare services. One thing that is often overlooked when going back to school is a student’s health insurance.

While you’re away at college you may get sick, injured, or need some sort of health care service. If you go without health insurance coverage – or coverage that is available in your area – you could end up having to pay steep medical bills.

However, as a student you have several options for health insurance regardless of what your income is, where you’re going to school, and how old you are.

Stay on your parent’s insurance

If you are under the age of 26, you are able to stay on your parent’s health insurance plan. Thanks to provisions in the Affordable Care Act (ACA), adult children are able to stay on their parent’s health insurance plan until they turn 26.

This is a great option if you are going to college in your parent’s home state as your health insurance plan is more likely to cover providers in your area than if you were going out of state for school.

However, if you do choose to go out of state for school your plan may not cover providers in the area where you will be going to school. According to Cheryl Fish-Parcham of Families USA, some insurance companies may have affiliated networks in other states, but you will need to check with your particular plan.

If you choose to remain on your parent’s health insurance while you are in school, you may want to schedule preventative health care services while you are home on summer vacation or other times you visit home in order to receive in-network care. This solution to student health insurance may not be the right one for you if you live very far away from your parents and their health care network.

Staying on your parent’s plan may force you to make difficult choices as a student. For instance, if you cannot receive in-network care near your university and end up needing long-term care for a more serious illness or injury, you may end up paying large medical bills or be forced to take time off of school to receive affordable care near home.

Sign up for student health insurance at your university

There are many college that off their own student health insurance plans. These colleges either work with an insurance company or plans may be self-insured by the school.

A lot of times the cost of these plans is grouped in with your tuition, which can be helpful because you can use student loans to help pay for your health insurance premiums.

These plans may appeal to you if you’re going to school outside of the coverage range of your parent’s health insurance, or if you are over the age of 26.

It is a good idea to make sure that these plans cover the services you need. These student health insurance plans provided by your school may be more limited than other individual health insurance plans. For instance, some school health insurance plans will not pay for services to treat injuries to a student who got hut while intoxicated according to Bankrate.com.

However, there are some universities that automatically enroll their students in their health insurance plans. If you are insured through your parents, your own health plan, or in another way you will want to make sure you opt out of this coverage, so you’re not paying to be on two different plans at the same time.

In some cases in order to opt out of health insurance coverage, you may have to show evidence that you have equal or better health insurance coverage through another insurance company or program.

Purchase a marketplace health insurance plan

If you are over 26, moving outside of your parent’s plan’s coverage area, or if your school does not offer a health insurance plan, or does not offer a plan that meets your needs, you may want to purchase your own student health insurance.

You can purchase an individual health insurance plan during the open enrollment period, which typically runs from November 1st through December 15th, or you may qualify for a special enrollment period so that you may enroll during anytime of the year.

A special enrollment period is triggered by a qualifying life event. Turing 26 and moving out of your coverage area to go to school are both examples of a qualifying life event that will trigger a special enrollment period. Keep in mind that you will need to provide proof that you have experienced one of these qualifying life events in order to enroll. These special enrollment periods typically last 60 days and allow you to shop and apply for coverage.

Qualifying Life Events for Obamacare

You can apply for health insurance during a special enrollment period through your state or federal marketplace, or through an online broker such as eHealth.

Additionally, your estimated income for the year will determine how much you will pay for your health insurance coverage. So long as you are enrolled in the lowest-priced bronze plan available in your area, you will be eligible for ACA subsidies that will help you afford your monthly premiums.

Typically you will be eligible for subsidies if your income falls between 100% and 400% of the federal poverty line (FPL). This is helpful for students who are only able to work part-time, if at all, while they are getting their education.

Purchase catastrophic coverage

Catastrophic coverage is available to Americans under 30-years-old who are in generally good health. These plans come with lower premiums but tend to have higher deductibles.

These plans will help cover preventative care visits at little to no charge, you are likely to have an extremely large deductible – typically of more than $6,000.

These plans are helpful for those who are looking to save money, have some health insurance for worst case scenarios, and save on preventative care visits.

However, it is recommended that you compare catastrophic coverage with lower priced Marketplace health insurance plans available in your area. Unlike Marketplace plans, you will not be able to qualify for subsidies to help pay for the costs of catastrophic plans.

Make sure to compare catastrophic plans with marketplace plans with more comprehensive coverage to make sure you get the coverage that you need at an affordable cost.

 Apply for Medicaid

You also have the option as a student to apply for Medicaid, and use that as a form of “student health insurance”. This option may appeal to those who are 26 or older, don’t receive coverage through their parents, or moving outside of their coverage area.

Additionally, this may be the best option for comprehensive health insurance if you are unable to work while receiving your education.

5 Ways to Make the Most of your Group Health Benefits

Being able to offer your employees health insurance is a big deal and comes with a lot of benefits – for you and your staff. Here are 5 ways you can get the most out of your group health plan.

1. Use it as a recruiting tactic

When recruiting new talent, play up the fact that you offer health insurance. This will help you stand out among other small business who might not provide it. According to the Bureau of Labor Statistics, only 55 percent of private industry employees in small businesses with less than 100 employees were offered medical care employee benefits.

2. Use it as a retention tool

An existing employee might take employee-sponsored health insurance for granted. Once a year, it’s a good idea to put together a compensation package for your employees to remind them of the added benefits you offer. Putting a dollar amount to some of the intangible benefits (health insurance, paid holiday leave, 401k matching, etc.) can help with retention.

3. Capitalize on the tax benefits

Another advantage of providing small business health insurance are the tax benefits to the employer that come with a group plan.

There are several ways that a group health plan can result in tax advantages for your business:

  • Generally, employers can deduct 100 percent of the cost of monthly premiums they pay on qualifying group health plans from their federal business taxes.
  • Offering health insurance coverage to workers as part of their compensation package could also potentially mean that a business may benefit from reduced payroll taxes.
  • Employers can usually deduct HSA contributions from their small business taxes.
  • While group plans already tend to be more affordable than individual plans, the tax advantages from offering small business health insurance can further help your company in providing this highly valued and sought-after employee benefit.

4. Boost coverage by adding dental and vision plans to the package

By offering dental and vision coverage, you can add choices to the benefits table without a corresponding increase in your expense. How? Employees often pay the full cost of voluntary benefits but enjoy the advantage of group rates for the benefits when offered through their workplace.

5. Remind employees to use their benefits

Want a healthier workplace? Remind your employees to use the covered services under their group health plan. Most plans include annual physicals, screenings for women’s health, and flu shots (just to name a few). Encourage your staff to take advantage of these benefits by sending friendly reminders periodically throughout the year.

5 Common Myths about Supplemental Health Insurance

We’re always being told we need major medical health insurance. It covers doctor’s visits, prescriptions and hospital stays. But, what about insurance for oral and vision health? Our teeth and eyes are critical to our overall health, so why does this type of coverage go overlooked so often? There are a lot of myths out there that devalue ancillary insurance, but we’re here to prove them wrong.

1. It’s expensive.

Typically, ancillary health coverage, like dental and vision insurance, come with very affordable price tags. eHealth offers dental plans that start at $8.95* a month.

2. The coverage is limited.

Ancillary plans are great for preventative care and basic coverage. Most dental plans cover some or all of the costs of oral exams, cleanings, fillings and x-rays. Vision insurance tends to cover annual eye exams and usually covers some or all of the costs for lenses, frames and Lasik.

3. There’s no coverage for major procedures.

Ancillary plans usually pay a certain percentage for major procedures and surgeries. You likely won’t have to foot the entire bill for major work like crowns and root canals. Every plan differs, so it’s important to choose a plan that gives you enough coverage for higher-cost services.

4. It doesn’t save you money.

When you use your covered services, you’re likely to detect problems early. That means you’ll be able to avoid more costly procedures. Studies show that for each dollar spent on preventive services, it is estimated that $50 or more is saved on more expensive procedures.

5. It’s not as important as medical insurance

Wrong! Protecting your oral and eye health is critical to overall health. According to the mayo clinic, oral health problems can lead to serious health conditions, such as cardiovascular disease and pneumonia. Your mouth, and your eyes, are entry points to your internal system, so it’s critical to keep them healthy or you’ll put the rest of your body at risk!

To learn more about ancillary insurance options for you, visit eHealth.com. You can see covered benefits, get quotes and enroll online.

*Rates are illustrative only and vary based on individual circumstances.

How to Meal Prep When Life Gets Busy

As we move into fall, one thing is certain – our schedules are about to get even busier. Whether that’s because summer vacationing is coming to an end, school is back in session, or work is ramping up for the end of the year, it can be tough to find time to plan and prep meals for the week.

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One reason so many people are drawn to meal prepping is because of the direct link to a healthy diet. Prepping gives us the ability to control portions and know what we’re eating each day. However, meal prepping can take a few hours of shopping, cooking, organizing, and cleaning up — time which might not be available on the weekend when we’re busy getting all the other errands done.

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That’s why we’ve compiled some of the best tips to meal prep without the hassle.

1. Plan your schedule and shopping list in advance.

Spending 15 minutes sketching out your ideas for the week can save you an hour roaming around the grocery store deciding what to buy. Decide in advance what days you plan on prepping (most recommend 3-5 day increments), and what meals you’ll want to tackle. Once you have everything sorted, we recommend making a clickable shopping list in your phone, or an old-fashioned paper list, so you can check off as you go.

2. Get creative when cooking in batches.

Playing around with your cooking utensils is a great way to save time when meal prepping. An example would be using a muffin tin to hard boil eggs; this allows you to make 2-3 times the number of eggs over using a pot. You can also use a muffin tin to freeze mixtures like morning smoothie cups or bake breakfast frittatas. Also, feel free to play around with combinations; if you have various items that all cook at the same temperature, toss them in the pan together and take out each part as the time finishes.

3. Assemble meals in one container.

One of the most over-whelming parts of meal prepping is storage. It always feels like you need to use dozens of different sized containers, which means dozens of dishes at the end of the day. Instead of spreading out your meal in separate jars, combine what you can. An example would be assembled your yogurt, fruit, and granola into one jar – or your salad with the dressing at the bottom of the container.

4. Utilize your freezer space.

It’s never fun to watch food go bad before you’re able to eat it. However, going to the store for meal prepping every week can take time and energy. Instead, go for meals that can be assembled in one bag and frozen for more extended periods. There are lots of options online for freezer prep recipes, but some popular ones are marinated meats and seasoned veggies.

5. Start a ‘Slow Cook Sunday’ Routine.

What better way to cook your freezer prepped meals than not to have to cook them at all. Take back that extra time on Sundays (or whatever day your “Sunday” might be) and toss the frozen ingredients into a slow cooker. Chicken soup, pulled pork, teriyaki tofu are all great recipes to get you started!

Is a Recession Coming? 7 Ways to Prepare Your Business

It’s hard to escape the rumblings of an upcoming recession. Fear around the yield-curve inversion, a standard tool used to predict recessions, is at an all-time high. However, many experts disagree with the current state of concern.

One factor that plays a significant role in economic growth is consumer spending, which is continuing to hold up well. Unemployment is at a near 50-year low, and wages are growing strong. All of which are signs that point to a more positive outlook than the one you might be seeing across news headlines.

Regardless, as a small business, it’s crucial to build an action plan that can react to economic changes. As Warren Buffet said, “Someone is sitting in the shade today because someone planted a tree a long time ago.” Whether or not a recession is headed our way in 2020, it’s always a good time to get prepared.

1. Focus on your competitive advantage

This isn’t to say that you should move away from diversifying your business – in fact, it can help to broaden your offerings and decrease risk.

However, during tough times, it’s good to re-focus on your core offerings. Breaking into new markets, even during a growth economy, can be risky and requires a strong focus on research and development. By putting the majority of your time and energy into core offerings, you’ll remain the best at what you already do well and maintain customer and client loyalty along the way.

2. Add new skills to your tool set

In tandem with staying competitive and highly skilled, it’s important to continue personal growth during a recession. Learning new strategies or tools that your competitors are using will allow you not just to maintain a client base but continue to expand it. Also, with all of the free affordable training tools online, such as Udemy and YouTube, it’s easier than ever to pick up new talent in your spare time.

3. Utilize technology

And what better skill to learn than a new technology that can improve everyday projects. Lots of software online is offered at little-to-no-cost and can increase the efficiency of old methods. A few examples of this is Canva, a free graphic design, and marketing tool, Basecamp, an affordable project management system, and Airtable for accounting or administration tasks.

4. Hold on to your best employees

During tough economic times, many companies are tempted to pull back on employee spending. After all, the unemployment rates tend to rise, increasing the pool of people you could hire if needed, right? The reality is that the cost of training new employees and losing customers due to the loss of your best employees is much higher. By staying focused on employee retention during an economic downturn, you prevent your competitors from poaching your top talent and losing business because of it.

5. Take special care of your customers

On the same note of retaining employees, your time and energy must be spent proving your value to existing customers and clients. Loyal customers are proven to be more affordable to maintain over obtaining new customers. Existing customers are also likely to recommend your business to friends and family as a form of marketing. Take special care of his customer base by making sure any customer support processes are well-oiled, and that all of your employees are trained on a customer-first mentality.

6. Secure new partnerships

You want to be first in line when a new opportunity arises. That’s why it’s key to continue networking on focusing on building new partnerships, both business and vendor-related. By teaming up with another company that may be going through similar issues during an economic downturn, you can support each other. With new partners, you can provide each other with resources such as cross-marketing to existing customers, or discounted goods and services.

7. Keep marketing

Marketing is one of the top items companies consider decreasing during changing economic times. It’s also the one most companies regret cutting when times are lean as it costs them market share in the long run. During a recession, consumers are still moving about and looking for new companies to turn to. If you’re not getting your name out there, and your competitors are, then you’re losing ground quickly. If you can’t afford an extensive marketing campaign, there are still lots of digital, low-cost alternatives to turn to such as email, blogging, and social media.

Constantly Tired? 7 Ways to Increase your Energy During the Day

It’s 2 pm, and you’re reaching for another cup of coffee when you think, “why am I so tired – again?” The issue of tiredness and fatigue is more common than social media might have us believe. One survey reported that 76% of people feel tired throughout the day, with 44% of people saying that severe tiredness impacted their work and daily lifestyle.

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Tiredness comes in many shapes and sizes. Some people deal with issues like sleep apnea, while others simply don’t have time to get enough sleep because of external factors like work or having young children. For most of us, it’s not easy to change the causes behind why we might not be getting enough sleep. However, there are a handful of ways to build your daily energy and decrease your tiredness to help you make the most of every day!

1. Adjust your caffeine consumption.

More than 60% of Americans enjoy a cup of coffee every day, and most doctors agree that it’s fairly harmless to do so. The issue comes in when that cup of coffee turns into 3-4 cups or sugary energy drinks. Caffeine helps to increase alertness, but it can quickly turn into something that causes your body to crash by the afternoon. It’s also shown that consuming caffeine after 2 pm can cause insomnia and that large amounts of daily caffeine can lead to fatigue days afterward. With all this in mind, it’s important to drink coffee in moderation and to limit extended use of energy drinks or other sugar-heavy substitutes.

2. Put off the nap.

Sometimes the only thing that can get us out of bed in the morning is picturing a nice nap later in the day. However, by putting off taking that nap, you might be giving yourself an energy gift for days to come. Napping makes it more difficult to fall asleep at night and can prevent restful sleep by interrupting your body’s natural circadian rhythm. By not napping, you may be giving yourself more rest in the night and increased energy throughout the following day.

3. Limit alcohol and smoking.

Alcohol and smoking may have opposite effects on your tiredness, but they both have similar results to your energy. A sedative effect is created with alcohol, which can make you sleep in the afternoon if you have a drink at lunch or into the evening if you’re out at happy hour. If you suffer from fatigue and tiredness and plan to drink, it’s best to do so when you have the energy to wind down.

On the other hand, smoking can decrease your energy by acting as a stimulate. It increases your overall blood pressure and can make it hard to fall asleep later in the evening, causing insomnia or less restful sleep.

4. Reduce your list.

A common cause of fatigue is mental exhaustion. We tend to squeeze in as much as we can in the hopes that we’ll have the energy to get it all done. The problem with focusing on too many tasks at once is that we lose the ability to focus. That makes it harder to complete work and extends the amount of time it takes to get things done. All of this can also lead to an increase in anxiety and may prevent restful sleep or keep us up at night thinking of everything that has to get done tomorrow. For many, this is the hardest change to make. However, by setting priority tasks, and giving yourself more flexibility with those that are less important, it can increase your energy and peace of mind.

5. Add movement into a routine.

You don’t have to add more gym hours to your life to get more energy during the day. By setting reminders on your phone to get up, stretch, or go on a short walk, you can increase the flow of oxygen periodically throughout your daily routine. Exercise in the morning is shown to help increase energy-inducing hormones, and a nighttime routine can help reduce stress to enable a more sound sleep.

6. Balance your meals.

By giving your brain a steady amount of energy-heavy nutrients, you can decrease fatigue throughout the day. Snacks like nuts, fruits, and vegetables help to keep you moving and your brain active, while foods that are processed or high in sugar content can cause your mind to feel exhausted. Whole grains and high-fiber items are processed slowly by your body, allowing energy to release continuously instead of one quick spike.

7. Drink more water.

Water is a magical item for bodies. It can help keep our skin bright, help reduce headaches, and even help give us more energy throughout the day. Lack of fluids is actually one of the first signs of tiredness and fatigue. So when in doubt – reach for the water!

While all of these tips should help increase your energy during the day, there are many possible causes for feeling excessive tiredness. It’s important to talk to your doctor and rule out any medical reasons why you might be feeling tired or fatigued.

If you’re looking for a new health plan or network, make sure to visit eHealth.com. eHealth is the largest online marketplace for health coverage and provides free insurance support from licensed agents.

Health Insurance for Newborn Babies

Yes, you can get health insurance for babies since having a child is a qualifying life event that triggers a special enrollment period which allows you to enroll in or change your health insurance plan.

What are the risks of not having baby insurance?

According to Medibank, health care services for newborns are among the most expensive medical expenses. If you go without getting newborn during the window that you’re allowed, you could end up with expensive medical bills that are at times difficult to pay down.

Getting health insurance for babies will help you protect both your new born and your child.

Does my individual or family plan automatically cover my new baby?

The answer is to this question is both yes and no. After giving birth, the newborn is covered for the first 30 days of their life as an extension of the mother under her policy and deductible.

Starting on day 31, this extension of coverages ends. While maternity care (both pre and postnatal) and some health care services for children are essential benefits that are covered by all marketplace plans, health insurance for babies is not included as an essential benefit. In order to get health insurance for babies, you must enroll in or change your health insurance plan.

Having a child is a qualifying life event which triggers a special enrollment period that allows you to enroll or change your health insurance plan outside of the annual open enrollment period.

After your qualifying life event – in this case giving birth – you have a 60 day window to get health insurance for babies. During this time you can either enroll in or change your health insurance coverage to include coverage for your child.

Qualifying Life Events that Trigger Special Enrollment Periods

What do I do if I don’t have health insurance?

If you don’t have health insurance, you will have to pay all expenses out-of-pocket.

According to Parents.com, birth can cost between $2,000-$4,500 dollars depending on the method of delivery without complications. You would not only have to pay for prenatal, delivery, and postnatal care out-of-pocket but for all care that your newborn receives after birth.

You do however have options before giving birth if you are having a difficult time affording health insurance.

Even if you don’t think you qualify based on income for programs like Medicaid, you should still apply because you may be more likely to receive coverage if you are pregnant. This is a great way to get health insurance for yourself and health insurance for babies. With Medicaid you don’t have to wait until the annual open enrollment period to apply and enroll, you can enroll in coverage at any time of the year, if you qualify.

Planned Parenthood and CHIP as health insurance options

Additionally, there are facilities – such as Planned Parenthood – that sometimes offer prenatal care at lower-rates depending on your income.

If you don’t have health insurance and aren’t planning on getting health insurance, you can look into applying for CHIP. The Children’s Health Insurance Program (CHIP) is a way to get health insurance for families who have a difficult time affording health insurance for themselves or health insurance for babies or older children.

While what CHIP covers varies state to state, according to their official website (?) CHIP provides coverage for the following services in all states:

  • Check-ups
  • Immunizations
  • Doctor visits
  • Prescriptions
  • Dental and vision care (which are ordinarily covered through a parent’s health insurance)
  • Inpatient and outpatient care
  • Laboratory and X-ray services
  • Emergency services

Keep in mind that in some states CHIP may provide more covered benefits for your child.

The eligibility guidelines for CHIP vary from state to state, but like Medicaid you can enroll at any time.

Where should I start shopping for health insurance for babies?

It is a good idea to start looking into health insurance for your newborn before you give birth. You can start looking for health insurance that will meet your coverage needs on eHealth.com! Enter your zip code where prompted on this page to start comparing premiums for over 10,000 plans from over 180 companies right now!

Can I Get Health Insurance While I’m Pregnant?

Yes, you can get health insurance while pregnant. In the past pregnancy had been considered a preexisting condition, however under the Affordable Care Act (ACA) health insurance plans must cover pregnancy along with other essential benefits. Additionally, if you are pregnant and uninsured there are likely resources in your state to help you get low-cost maternity care until giving birth triggers a special enrollment period, which will allow you to enroll in health insurance outside of the open enrollment period.

Could you always get health insurance while pregnant?

You can get health insurance while pregnant now. However, that has not always been the case. Since the ACA was signed into law, pregnancy and newborn care is an essential benefit that all qualified Marketplace plans must provide.

Prior to the ACA, only around 12% of individual plans on the market had pregnancy as a covered expense, according to the National Women’s Law Center. Only 9 states required maternity benefits at the time.

Maternity coverage was only offered by some plans or had to be added on as a special rider in addition to a plan that often had a waiting period. Pregnancy was considered a pre-existing condition by insurers. This meant that coverage was either unavailable to women who were pregnant at the time of enrolling or would end up costing them more.

Additionally, some insurance carriers would see a previous cesarean section as a reason to decline, or charge a higher premium.

The ACA named maternity care as one of its 10 essential benefits that all marketplace plans must cover.

10 essential benefits graphic

What coverage can I expect with a marketplace plan?

You can expect coverage for services you need throughout pregnancy, inpatient services, and newborn care.

Some covered services often include:

  • Outpatient services – This includes prenatal and postnatal visits to the doctor, gestational diabetes screenings, laboratory services, medications, etc.
  • Inpatient services – This includes things like hospitalization and physician fees
  • Newborn care
  • Lactation counseling and devices

Keep in mind that while maternity is a covered expense, health insurance companies can choose how they cover these benefits. Additionally, your out-of-pocket costs are dependent on factors like the metallic tier of coverage you have, deductibles, and copayments.

When do I enroll in a health insurance plan to cover my pregnancy?

You can enroll in coverage every year during the open enrollment period for coverage starting in the following year. Open enrollment usually starts on November 1st for coverage starting in the next calendar year.

In most states, becoming pregnant is not a qualifying event that allows you to enroll in or change your health insurance plan outside of open enrollment. However, according to healthinsurance.org there are laws in New York and Connecticut that allows pregnancy to trigger a special enrollment period.

Even though in most states pregnancy is not considered a qualifying life event, the birth of your child is. If you are looking for an opportunity to enroll in health insurance or change your plan outside of the open enrollment period, the birth of your child is an opportunity to do so.

What if I am pregnant and uninsured?

If you are pregnant and uninsured, you have a few options to find coverage or low-cost maternity care in your area.

  • Public health department: Many local health departments provide maternity care. However, you may have to meet an income criteria.
  • Community health center: These centers provide care to those with limited access to health care services. They do not provide maternity or baby insurance, but they do provide comprehensive prenatal care with fees that are usually based on income.
  • Medicaid: If you are without health insurance and are a low-income household or individual, you may qualify for Medicaid. Even if you don’t think that you are eligible based on income alone you should still apply as eligibility levels are higher for pregnant woman than they are for other adults. Additionally, you can apply year round.
  • CHIP: The Children’s Health Insurance Program provides health insurance to uninsured children. However, in a few states it also provides coverage to pregnant women. Even though CHIP focuses on low-income families, CHIP has a higher income threshold than other government run programs. Like Medicaid, you can apply year round.
  • Hill-Burton Facility: There are 136 hospitals and clinics nationwide that are obligated to provide free or low-cost care because they have accepted loans under the Hill-burton act. Request to apply for Hill-Burton free or discounted care at one of these facilities. You do not have to be a US citizen to qualify, but you do need to meet low-income requirements.
  • Charity care organizations: There are organizations such as Catholic Charities and Lutheran Services that offer services to help women with pregnancy care. Services may vary depending on your location, however some services are as extensive as free maternity care, postpartum care, and lodging.
  • Planned Parenthood: Some, but not all, Planned Parenthood locations provide pregnancy care. Some locations base their prices on a sliding-scale based on your income.
  • Self-pay rate: If you end up having to pay for your pre and postnatal care out-of-pocket, you may be able to negotiate a self-pay rate. Frequently, hospitals have a self-pay discount rate or a charity rate. Asking what the charity rate is may help you know how to qualify and help start negotiations.

What Happens After I Meet My Deductible?

After you pay your deductible, your insurance starts paying toward covered care you receive for the rest of the year. Additionally, depending on the service, the health care provider, and your insurance, you may have a copayment for any covered care you receive.

What is a deductible and how does it work?

Your deductible is the amount of money you pay out-of-pocket for covered benefits before your insurance company pays anything. This excludes certain preventative services all plans must pay the full cost of.

If you have a deductible of $2,000, you will pay 100% of your health insurance bills for covered services until you’ve paid your $2,000 deductible out-of-pocket. Once you’ve paid $2,000 and reached your deductible, your insurance company starts picking up the bill.

You will typically share the cost of the rest of your covered services you receive in the coverage year with your insurance company by paying either a copayment, also referred to as a copay, or a coinsurance.

Keep in mind that some plans have separate deductibles for certain services. Like prescription drugs for example; your plan may have a separate deductible you must reach before your insurance starts paying for prescriptions.

Additionally, if you have a family plan you can expect to have two deductibles. You can expect to have both an individual deductible and a plan deductible you must reach before your insurance starts paying for care.

For example, let’s say you have an individual deductible of $500 and a family deductible of $1,200. Let’s say that you have a health care bill for $600 for yourself. You would pay $500 toward your deductible, and your insurance would cover the remaining $100. Later in the year, let’s say your partner incurs a bill of $400. You would have to pay that out-of-pocket, but it would go toward your family deductible. Later in the year if a dependent receives care that costs $300, you would only pay $200 out-of-pocket as you’ve reached your family deductible of $1,200. Now that you’ve reached your family deductible your insurance would pay for any other health care you receive until the end of the plan year apart from any copays or coinsurances you may have.

What is a copayment?

A copayment, or copay, is a fixed amount of money you pay for a covered health care service. The amount can vary by the type of service.

Your health insurance plan determines what your copay is for different types of healthcare services, which you typically pay at the time you receive the service.

You may have a copay before you pay your deductible, after you pay your deductible, and when you owe coinsurance depending on your plan.

What is coinsurance?

Coinsurance is the share of the cost of a covered health care service that you pay after you’ve reached your deductible. It’s usually figured out as a percentage.

Once you’ve met your deductible, instead of paying 100% of the cost of a service you only pay a percentage. Your insurance company pays the rest.

For example, if you receive a health care service after reaching your deductible that is $1200 and you have a 20% coinsurance, you will pay $240 and your plan will pay the remaining 80% – which in this example is $960

Is there a limit to what I have to pay out-of-pocket?

Yes. Every year an out-of-pocket maximum is placed on both individual and family plans. This is the most you have to pay out-of-pocket for covered services during that plan year.

After you spend this pre-determined amount of money on deductibles, copays, and coinsurance, your health insurance plan picks up 100% of the cost of covered benefits.

Keep in mind that an out-of-pocket maximum does not include your monthly premiums. It also doesn’t include any money you pay out-of-pocket for non-covered services.

Should I choose a high or low deductible plan?

There are both plans with high and low deductibles. There are some plans – typically HMOs – that don’t have deductibles at all.

While a lot of people are initially attracted to the high-deductible plans because they tend to have lower premiums, that doesn’t always make them the most cost effective. High-deductible plans are great for people who are generally healthy and don’t expect to need a lot of health care services during the plan year.

You may end up spending more over all with a high-deductible plan than a low-deductible plan. While your premium is likely to be lower, you may end up paying a lot out-of-pocket toward your deductible if you end up requiring more or more complicated care than expected.

Low-deductible plans may seem pricey at first because they tend to have higher premiums. However, if you expect to require a lot of medical care throughout the year, have a chronic illness, or dependents to worry about, you may find that a plan with a lower deductible would better suited for your budget.

When choosing a plan reflect on the care you – or you and your family – has needed in the past and think about the health care services that you may require in the upcoming year.

2020 Open Enrollment Dates in Georgia

Watch our video on Health Insurance Open Enrollment Periods

How much is health insurance per month for a single person in Georgia?

According to eHealth.com and Healthcare.gov, these are the starting prices for a 40-year-old woman buying individual coverage in Georgia:

Georgia Open Enrollment Dates

How do I get cheap health insurance in during the Open Enrollment Period in Georgia?

  1. Assess your personal needs: Think about the coverage you have received in the past and think about the healthcare services that you may plan on receiving in the coming year. Ask yourself if you need Rx coverage and if you have a doctor you like. These questions may affect which kind of plan you choose.
  2. Research available options in your Georgia: Compare Obamacare plans, short-term plans, and other alternatives online. A great place to start is on eHealth.com.
  3. Understand which options you can qualify for: You can enroll in any Obamacare plan during open enrollment. When it comes to short-term health insurance or other alteranatives to major medical plans, you can apply online at anytime. However, unlike Obamacare plans, when applying for short-term plans and other alternatives you may be declined coverage.
  4. See if you qualify for discounts: Depending on what your yearly salary is in comparison to the Federal Poverty Line, you may qualify for tax credits or extra savings thanks to the ACA. These subsidies can save you hundreds and sometimes thousands of dollars on your monthly premiums and out-of-pocket expenses.
  5. Make sure your prescriptions are covered: eHealth.com provides a prescription drug coverage comparison tool that helps you find the plan that covers your drugs with the lowest out-of-pocket cost.
  6. Make sure your doctor is covered: Finding a doctor you like and who meets your health care needs can be difficult. But making sure your preferred physician is in-network doesn’t have to be. eHealth has a physician finder tool that lets you compare plans that cover your preffered doctor.
  7. Enroll online: You can easily enroll in a health insurance plan online with eHealth, even if you qualify for an ACA subsidy.

What health insurance companies sell individual health insurance policies in Georgia?

Other Insurers on the Exchange, but not available at eHealth in Georgia

Alliant Health Plans

Mental Health Coverage in US Health Plans

Affordable Care Act (ACA) compliant plans are required to have mental health coverage due to provisions under both the ACA and the Mental Health and Addiction Parity Act (MHPA).

What is the Mental Health Parity and Addiction Equity Act?

Graphic describing mental health parity

The Mental Health Parity Act (MHPA) was signed into law in 1996 and required that no annual or lifetime limits on mental health benefits could be any lower than any limits for medical or surgical benefits. However, as soon as this law was passed, insurers immediately found and took advantage of loopholes.

The MHPA was largely superseded in 2008 by the Mental Health Parity and Addiction Equity Act (MHPAEA), which extended the reach of the 1996 provisions and sought to close loopholes that were left open by the MHPA.

The MHPA required that no plans make the financial requirements on mental health coverage benefits (including co-pays, deductibles, or out-of-pocket maximums) or treatment limitations (such as caps on mental health service visits or hospital stays) more restrictive than the financial requirements or treatment limitations for medical or surgical benefits.

What did the ACA do for mental health coverage?

With ACA compliant plans, you can expect to have mental health services covered just as you can expect other services to be covered such as preventative care visits or hospital visits.

According to CMS.gov, under the ACA all compliant health insurance plans must cover ten essential benefits.

10 essential benefits graphic

While all plans must cover these benefits in some way, keep in mind that plans can choose how they cover these benefits.

Additionally, under the ACA health insurance companies must cap customers’ out-of-pocket spending and must not place limits on annual or lifetime coverage for these services.

Has mental health always been covered?

Before the ACA, mental health coverage was lacking with most plans being sold on the individual and family health insurance market. Mental health coverage was much better with employer-sponsored insurance. Before the ACA, people could be denied coverage to those based on preexisting conditions – including mental health conditions. People with preexisting mental health conditions, faced difficulty finding health insurance coverage or finding coverage at an affordable rate.

Additionally, marketplace plans cannot put yearly or lifetime limits on coverage of any essential health benefit. This includes mental health and addiction services.

Because of the ACA, those who have a preexisting or a history of mental health conditions cannot be denied health insurance or charged at a higher rate than anyone else.

What mental health coverage can I expect with an ACA compliant plan?

With an ACA compliant plan, you can expect to have mental health coverage. Your plan should cover some part of the expense of both mental health services and behavior health services. If you feel that your plan is denying you comprehensive mental health coverage you can talk with your plan provider or write a formal appeal.

All ACA plans must cover behavior health treatment, such as psychotherapy and counseling, as well as substance use disorder (also known as substance abuse) treatment. Additionally all plans must cover mental and behavioral health inpatient services.

Like with any other benefit, the higher metallic level you have the more coverage – including mental health coverage – you’ll get overall. Consider a higher metallic level (such as gold or platinum) if you require or expect to require a lot of or frequent mental health services.

According to a 2017 report by the Milliman firm, an office visit with a therapist is five times as likely to be out-of-network than a primary care appointment. You may want to opt for a plan type that doesn’t tend to have high out-of-network costs (such as a PPO plan) because your preferred mental health provider may be out-of-network or it may be difficult to find a provider you like in-network.

Where can I find health insurance plans that meet my mental health coverage needs?

You can find plans that offer the mental health coverage you need on your state or federal marketplace, as well as eHealth.com! eHealth is the first and largest online health insurance brokerage. Start shopping for a plan that meets your mental health coverage needs with one of our licensed insurance agents or enter your zip code where prompted on this page to start comparing plans now!

How Much Does an Urgent Care Visit Cost?

When experiencing the sudden onset of symptoms like a sore throat or experienced a minor trauma, you’ve probably wondered whether or not you should try to get in with your primary care physician, head to urgent care, or go to the emergency room. However, these three health care options can often come with a vastly different price tags.

How much does a visit to urgent care cost?

On average, urgent care costs are pretty low in comparison to a visit to the emergency room. According to Debt.org, an urgent care visit costs around $150.

Urgent care is a great option for those who need same-day treatment for a non-life-threatening injury or illness.

If you find that you need care on a weekend or that you can’t get in with your primary care provider, urgent care may be your best option.

Most urgent care centers are open into the evening and are open on weekends. Additionally, most urgent care centers don’t require you to make an appointment. Although, if you’re looking to skip the line or wait at home some facilities now allow you to make appointments in advance online.

In the event that the staff can’t treat you or believe that your condition is much worse, they will usually prompt you to go to the emergency room.

There are even options such as virtual care, or E-visits, that may allow you to get care for certain common conditions without having to leave the house.

According to chat with a provider to get a treatment plan or a prescription (if needed). You often don’t need an appointment in advance and can get one same-day.

How much cheaper is urgent care in comparison to the emergency room?

When it comes to costs, a visit to urgent care usually costs much less than a trip to the ER. ER visits can cost anywhere from around $600 for a minor problem to well over $3,000 for a serious and complex health issue or injury.

Even if you have health insurance, you can still expect to pay a large amount out-of-pocket until you reach your deductible.

According to debt.com, the cost of treating a non-life-threatening issue such as strep throat at the ER can cost up to 5x more than seeking treatment from an urgent care facility.

Refer to the graphic below to see how much more treatment for some common health issues costs at the ER in comparison to urgent care.

Emergency room costs in comparison to urgent care costs for the same treatments

Source: Debt.org

In addition to being more expensive, it may take longer to be seen by a doctor in an emergency room situation as patients with more severe illnesses or injuries are usually seen first.

Does my insurance cover urgent care visits?

While all major medical plans are required to cover emergency services under the Affordable Care Act, some insurers may not consider urgent care as emergency care.

However, most plans cover urgent care visits. Patients can usually expect to pay a copay or deductible for visits to urgent care treatment centers.

In some cases, your insurance may not be accepted by a given urgent care facility. If you aren’t sure if the facility takes your insurance, you can always call ahead.

If you aren’t sure if your health insurance plan covers urgent care visits, look at your plan details as soon as possible or before enrolling in the plan.

Plans that cover urgent care visits can be found here, on eHealth.com. eHealth is the first and largest online health insurance brokerage. On eHealth.com you can get a quote or compare plan benefits online. Start shopping for a plan that meets your coverage needs by entering your zip code where prompted on this page or by calling one of our licensed insurance agents.

2020 Open Enrollment Dates in North Carolina – Affordable Care Act

Keep reading to learn more about enrolling in health insurance during the Open Enrollment Period in North Carolina.

Watch our video on Health Insurance Open Enrollment Periods

How much is health insurance a month for a single person in North Carolina?

If you’re purchasing health insurance in North Carolina, you may want to start browsing the plans available in your area as the open enrollment period approaches.  to the latest eHealth marketplace survey, these are starting prices for a 40-year-old woman buying individual coverage in North Carolina

Zip, City, State  Lowest Cost Bronze Plan

(Healthcare.gov 7/17/2019)

 6-Month short-term plan (lowest priced plan on eHealth.com 7/17/2019)  12-Month short-term plan (lowest priced plan on eHealth.com 7/17/2019)
28105
Charlotte, NC
$360.60 $73.80 $106.50

How do I get cheap health insurance in North Carolina?

  1. Assess your personal needs:Do you need Rx coverage? Do you have a doctor you like?
  2. Research available options in your North Carolina:Start at eHealth.com to compare Obamacare plans, short-term plans and other alternatives.
  3. Understand which options you can qualify for: You can enroll in any Obamacare plan during open enrollment. For short-term health insurance and other medical insurance alternatives, you can apply any time, but you typically need to answer medical questions and may be declined.
  4. See if you qualify for discounts: ACA plans may be available to you with a tax credit, which can save you hundreds and sometimes thousands of dollars on monthly premiums.
  5. Make sure your prescriptions are covered: eHealth.com provides a prescription drug coverage comparison tool that helps you find the plan that covers your drugs with the lowest out-of-pocket cost.
  6. Make sure your doctor is covered: eHealth has a physician finder tool that lets you compare plans using your preferred doctor.
  7. Enroll online: eHealth makes it easy to complete your health insurance application online, even if you qualify for a tax credit.

What health insurance companies sell individual health insurance policies in North Carolina?

Insurers in North Carolina with Plans Available on eHealth.com Short-Term Health Insurance Major Medical Health Insurance Medical Insurance Packages
Companion Life Insurance Yes No No
Independence American Yes No Yes
National General Accident & Health Yes No No
United Healthcare Yes No Yes
Ambetter No Yes No
Cigna HealthCare of North Carolina, Inc. No Yes No

Other Insurers on the Exchange, but not available at eHealth in North Carolina:

Blue Cross and Blue Shield of NC

Tips to Running a Successful Small Business

As a small business owner, you are always looking for new ways to build upon and improve your small business. While there is a lot of business advice out there, you may be surprised to learn that remembering some of the fundamental principles of business may lead to helpful tips for your company.

Here are three essential tips to running a successful small business, which include starting with a budget, creating a sound business plan, and working with engaged employees.

1. Start with a sound budget for your small business

Keeping track of finances is one of the most important parts of running a small business. Managing costs can be a challenge for any small business owner, which is why creating a realistic budget and sticking to it may be one of the top pieces of advice for running a successful small business.

According to a study by CB Insights about the most common reasons startups fail, 29 percent of startups failed because they ran out of cash, which was the second most frequently cited reason for failure.

Source: CB Insights / Entrepreneur

Here are several ways a small business owner may avoid having to deal with budget overruns:

  • Reduce unnecessary expenses – Examples of cutting out unneeded spending include minimizing overhead costs, managing inventory efficiently, and maintaining equipment to reduce the likelihood of expensive repairs. Technology upgrades may also help reduce costs for a small business owner.
  • Be prepared for unexpected costs – Even with a well-planned budget, unexpected costs can appear. Be sure to leave enough room in your small business budget for unanticipated expenses, or have back-up funds available in reserve in case of financial surprises.

To avoid budget mistakes which may prove costly in the long run, it may be advisable for a small business owner to work with a tax, accounting, or legal advisor who can help his or her small business navigate financial questions.

2. Achieve focus with a solid business plan

Besides staying organized with a budget, having a specific business plan that outlines key objectives serves as an essential component of running a successful small business. Taking the time to create a business plan provides structure, clarity, and focus for a small business owner navigating the opportunities and challenges of entrepreneurship.

According to the U.S. Small Business Administration (SBA), there are typically two categories of business plans that may be used by a small business owner:

  • Traditional business plans seek to be comprehensive reports of how a business will operate and function, including what product or service is offered, how the business’s strategy shapes its sales and marketing initiatives, whether additional funds are needed, and financial projections.
  • Lean startup business plans provide a summary or high-level view of a business. They are often presented as a simple chart or similar visual form in order to present the essentials of a company, such as its unique value proposition, customers, structure, and revenue streams.

Source: U.S. Small Business Administration

Here are some tips on how to use a business plan to run your small business more efficiently.

  • Set out clear goals – By clearly defining quarterly, annual, short-term, and long-term strategic goals for your small business, you can create useful benchmarks that allow you to track progress, avoid distractions, and compare and analyze initial expectations to actual results.
  • Focus on one value proposition – A small business owner may lose his or her way by spreading resources too thin and trying to do too many things at once. Specializing in one product or service may allow your business to achieve recognition in a specific expertise that meets market demand.
  • Understand customer needs – A business plan can allow a small business owner to set out how exactly they will appeal to their target audience. By understanding what customers are really looking for, a small business may be able to create better client experiences and relationships.

Overall, a well-constructed business plan can help a small business owner by providing both foundational guidance and a point of reference as the company continues to expand and grow.

3. Surround your small business with the right employees

Staying within your budget and following a focused business plan are among the most fundamental elements of running an effective company for a small business owner. Yet in order to achieve your goals, your small business will often need motivated and skilled employees to take action and implement them.

Having engaged employees who care about their work, and who view their occupation as more than just a job, is often the key to realizing a successful business. According to Gallup, engaged employees are those with significant involvement, enthusiasm, and commitment to their work and workplace.

Here are a few tips to help a small business owner cultivate greater employee engagement.

  • Foster a positive company culture – Creating a company culture is about developing a unique, positive, and open environment that helps employees grow and thrive. Whether company culture takes the form of company traditions or shared office tasks, it helps small businesses by supporting greater teamwork and better cohesion among employees. Additionally, a great company culture may be able to reduce turnover and inspire greater employee retention.
  • Offer employee benefits – One way a small business owner may be able to attract the right talent is by offering popular employee benefits such as group health insurance, retirement plans, and vacation days. According to a 2018 eHealth report, 66 percent of small business owners offer health insurance in order to recruit and retain the best employees, while 27 percent felt that providing health benefits to their workers helped encourage productivity.

As a growing small business, don’t underestimate the importance of highlighting your health insurance benefits and other highly sought-after employee benefits in order to attract quality workers.

Although all businesses have unique strategies and different needs, understanding fundamental tips such as creating a budget, following a business plan, and working with motivated employees are all excellent ways to help you run a successful small business.

To learn more about small business health insurance plans, visit eHealth.com or speak with one of our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How to Hire Employees

Regardless of industry, hiring decisions are among the most challenging choices that small business owners have to make, especially when hiring their first employee. Key factors for an employer to consider when hiring their first employee include: following state and federal hiring regulations, finding candidates with the requisite skills and experience, and understanding the effective management of employees.

What are the initial factors to consider when hiring a first employee?

Given the importance of working with motivated employees, small business owners should invest the proper time and care into the hiring process in order to find their optimal first employee. Employers can start out by asking themselves how their first employee will:

  • Add value to the business? – What is the first employee’s purpose and job function? Are they needed to expand current operations, or will they bring an entirely new skillset to the table?
  • Affect the business’s bottom line? – Will the first employee help generate enough revenue to justify hiring costs? Do budgets or prices need to be adjusted as a result of hiring a new employee?
  • Advance the business’s objectives? – Will the first employee contribute to improving products or services? Can their talent help achieve both short-term and long-term goals?

By asking the right questions at the start of the hiring process for a first employee, a small business can set itself on the right path moving forward. Once business owners have created a hiring plan, they can begin to look into the details of hiring regulations, finding the right candidates, and the proper management and leadership of employees and workers.

Complying with state and federal hiring laws

One of the most important parts of hiring a first employee involves understanding state and federal employment requirements. Here is an overview of critical labor regulations that affect small business owners and their employees throughout the hiring process.

  • Business Taxes – When a business begins hiring employees, it must pay taxes for payroll, as well as taxes for fringe benefits including Social Security, Medicare, and state unemployment insurance. A business must also acquire an employment identification number (EIN) from the IRS for tax return purposes and start keeping payroll-related records for their employees (such as time sheets).
  • Worker Classification – At the start of the hiring process, a business must determine if its new employees will be full-time employees (also known as W-2 or common-law employees) or independent contractors (or 1099 employees), since this impacts tax liabilities. An employer must pay minimum wage and decide whether its employees will be paid on an hourly basis or with a salary.

Depending on the state, a business may be required to provide workers’ compensation insurance once it starts hiring employees into its workforce, in case their employees face the risk of accidents during their employment. Companies in certain industries may find it worthwhile to purchase forms of small business insurance coverage, such as general liability insurance and other liability insurance types.

As a small business owner going through the hiring process for your first employee, be sure to work with a legal, accounting, or tax advisor to make sure you’re going in the right direction, as well as consult with state and federal labor regulations available through the U.S. Department of Labor.

Source: SCORE

Finding candidates with the right skills and experience

With online job sites, it is easier than ever to find talented employees; the challenge is finding and hiring employees who are the right fit for your small business.

To begin, a small business owner should create the job description, advertise the role, choose resumes from applicants, and then evaluate candidates through the right interview techniques. Throughout the hiring process, a soon-to-be employer should keep the following questions in mind, especially when looking for a first employee:

  • How well do the skills and experiences of job candidates match the expectations and responsibilities required of the role?
  • Do they have the proper industry knowledge, education, certifications, or licenses?
  • What are their strengths and weaknesses? Are they willing to learn and improve as employees after hiring?
  • Do they demonstrate enthusiasm, interest, and excitement regarding the role? Is there a clear culture fit–that is, do the candidates demonstrate the right attitude and mindset?

Be sure to ask for references, perform background checks, and follow fair hiring practices. When hiring a first employee, it may also be helpful to seek out referrals in order to find high-quality job candidates.

Source: LinkedIn 2018 Global Recruiting Trends Report

Leading employees to success with the right management

Once a business’s first employee has been hired, it is imperative for the business owner to implement effective leadership and management in order to help their new employee succeed. Critical factors for an employer to consider when managing employees include:

  • Training – After hiring, how much training does the first employee require? Will employees require significant supervision and guidance, or can they work fairly independently?
  • Delegating responsibilities – Determine which tasks to delegate to newly hired employees, then clearly communicate job expectations, schedules, and short-term and long-term goals to them.
  • Evaluation – Be sure to have a framework in place to evaluate the performance of employees on at least an annual basis. This can allow for more effective feedback, better accountability, and greater transparency.

While a role may evolve over time after hiring, especially for a first employee, working under the guidance of effective management can help both employers and employees operate more efficiently.

What happens after hiring new employees?

After you’ve hired your first employee, you may also consider offering popular employee benefits, such as group health insurance, dental and vision insurance, retirement benefits, and vacation or paid time off (PTO). You don’t need to be a large company to have benefits for employees: even small businesses with only one employee can qualify for a group health insurance plan. Investing in quality benefits for your workforce may help with retaining current employees, as well as hiring and recruiting new talent by being seen as an employer of choice.

To learn more about your options for affordable small business health insurance coverage for yourself and your employees, visit eHealth.com or speak with one of our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How to Set Up an HSA for Your Employees

A Health Savings Account (HSA) is a financial account used with a qualifying high-deductible health plan (HDHP) that allows employees to pay for health care expenses on a pre-tax basis.

It takes a few steps to set up an HSA for the employees of your small business. First, decide on the HSA contribution amounts for employees with qualified HDHPs. Next, create a Section 125 plan that enables employees to contribute tax-free dollars to the HSA. Employers and employees then send their contributions to the HSA custodian (typically a bank), and the business prepares the appropriate tax documentation for the end of the tax year.

What is a Health Savings Account (HSA)?

A Health Savings Account (HSA) is a tax-favored savings account that, when paired with a high-deductible health plan (HDHP), can be used to help your employees pay for qualifying medical expenses. An HSA-compatible HDHP typically has lower monthly premiums than lower-deductible health insurance plans, and contributions to an HSA may be made on a pre-tax basis, up to annual IRS limits.

Both employers and employees can contribute to an HSA, and there are several benefits of using an HSA for each group.

  • For employees: Employee contributions to an HSA are paid before tax, allowing them to cover their out-of-pocket costs with pre-tax dollars. An HSA is connected to a specific individual, not their job. Unused money in employees’ accounts can roll over year to year, potentially growing over time, and can earn tax-free interest.
  • For employers: All employer contributions to employee HSAs can be used as an income tax deduction for your small business. Employers also will not have to pay for payroll taxes on the pre-tax contributions of employees. The lower premiums of an HSA-compatible HDHP for employees may mean reduced cost-sharing for the employer.

It is important to know that not all HDHPs are HSA-eligible, so be sure to select an HSA that works for the needs of your small business.

Overall, an HSA may be an affordable, tax-favorable option to consider for both small business owners and their employees.

Interest in HSA-eligible plans among businesses

HSAs have become more common in recent years. A Society for Human Resource Management (SHRM) report on employee benefits in 2019 found that interest in HSAs and employer contributions to HSAs has grown since 2015.

Source: SHRM Employee Benefits Report 2019

According to eHealth’s 2018 small business health insurance report, few employers offering HSA-eligible plans fund them, with 21 percent of small employers saying they offer an HSA-eligible health insurance plan to their employees. Of these employers, 16 percent contribute money to their employee’s HSAs.

What are the steps required to set up an HSA for employees?

Setting up an HSA for your small business employees is a straightforward process. Here is an overview of the required steps.

  1. Determine plan eligibility and contributions – First, find out if your employees have HSAs though eligible high deductible health plans, either provided by the business or purchased individually. Then, decide how much employees will contribute to their HSAs, as well as whether your business will contribute to their accounts.
  2. Create a Section 125 plan – A section 125 cafeteria plan allows employees and employers to contribute tax-free dollars to the HSA. The plan can be made available to employees, spouses, and dependents. Either your business or a payroll service can set up one of these plans.
  3. Manage contributions and tax documentation – After implementing the Section 125 plan, employees can send HSA payments to their custodian or bank-administered account. As an employer, you are required to send your payments to employees’ accounts (if you decide to contribute to their HSAs). Your business is also required to provide the appropriate tax documents, including W-2s, to your employees at the end of the tax year.

Keep in mind that both employees and employers must adhere to annual HSA contribution limits. In 2019, individual HSA holders are allowed to contribute a maximum of $3,500, and HSA account holders with a family can contribute a maximum of $7,000, according to the IRS.

Overall, offering an HSA can be an affordable way to supplement the health insurance plans of your employees while also providing tax advantages for your business.

eHealth makes it easy to find HSA-compatible health insurance coverage for your business by allowing you to clearly identify and compare different group plans. Learn more about your options for small business health insurance by visiting eHealth.com or speaking with our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Contract Employees vs. Full-time Workers

The primary distinction between contract employees and full-time workers revolves around differences in the employer-employee relationship and tax liabilities. Typically, a contracted worker has more independence over how they complete their work and is responsible for their own taxes, while a full-time employee works under the direction and supervision of an employer who reports their taxes. For a small business, working with contracted and full-time employees can have advantages for both the employer as well as employees.

What are the differences between contract employees and full-time workers?

While there is no exact definition of either contracted or full-time workers, the main differences between contract employees and full-time employees are the degree of the employer’s control over their work and the manner in which their taxes are reported to the IRS.

Here is a general overview of how to understand the major difference between contracted workers and full-time employees:

  • An independently contracted worker performs their services separately from the business that contracts them. The contract employee also pays taxes on the money they are paid by their client, the business.
  • A full-time worker functions as part of a business, with their employer reporting their taxes and providing them with direct supervision over the work they perform.

While contracted employees often tend to be cheaper for a business (since employers do not need to offer them fringe benefits such as health insurance or pay payroll taxes for them), there have been issues in the past where businesses have misclassified full-time employees as contracted employees, resulting in significant tax penalties and fees.

To help small business owners properly classify employees, the IRS has guidelines which provide assistance in defining different types of workers. Employers can also consult this checklist to help them differentiate full-time employees and independent contractors.

Understanding the distinctions between contracted and full-time employees is crucial for a small business seeking to expand or enhance its workforce. Continue reading to find out more specific requirements associated with both types of workers.

Source: U.S. Small Business Administration (SBA)

What are contract workers?

A contract worker, also known as an independent contractor or 1099 employee (based on the 1099 tax form they receive), is an individual who enters into a contractual agreement with a business in order to provide a service in exchange for a fee.

To be considered a contracted employee, a worker must generally meet the following requirements:

  • Be responsible for paying their own taxes on the payment they receive from the business
  • Use their own equipment and supplies in order to complete their contracted work
  • Provide an invoice upon the completion of their work, as per their contractual agreement

Contracted workers are not technically “employees” since they provide services on a short-term or individual project basis. Also, unlike full-time employees, contract workers do not have to be offered employment benefits by the businesses that hire them.

What are full-time employees?

Full-time employees, also known as common-law employees or W-2 employees (based on the W-2 tax form they receive), are supervised by their employer, who directs and controls their work throughout a long-term relationship. The employer must pay payroll taxes for each of their full-time employees, as well as provide them with certain legally required benefits.

According to the IRS, there are three factors for businesses to consider when classifying workers as either full-time employees or contracted workers:

  1. Control over behavior – Does the employer have the right to control what the worker does and how the worker completes his or her job (i.e. the scheduling or process of the work)?
  2. Control over finances – Does the employer control how the worker is paid? Does the employer provide supplies, reimburse expenses, or pay payroll, Social Security, and Medicare taxes?
  3. Type of employer relationship – Does the employer offer employee-type benefits? Is the relationship between the employer and worker ongoing or a key part of the business?

If most of these factors apply to the workers hired by a small business, then they would probably be considered full-time employees by the IRS.

Contract employees vs. full-time workers: what are the benefits of each?

For a small business, there are advantages to working with both contracted workers and full-time employees. Here are several factors to consider when comparing these two types of workers.

  • Costs – Due to differences in tax liabilities and benefit obligations, contract workers (who often charge higher flat fees or hourly rates than employees) tend to cost less overall for a small business than full-time employees. However, small business owners should make sure they do not end up misclassifying workers, as they could end up facing tax penalties as a result.
  • Project Scope – Contract workers may be a better choice for short-term projects which require outside expertise, such as technical consultations, seasonal assistance, or administrative services. For ongoing work that requires supervision, involves building relationships, or plays an important role for the business, hiring full-time employees may be the right way to go.
  • Loyalty – Due to the short-term nature of contract projects, a contracted worker might stop working with a business if another company offers to pay them more, or be less accessible if they have multiple clients. Full-time employees may be more likely to remain loyal and committed to their employer in the long-term, especially if they are offered desirable benefits.

Ultimately, both contract workers and full-time employees can serve as good choices to fulfill the different projects and needs of a small business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Getting to Know Online Marketing as a Small Business Owner

Online marketing can serve as a powerful tool for a small business owner. While all businesses are different, expanding and amplifying awareness about your company through online marketing can be a great way to promote your products and services, acquire leads, and ultimately grow your business.

Compared to traditional marketing, online marketing may be an easier and more efficient way to share your key message with customers, reach a wider audience, and track and analyze business results.

Overall, online marketing is an essential component of your small business strategy because it helps you stand out from the completion while delivering your value proposition to prospective customers.

Getting started with online marketing as a small business owner

Whether you are a new small business owner or an entrepreneur seeking to further build your company, taking the time to refresh or reevaluate your online marketing initiatives can help bring clarity, direction, and focus to your business.

Here are three key steps to help your small business get started:

  1. Create a plan – When creating your online marketing plan, your first priority should be to determine goals, followed by the channels you will use to achieve them. Is your small business working to increase sales, build awareness, or both? What communication channels will you use to spread your message? By identifying the purpose and platforms of your marketing strategy, you can concentrate on what matters most while creating a playbook that you can refer back to.
  2. Understand your audience – After deciding on the marketing methods that you will use to achieve the goals of your small business, you should make sure that your online marketing will capture the attention of your customers. How will your message appeal to the needs of your target audience? One way to accomplish this can be creating “personas,” or hypothetical profiles of different types of customers that your product or service is directed toward.
  3. Track and analyze results – To better determine the return on investment (ROI) of your online marketing, you need a way to observe the impact of your efforts. Keep track of your data (such as new leads, sales, website visits, or social shares resulting from an online marketing campaign) through digital analytics tools. Being able to easily access and analyze results in real time can help your small business decide which strategies are successful and which need refining.

Once you have identified your objectives, be sure to have a sound budget as well as a content calendar that outlines the implementation schedule of your online marketing initiatives. At this point, you can now decide which types of online marketing will best serve the needs of your small business.

What are the major types of online marketing?

Online marketing comes in many forms, each with their own advantages for a small business.

  • Content Marketing – Content marketing is a method of creating relevant, valuable, and engaging information related to your product or service for the benefit of your customers. The most common form of content marketing is publishing articles on a blog, website, or through a content management system (CMS) such as WordPress. These short-form or long-form content pieces provide opportunities for your small business to demonstrate credibility and expertise.
  • Email Marketing – With email marketing, your small business can reach out directly to your customers. Your company can share exciting updates, promote sales and offers, or highlight new features for your product or service. A typical way to set up email marketing is to create email newsletters that you can send to current and previous clients, or encourage visitors to your website to subscribe to them. Many email services also include useful built-in analytics tools.
  • Search Engine Optimization (SEO) – One major goal of SEO is make your website more accessible and visible to your customers by working to make your webpage more likely to appear in search engine results. SEO best practices include using targeted keywords on your website and acquiring backlinks from other websites. SEO can be especially valuable since it may help your small business find customers without having to pay for additional advertisements.
  • Social Media Marketing – Having a strong social media presence can allow your small business to build an online community of followers, fans, and supporters that contributes to long-term loyalty for your company. Social media pages enable small businesses to receive feedback in the form of comments and reviews while engaging with their customers on a more personal level. Cultivating an online following can help you stay on the pulse of trends and audience interests.

Ultimately, by developing greater familiarity with online marketing, your small business can better communicate the strengths, advantages, and benefits of your product or service in a way that may help drive sales and contribute to greater brand recognition for your company.

Hiring Independent Contractors as a Small Business Owner

If you are a small business owner who is currently in the process of growing your business, you may potentially consider hiring new employees such as independent contractors. While independent contractors are distinct from employees from a legal and tax perspective, hiring contractors may be advantageous for financial and strategic reasons.

A small business is not legally obligated to offer health insurance to independent contractors; however, deciding to offer health coverage to one contractor requires a business to provide health insurance to all employees at that level.

What is an independent contractor?

According to the IRS, an individual can generally be defined as an independent contractor if those who pay him or her only have the right to direct the result of the individual’s work, and not what or how the work will be done. If an individual works as an independent contractor, what they earn is subject to the Self-Employment tax.

When hiring workers for your business, it is important to understand the legal differences between independent contractors and employees. Although independent contractors or self-employed workers are often referred to as 1099 “employees,” they are usually not really employees from a tax and legal perspective. The tax forms used for payroll tax deductions, 1099 and W-2s, can be used to help distinguish independent contractors from employees.

  • Independent contractors are self-employed, paid as per their contract, and receive a 1099 tax form to use when filing their tax return.
  • Employees are paid a wage, offered employee benefits, and receive a W-2 tax form. Their employer will withhold income taxes from their pay, unlike for independent contractors.

While there is no exact definition of an independent contractor, the IRS has suggested that the level of employer control and relationship between employer and worker can be used as ways for small business owners to help classify their workers.

Examples of self-employed workers who may be independent contractors include doctors, building subcontractors, accountants, lawyers, and freelancers.

What are the advantages of hiring independent contractors?

A company may consider hiring independent contractors for several strategic reasons, especially when growing their small business.

  • Financial savings – One of the advantages of hiring independent contractors is that they may be a less expensive option than a regular employee. For instance, independent contractors do not require a workspace or need to be compensated with employee benefits. There are also fewer tax conditions associated with hiring contractors compared to regular employees.
  • Adaptable workforce – Depending on the scale of your projects, hiring independent contractors may be an optimal choice for completing a variety of short-term goals and objectives. Oftentimes, contractors might be hired as seasonal workers for a few months, or temporarily brought on to cover for employees absent due to family leave or a medical illness.
  • Skillset and expertise – Independent contractors often have a particular set of skills or a specialization within a specific field, providing value to a small business with their professional knowledge. Using contractors allows you to benefit from their talent without having to bring them on as full-time employees.

Ultimately, hiring independent contractors may allow you to create an adjustable roster of skilled workers who could help address your needs as a growing small business.

How does hiring an independent contractor work?

Generally, the hiring process for bringing on independent contractors includes recruiting candidates, developing a contract, and completing required tax and hiring documents.

  1. Recruit independent contractors – The overall recruiting process for independent contractors is similar to the hiring process for regular employees. However, be sure that your job listing specifically stipulates that the position is for an independent contractor.
  2. Create an independent contractor agreement – A contract for independent contractors should include clear descriptions of the work they are expected to complete, the duration of their engagement, payment details, and relevant sections such as non-disclosure and dismissal.
  3. Complete hiring and tax documentation – As you onboard a new independent contractor, make sure that he or she submits the proper tax documents, such as IRS Form W-9, as well as the required federal forms needed for new workers.

In order to accurately and efficiently streamline the hiring process, a small business may consider working with a legal, accounting, or tax advisor when deciding whether to hire independent contractors.

Are you required to offer health insurance to independent contractors?

As you manage the hiring process for new employees or independent contractors, you may be wondering whether you have to offer group health insurance to your workers.

According to the Affordable Care Act, a small business with less than 50 full-time equivalent employees is not required to offer group health insurance to its employees. Still, many small businesses choose to offer health insurance to their workers due to the popularity of this employee benefit.

You are not legally obligated to offer health insurance to independent contractors, since they are not officially employees. However, if your small business decides to offer health insurance coverage to one contractor, then you must offer health insurance to all workers at that same level.

Why might you consider offering health insurance to independent contractors?

Although you are not required to offer group health coverage to independent contractors, choosing to provide them with medical benefits may be an effective decision for your small business.

Advantages of offering group health insurance to independent contractors may include:

  • Enhanced recruiting – From a hiring strategy perspective, your small business may be better able to recruit independent contractors if you offer them health insurance as part of their job offer. When competing for the services of skilled and talented contractors, a group health plan may serve as a key differentiator for your business, especially when seeking a long-term contractor.
  • Consistent productivity – Contractors with access to group health coverage may take less sick days or be less absent, which could be important if they are needed for seasonal work services. When contractors stay healthy, they can remain productive and focused on their jobs.
  • Reduced plan costs – Due to the risk pool advantage associated with having more workers enrolled in a group health plan, a larger group of 1099 workers or contractors may lead to reduced premiums for yourself and other workers on the group plan.

Finding group health insurance for independent contractors

eHealth can help you find small business health insurance for yourself, your family, and your employees, as well as independent contractors. Our private health insurance marketplace offers the largest selection of quality health plans available online. When you use eHealth to shop for health insurance, you can quickly compare group health plans from different companies side by side, making it easy for your business to find the right health coverage for your needs and budget all in one place.

Find out what your options are for affordable group health insurance by visiting our small business page at eHealth.com or by contacting one of our helpful licensed insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How Much Does a Small Business Health Insurance Broker Cost?

Using eHealth as a small business health insurance broker does not cost any extra money, since eHealth does not charge any broker fees. Shopping for small business health insurance quotes through eHealth’s online marketplace is free, and you can benefit from speaking with our licensed health insurance agents with no extra cost to you.

Why use a small business health insurance broker?

The services of a broker can help small business owners better understand their small business health insurance options. Beyond being able to access free group health plan quotes, using a small business health insurance broker like eHealth provides a greater variety of choices for affordable health coverage.

One of the advantages of using the services of a broker, rather than going directly to an insurance company, is that the broker can offer more plans while also allowing you to compare options from many different insurance companies. As a small business owner, you could benefit from a better selection of health plans, enabling you to find the best group health coverage solution for your employees.

Another benefit of working with a small business health insurance broker such as eHealth is being able to use the services of a licensed health insurance agent at no cost to you. In addition to the convenience of free, no obligation health quotes, you can be sure that a broker’s licensed agents have no incentive to favor one insurance company or plan over the other, allowing them to better serve your needs.

What is the average cost of small business health insurance?

Although there is no additional cost to use eHealth as a broker, you may still be wondering about the average cost of small business health insurance. According to a 2018 eHealth report, the average cost of small business health insurance was $409 for premiums per person and $3,140 for deductibles per person in 2018.

Small business owners may be interested in knowing that in 2018, the average premium per-person under a small business plan was 7 percent lower than the average premium for an individual plan, while the average individual deductible for group plans was 31 percent lower than the average deductible for individual coverage, according to the eHealth report.

Since all health plan prices are set by law, brokers must follow government regulations and thus cannot raise or reduce the prices of group health plans. A small business health insurance broker can help you find affordable health insurance coverage for yourself and your employees and may even be able to inform you of health plan options you may not have previously been aware of.

Using eHealth as your small business health insurance broker

When you use eHealth to shop for small business health insurance, you benefit from an excellent selection of quality health plans, dedicated customer service, and long-term advocacy.

  • Affordable, accessible choices – eHealth’s online marketplace has over 10,000 plans from over 180 companies. The group health insurance plans we offer are priced the same everywhere else, and we make it easy to find and compare your coverage options all in one place.
  • Expert, unbiased advice – As a small business health insurance broker that can offer plans from multiple health insurance companies, eHealth is able to offer unbiased advice. Our licensed health insurance agents are committed to helping you find the best option for your business.
  • Advocacy and support – After enrolling in a group health insurance plan, we serve as your point of communication with the insurance company. We can help answer your questions about coverage and billing for the entire time you are enrolled in the group health plan.

Ultimately, the value of working with eHealth as your health insurance broker is that our licensed agents can help simplify and streamline the research, shopping, and application process, empowering you to select the optimal health plan for the budget and coverage preferences of your business.

Learn more about using eHealth as your broker for group health insurance by visiting eHealth.com or consulting one of our licensed health insurance agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Average Cost of Employer-Sponsored Health Insurance

According to research published by the Kaiser Family Foundation in 2018, the average cost of employer-sponsored health insurance in terms of average annual premiums was $6,896 for single coverage and $19,616 for family coverage. The KFF report also found that the average annual deductible amount for single coverage was $1,573 for covered workers.

Overall, despite growth in premiums over time, the average cost of employer-sponsored health insurance has remained relatively stable in the health insurance market.

Source: Kaiser Family Foundation 2018 Employer Health Benefits Survey

How has the average cost of employer-sponsored health insurance changed?

Average employer-sponsored health insurance costs have increased modestly in recent periods. The KFF 2018 survey found that the average single premium increased by 3 percent and the average family premium increased by 5 percent over the previous year.

However, a long-term view of employer-sponsored health insurance costs reveals a larger change in the costs over time. According to the KFF report, the average premium for employer-sponsored family health coverage increased 20 percent from 2013 and 55 percent from 2008.

Source: Kaiser Family Foundation 2018 Employer Health Benefits Survey

Although average premium costs have risen to a degree over the past several years, employer-sponsored health insurance may often be a more affordable option than individual health insurance coverage.

Employer and employee contributions to monthly premiums

As a small business with less than 50 full-time equivalent employees, you are not required to offer group health insurance. If your company does decide to offer health coverage to your employees, then you are typically required to pay for at least 50 percent of employee premiums as an employer. Keep in mind that your business can also decide to contribute a larger amount to your workers’ premiums.

The KFF survey noted that the level of employer contributions to worker premiums tends to vary:

  • 27 percent of covered small firm employees had their employer pay the entire premium for their single coverage.
  • 34 percent of covered small firm employees were enrolled in a plan where they contribute more than one-half of the premium for family coverage.
  • In 2018, the average amount covered employees contributed was $1,186 for single coverage and $5,547 for family coverage, which was similar to the amounts workers paid the year before.

Source: Kaiser Family Foundation 2018 Employer Health Benefits Survey

How many small businesses offer employer-sponsored health insurance?

When considering the costs of health coverage for employees, small business owners may wonder how common it is to provide an employer-sponsored plan.

According to the KFF survey, 54 percent of small firms (with between 3 to 49 workers) offered health benefits in 2018. The percentage was slightly lower for smaller groups, with the survey noting that only 47 percent of firms with 3 to 9 workers offered health coverage to their employees.

Source: Kaiser Family Foundation 2018 Employer Health Benefits Survey

The fact that only about half of small businesses offer employer-sponsored health insurance could be advantageous for the companies that do choose to provide this popular employee benefit. Offering health insurance may be an excellent way to stand out from competing employers while contributing to a company’s recruiting strategy and employee benefits package.

Overall, the KFF survey concludes by observing the continued stability and relatively low growth in costs for employer-sponsored health coverage.

The importance of affordable employer-sponsored health insurance

Understanding the average cost of employer-sponsored health insurance can help small business owners explore coverage options for themselves, their families, and their employees.

According to an April 2019 eHealth survey of small business owners, the top two most important factors for small employers when choosing a group health plan are affordable monthly premiums and out-of-pocket costs.

Source: eHealth 2018 Small Business Health Insurance Report

Shopping for employer-sponsored health insurance

With eHealth, small business owners can easily shop for affordable employer-sponsored health insurance coverage. By quickly entering in your business’ zip code and number of employees on our small business health insurance page, you can immediately gain access to free, no-obligation group health insurance quotes.

Our marketplace offers the largest selection of health plans on the Web, which allows you to quickly compare different group plans offered by different insurance companies side by side.

Find out more about how eHealth can help you find the optimal health insurance for your small business by visiting eHealth.com or speaking with one of our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

3 Mistakes to Avoid When Growing Your Small Business

Updated August 19, 2019

Running your own company presents a variety of opportunities and challenges, especially when you decide how to grow your small business. Although expanding your business involves deciding on a number of significant factors, there are a few important considerations, which you should make sure not to forget about, like your company’s health insurance benefits, online presence, and branding initiatives.

Continue reading to learn about these 3 key areas you should not neglect during the expansion of your small business.

1. Don’t underestimate the importance of highlighting your health insurance benefits

Offering health insurance as a small business can be a significant differentiator for your company, so you should not forget to bring attention to the fact that your business offers this popular benefit. One of the main advantages of offering health coverage to employees is how it may boost your hiring strategy.

According to a recent eHealth survey, 66 percent of small business employers decide to offer group health insurance in order to recruit and retain the best employees. Here’s why:

  • Recruitment – Consistently ranking as one of the top employee benefits, group health insurance may be a sign of a strong, supportive, and positive company culture to prospective hires. Creating a package of benefits that employees care about could help your small business stand out from competitors while catching the attention of potential future employees.
  • Retention – Retaining key employees means more than just reducing turnover costs: it means avoiding the loss of experienced talent, as well as the time, effort, and training required to find new employees who are the right fit for your company. Offering group health insurance may help keep your best employees by signaling that you care about your workforce’s well-being.

If your small business does not currently offer group health insurance (only businesses with 50 or more full-time equivalent employees are required to offer medical coverage), deciding to provide health benefits may be a worthwhile choice as your company continues to expand.

You can find, compare, and shop for small business health insurance plans though eHealth, and you can learn 9 great reasons to offer small business health insurance here.

2. Don’t forget about the Internet

As you focus on growing your small business, be sure to remember to invest some time in building your Web presence. Doing so can make it easier for both current and new customers to find and contact your business while providing an official, up-to-date source of information about your products and services.

Here are a few ways you can grow your company’s digital presence:

  • Create a website for your small business if you haven’t already, or consider updating your website if needed, in order to highlight recent progress, relevant developments, or exciting news you want to share with customers. An informative website may also be a showcase, portfolio, or great business development tool that could help acquire prospective clients.
  • Social media marketing can be another effective way to connect with your customers. By cultivating a strong following through community engagement, you may be able to expand your company’s reach and ultimately better understand the preferences of your audience. Learn more about easy and affordable digital marketing ideas for small businesses here.

Overall, prioritizing the Internet presence of your small business should definitely serve as an essential element of your company’s growth strategy.

3. Don’t overlook opportunities to build your brand

Given all of the responsibilities you have as a small business owner working to expand your company, it can be all too easy to overlook opportunities to further develop and amplify your company’s brand. Your brand is your business identity, representing what makes your company valuable and memorable. As a seemingly intangible yet crucial idea, your brand communicates what makes your small business unique.

Key factors to consider when crafting your company’s brand include:

  • When people think of your business, what qualities should come to mind? In other words, what makes your small business special? Is it a focus on quality, an emphasis on value, a reputation for reliability and consistency, friendly service, or an excellent selection and inventory?
  • Your brand should be able to make an impact and leave a positive impression. You can visually communicate your brand through your logo, merchandise, or marketing materials. Socially, testimonials, referrals, and reviews can be excellent evidence of your brand’s strength.

In the big picture, your brand not only serves as an extension of your marketing efforts; it may also help define what your company stands for while providing the foundation for future business opportunities.

Ultimately, investing a small amount of extra time to promote the core strengths of your small business can go a long way toward helping your company grow and thrive. To learn more about group health insurance plans for your small business, visit eHealth.com or speak with our licensed agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

What is COBRA Health Insurance?

COBRA, or the Consolidated Omnibus Budget Reconciliation Act, allows those who have quit or lost their job to keep the coverage they had under their employer for 18 months. However, with COBRA you have to front the entire bill for your health insurance instead of splitting the cost with your employer.

How does COBRA work?

If your employer offers COBRA, you may be eligible to keep your insurance if you lose your job (except in cases of gross misconduct) or lose your health insurance benefits due to a reduction in work hours.

COBRA benefits also extend to spouses and any dependents in the case of divorce or death of a covered employee. Children who are born to, adopted, or placed for adoption with a covered employee while they are on COBRA coverage are also likely to be entitled to COBRA coverage.

How do I qualify for COBRA?

You may qualify for COBRA coverage in the event of

  • Voluntary or involuntary job loss – except in the case of gross misconduct
  • A decrease in the number of work hours resulting in the loss of health insurance benefits

In addition of the above two events, spouses of COBRA covered employees may qualify for COBRA coverage if

  • Their spouse has aged into Medicare
  • They divorce or legally separate from the covered employee
  • The covered employee dies

In addition to the above events, dependent children may be entitled to COBRA if they age out of dependent child status (in most cases, this means turning 26).

What does COBRA cost?

May of those who qualify for COBRA are often shocked to know how much it costs. Those who choose to opt into COBRA have to pay the percentage of their health insurance premium that they were previously paying for their employer sponsored coverage, their employer’s share of the cost, and up to a 2% in administrative fees.

According to a 2018 survey conducted by The Kaiser Family Foundation (KFF), on average employees paid 18% of their health insurance premium for single coverage. According to the same survey workers paid 29% of their health insurance premium for family coverage in 2018.

Percentage of Premium Paid by Employee

Source: KKF Employer Health Benefits Survey 2018

With COBRA, an enrollee would go from paying around 18%-29% of their health insurance premiums to 100-102% depending on administrative fees.

According to the KFF, the average total cost of an annual premium for an employer sponsored plan for single coverage was $6,368 and $19,616 for an employer sponsored family plan in 2018. Note that these are the average total annual premium, not the employer or employee contribution.

Do I have any alternative options to COBRA?

If you decide that you do not want to opt into COBRA coverage, you have other coverage options as losing your insurance through your job doesn’t just trigger COBRA eligibility.

Quitting or losing your employer sponsored insurance is a qualifying life event that also triggers a special enrollment period which allows you to enroll in a health insurance plan outside of the open enrollment period.

Qualifying Life Events that Trigger Special Enrollment Periods

If you decide that you would rather enroll in a different major medical plan, you can do so during this special enrollment period. eHealth is a great place to shop for new coverage as eHealth is the first and largest online health insurance brokerage.

If you expect to get another job with health insurance or would prefer to wait until open enrollment to choose to enroll in a major medical plan, in most states you can purchase short-term health insurance plans that will help fill any gaps you have in health insurance coverage.

Short-term plan premiums generally cost much less than major medical plans but tend to have much less comprehensive coverage. They still do supply some coverage and having a short-term plan is much better than going without any coverage at all.

Short-term plans are a great choice for those who’ve opted into COBRA, decided they didn’t like it or that it was too expensive, and decided to end their coverage early since ending COBRA early doesn’t trigger a special enrollment period.

eHealth also offers a wide selection of short-term health insurance plans to choose from – along with other health insurance products that may help supplement a short-term insurance plan – that may be right for you.

 

Should Your Small Business Offer More Than One Plan Type?

Wondering if your small business should offer more than one plan type for group health insurance? While all companies have unique medical needs and different employee coverage preferences, a majority of small businesses who offer health coverage decide to offer only one type of group health plan. However, a small business can still choose to offer more than one plan option to its workforce.

Continue reading to find out factors to consider when deciding on how many plan types you could offer.

How many small businesses offer multiple health insurance plan types?

According to a Kaiser Family Foundation report, 83 percent of small firms (with between 3-199 workers) offer one plan type, 15 percent offer two types of plans, and 2 percent offer three or more plan types.

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2017

How does a small business decide what number of plan types to offer?

Although a small business with less than 50 full-time equivalent employees is not required to offer group health insurance coverage to its workers, a small business owner can still decide to offer at least one health plan option to his or her employees. Depending on their preferences, small employers might also consider offering more than one group plan type to their workers.

Here are a few key factors to keep in mind when deciding how many plan types to offer:

  • The ages and medical needs of your workforce – Some employees might prefer not having to see a primary care physician (PCP) for specialist referrals, so they might find a PPO plan to be convenient. Younger and relatively healthy employees who may not need to visit the doctor as often might prefer an HMO plan with low premiums, while older employers who need to see the doctor more frequently or get prescriptions might instead opt for a lower deductible plan.
  • Budget – Both affordability and flexibility tend to be a major considerations when choosing a small business health insurance plan. For instance, an HMO plan tends to have lower premiums than a PPO plan; however, a PPO plan typically provides greater flexibility in terms of obtaining medical services outside of your network. A POS plan generally requires a PCP (like an HMO) while also allowing a wider range of health care providers (like a PPO).
  • Location – If most of your employees live and work in the same geographical area, they might appreciate the convenience using nearby networks or local providers, and may benefit from the managed care system of an HMO plan or network-centric services of an EPO plan. Alternatively, if your workers commute throughout a larger, more spread-out region, they might find value in the network flexibility of a PPO or POS plan.

Knowing how much each plan type pays for covered medical services can help your small business decide what number of health insurance options would best serve the needs of your employees. When deciding on health coverage, be sure to talk with your group to find out what they want out of a plan.

What is the most popular small business health plan type?

According to an eHealth survey, almost half (47 percent) of small business owners chose to enroll in a POS plan in 2018, while POS and HMO plans accounted for nearly three quarters of all plans selected in 2018. The report also found that:

  • HMO plans accounted 26 percent of small business plans in 2018 (up from 24 percent in 2017).
  • PPO plans accounted for 15 percent of plans in 2018 (up from 12 percent in 2017).
  • EPO plans accounted for 12 percent of plans in 2018 (down from 14 percent in 2017).

Source: eHealth 2018 Small Business Health Insurance Report

Ultimately, some small businesses may find that one plan type is the most effective way to provide health insurance to all of their workers, while other businesses may decide that offering more than one type of health plan lets them better address the variety of medical services their employees require.

Where to shop for small business health insurance

You can find affordable group health insurance plans through eHealth. As one of the largest private health exchanges for small business, we make shopping for group health insurance simple and easy. You can conveniently compare plan types from multiple insurance companies all in one place though our website, and can get unbiased expert advice from our licensed health insurance agents. Visit eHealth.com today to learn more about finding the right health insurance for your small business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Supplemental Health Insurance for Small Business

While numerous studies and surveys highlight how health insurance is one of the most popular benefits among employees, small business owners creating a benefits package for their workforce may be wondering what other worthwhile employee benefits they should consider.

Although they are typically not required to do so, many small businesses decide to separately offer supplemental health insurance plans to help their employees with paying for medical expenses not otherwise covered through their group health plan.

What is supplemental health insurance for small business?

A supplemental health insurance plan provides separate coverage for medical services that a basic essential group medical plan does not cover.

Examples of common supplemental insurance plans for small businesses include:

Supplemental health insurance is optional, and a small business (with less than 50 full-time equivalent employees) is not required to offer this kind coverage to its workers. Still, depending on your company’s budget and coverage preferences, it may be worth exploring the possibility of providing supplemental insurance plans to better meet the medical needs of yourself and your employees.

What are the most popular small business supplemental health insurance plans?

According to a 2018 eHealth survey, the two types of supplemental insurance most often offered by small businesses to their employees are dental (52 percent) and vision (41 percent) insurance plans.

  • Group dental plans – The main types of supplemental dental insurance are indemnity plans (which usually have less network restrictions), managed-care plans (such as PPO and HMO plans, which usually require a provider network), and discount plans. You can learn more about these group dental plans by reading our comprehensive guide to supplemental dental insurance.
  • Group vision plans – The two primary forms of vision insurance are ancillary insurance (which covers a percentage of eye care costs, while your employees pay the rest out of pocket) and optional rider insurance (which provides access to a specific dollar amount of insurance coverage by paying a monthly premium). Learn more about small business vision coverage here.

Source: eHealth 2018 Small Business Health Insurance Report

Why might a small business decide to offer supplemental insurance?

There are several compelling reasons why a small business may consider providing supplemental health insurance to its employees.

  • Hiring strategy – According to a 2018 eHealth report, 66 percent of small business owners offer group medical coverage to better recruit and retain the best employees. Prospective workers may be more likely to join companies that offer appealing benefits packages, and group medical, dental, and vision insurance tend to be among the most desirable of employer-sponsored perks.
  • Affordability – With vision and dental plans starting as low as $12 per month per individual on eHealth, it is easy to see why a significant number of small business owners decide to offer supplemental health insurance benefits to their workforce. Your small business may also be able to limit your actual costs through tax deductions and cost-sharing for employee premiums.
  • More comprehensive coverage – No one wants to be uninsured when they need a major dental procedure or new pair of glasses. Making supplemental insurance available to your employees may provide more complete coverage for less frequent yet equally important medical services.

Overall, even though offering supplemental health insurance coverage means paying for a larger portion of employee premiums each month, the long-term benefits of offering additional plans may well outweigh the costs. Whether in the form of greater employee retention or coverage when you and your workforce need it most, supplemental plans may provide significant advantages for your small business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

What is a Private Health Exchange for Small Business?

As a small business owner considering group health insurance, you may be wondering what your options are in terms of where to find coverage. Private health exchanges are marketplaces for health insurance plans run by private companies. A private health exchange like eHealth lets you shop for and compare small business health insurance plans available from a variety of health insurance companies, and may also include a greater selection of plans than public health exchanges.

What is a private health exchange for small business?

A private health exchange, also known as a health insurance marketplace, is a resource that enables you to shop for, review, and purchase health insurance plans. Run by a private company, this type of online exchange or marketplace usually provides a selection of health insurance options available in your area.

As a small business owner, you can use a private health exchange to find group health insurance for yourself and your employees at any time of year. By using quotes to explore different small business health insurance plan types, you may be better able to find the right plan for the unique needs of your company. A private health exchange for employers may also allow you to learn more about health care tax credit options (if applicable) that may be available for small businesses.

What is the difference between a private health exchange and a government health exchange?

In accordance with the Affordable Care Act (ACA), both private health exchanges and government health exchanges facilitate the process of finding, comparing, and purchasing health insurance. The main difference between them is that a private health exchange is run by a private company, and public health exchange is run by the government, at either the federal or state level.

  • State government health exchanges – Depending on the location your small business, some states run their own health insurance marketplace.
  • Federal government health exchange – Since not all states run their own health insurance marketplace, small business owners can also use the federal health insurance marketplace.
  • Private health exchanges – A private health exchange like eHealth may offer plans which may not be available through public health exchanges. As a small business owner who wants to explore all of your options for affordable health coverage, using a private health exchange could be a great way to benefit from comparing a potentially wider selection of plans and choices.

While government marketplaces only offer ACA-complaint exchange plans, a private health exchange can offer both ACA-compliant plans as well as alternative health insurance plans. If you decide to buy an ACA plan from eHealth, it will include the same essential benefits that you would get from a state or federal health exchange.

Since ACA plan prices are fixed by law, you will always pay the same price for the same insurance plan, no matter where you purchase it. Note that premiums will vary based on factors such as the state your small business is located in and your number of employees. eHealth will have the best prices on any product we sell, and our plans and premiums cost the same as they would on any other platform.

Why use a private health exchange for small business health insurance?

You can find group health insurance through eHealth, a leading private health exchange that offers the largest selection of small business health insurance plans available online. eHealth offers a variety of features to help make finding group health insurance as simple, easy, and informative as possible.

  • Free quotes – You can instantly access free personalized, no-obligation quotes for your small business by entering in your ZIP code and number of employees on our small business webpage. Plus, since we do not have broker fees, you can avoid spending additional money.
  • Easy comparisons – You can conveniently compare the prices of many different health insurance plans available from multiple insurance companies and provider networks in your area, all in one place, helping you to find the right coverage option for your business.
  • Expert advice – With eHealth, you benefit from access to our licensed health insurance agents, who can help answer your specific questions, provide unbiased expert advice, and guide you through every step of our streamlined shopping, enrollment, and implementation process.
  • Long-term advocacy – Even after you enroll in a group health insurance plan, eHealth continues to be available as a resource to your small business. By serving as your advocate and point of communication with the insurance company, we can help you answer questions related to claims, billing, or other areas where you may need assistance.

With our easy-to-use website, world-class customer service, and large variety of health plans, we aim to provide the most comprehensive group health insurance coverage options for small business owners.

To learn more about affordable choices for quality small business health insurance, visit eHealth.com or speak with one of our helpful licensed insurance agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Health Insurance Reimbursements for a Small Business

A health insurance reimbursement serves as a tax-advantaged way for an employer to reimburse employees for qualified medical expenses. Continue reading to learn more about how a health insurance reimbursement works specifically for a small business.

What is a health reimbursement arrangement (HRA)?

An integrated health reimbursement arrangement, also called a health reimbursement account and usually referred to as an HRA, provides a monthly, tax-free allowance for employees to pay for their medical expenses. Workers formally submit proof of their medical costs to their employer, who then reimburses employees for qualified expenses from their monthly allowance.

While terms and conditions vary depending on the type of HRA, here is an overview of how a health reimbursement arrangement typically works:

  • A qualifying small business creates an IRS-approved HRA account on an employee’s behalf, placing a certain amount of money in the account based on whether the HRA is for a single employee or an employee with a family.
  • The employee with the HRA account can then purchase their own individual or family health insurance plan (or enroll in the employer’s qualified high-deductible group plan for a group coverage HRA) through private exchanges like eHealth.com or from an insurance company.
  • The employee can apply the money in their HRA toward paying for monthly premiums, or particular out of pocket costs such as deductibles, copays, and coinsurance.

An HRA benefit must also follow applicable federal rules such as the Affordable Care Act (ACA). Note that employees receiving HRA contributions usually will not be eligible for government subsidies when they purchase health coverage on their own through a government health exchange.

What is a QSEHRA?

A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is a type of HRA for a small business with less than 50 employees that does not offer a group health insurance plan. A QSEHRA allows a small business to give workers a tax-free allowance every month, which employees can choose how to spend and can be reimbursed for qualified medical expenses by their employer.

One benefit of this health insurance reimbursement option is that, by setting a budget for their employees, a small business does not have to select a one-plan-fits-all health plan for their entire workforce. This means that employees can decide how much they want to spend on their health plan. For instance, older employees with families might spend more compared to younger employees, or employees who already have health insurance through their spouse might want to spend less.

To learn more about setting up a QSEHRA, visit the IRS website.

How does a health insurance reimbursement compare to a group health insurance plan?

A health insurance reimbursement is not really an alternative to group health coverage, and instead functions as a way to supplement a health insurance plan, primarily by helping employees pay for particular out-of-pocket medical expenses.

While a small business splits the cost of monthly premiums with employees through an employer-sponsored health insurance plan, employers are the only ones who contribute to an HRA account in order to later reimburse their employees. Money in an HRA account also belongs to the business.

To qualify for tax advantages, a health insurance reimbursement arrangement usually needs to work with health insurance that meets minimum essential coverage according to the ACA.

Overall, depending on your budget preferences and coverage needs, a health insurance reimbursement may be a worthwhile option for your small business to consider in lieu of, or in addition to, a group health plan.

To get more information about how a health insurance reimbursement works for a small business, speak with an accountant or legal and tax advisor.

Visit eHealth.com or talk with one of our licensed agents to learn more about your small business health insurance options today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Texas Open Enrollment Dates 2020 – Affordable Care Act (Obamacare)

In Texas, if you’re applying for health insurance under the Affordable Care Act (ACA or Obamacare), your open enrollment period for the 2020 coverage year begins on November 1, 2020.

How much is health insurance a month for a single person in Texas?

According an eHealth marketplace survey, these are starting prices for coverage in Texas

  • Obamacare or Major Medical coverage for a 40-year-old costs $227.85 per month1
  • A 12-Month Short-Term Health Insurance plan* for a 40-year-old costs $111.24 2

1 This is based on the lowest cost plan available for a 40-year-old on Healthcare.gov in October of 2018.

2 This is based on the lowest cost plan available for a 40-year-old woman on eHealth.com with a $5,000 deductible and 20% coinsurance, or less.

How do I get cheap health insurance in Texas?

  1. Figure out your personal needs: Do you need prescription coverage? Do you have a doctor you like?
  2. Research the options you have in Texas:Start at eHealth.com to compare Obamacare plans, short-term plans and other alternatives.
  3. Research the options you can qualify for:You can enroll in any Obamacare plan during open enrollment. For short-term health insurance and other medical insurance alternatives, you can apply any time, but you typically need to answer medical questions and may be declined.
  4. See if you qualify for discounts or subsidies: ACA plans may be available to you with a tax credit, which can save you hundreds and sometimes thousands of dollars on monthly premiums
  5. Be certain your prescription drugs are covered: com provides a prescription drug coverage comparison tool that helps you find the plan that covers your drugs with the lowest out-of-pocket cost
  6. Find plans that accept your doctor: eHealth has a physician finder tool that lets you compare plans using your preferred doctor.
  7. Apply online: eHealth makes it easy to complete your health insurance application online, even if you qualify for a tax credit.

How much is health insurance per month for a single person in Texas?

With the Open Enrollment period coming to an end, you’re probably starting to think about the cost of health insurance plans in Texas. According to the most recent data online, here are the starting prices for coverage for a single 40-year-old man in Texas:

Zip, City, State  Lowest Priced Bronze 

(Healthcare.gov on 7/17/2020)

12-Month short-term plan (Lowest Priced Plan)

(ehealth.com 7/17/2019)

73301, Austin, TX $313.55 $125.82

1This is based on the lowest cost plan available on Healthcare.gov in July 2019

2This is based on the lowest cost plan available on eHealth.com with a 10K deductible, 20% coinsurance, or less

How much can people save on prescription drug coverage with an Obamacare plan?

In Texas, the average person using eHealth’s Rx drug tool saved over $2,000 on out-of-pocket drug costs by having an Obamacare plan, according to research from eHealth.com.

What types of health insurance can I get in Texas?

Insurance Companies in Texas with Plans Available on eHealth.com Short-Term Health Insurance Major Medical Health Insurance Medical Insurance Packages
Blue Cross, Blue Shield of Texas No Yes No
Companion Life Insurance Yes No No
Independence American Yes No s
National General Accident & Health Yes No No
United Healthcare Yes No Yes

2020 Open Enrollment Dates in Florida – Affordable Care Act (Obamacare)

Watch Our Video on How Florida Open Enrollment Works

How much is health insurance a month for a single person in Florida?

With the Florida Open Enrollment coming up, you’re probably starting to think about the cost of health insurance plans in Florida. According to the latest eHealth marketplace survey, these are starting prices for coverage for a single 40-year-old male in Florida:

Zip, City, State  Lowest Priced Bronze 

(Healthcare.gov on 7/17/2019)

 6-Month Short-Term Plan (Lowest-priced plan)

(eHealth.com 7/17/219)

33443
Miami, FL
$329.25 $96.40

1 This is based on the lowest cost plan available on Healthcare.gov in July of 2020.

2 This is based on the lowest cost plan available on eHealth.com with a $12,500 deductible and 30% coinsurance, or less.

Insurance Companies in Florida with Plans Available on eHealth.com Short-Term Health Insurance Major Medical Health Insurance Medical Insurance Packages
Companion Life Insurance Yes No No
Independence American Yes No Yes
National General Accident & Health Yes No No
United Healthcare Yes No Yes
CoreHealth Insurance No No Yes
Health First No Yes No
Oscar No Yes No
Ambetter No Yes No
Molina No Yes No

How do I get cheap health insurance during the Florida Open Enrollment Period?

  1. Assess your personal needs:Do you need Rx coverage? Do you have a doctor you like?
  2. Research available options in your state:Start at eHealth.com to compare Obamacare plans, short-term plans and other alternatives
  3. Understand which options you can qualify for:You can enroll in any Obamacare plan during open enrollment in Florida. For short-term health insurance and other medical insurance alternatives, you can apply any time, but you typically need to answer medical questions and may be declined.
  4. See if you qualify for discounts:ACA plans may be available to you with a tax credit, which can save you hundreds and sometimes thousands of dollars on monthly premiums.
  5. Make sure your prescriptions are covered:com provides a prescription drug coverage comparison tool that helps you find the plan that covers your drugs with the lowest out-of-pocket cost.
  6. Make sure your doctor is covered: eHealth has a physician finder tool that lets you compare plans using your preferred doctor
  7. Enroll online: eHealth makes it easy to complete your health insurance application online during the Florida Open Enrollment Period. Even if you qualify for a tax credit through the government, you can still enroll through eHealth and receive your tax credit.

How much can people save on prescription drug coverage with an Obamacare plan? 

In Florida, the average person using eHealth’s Rx drug tool saved $1,600 on out-of-pocket drug costs by having an Obamacare plan, according to  research.

3 Ways to Save on Group Health Insurance

With rising health care costs, you may be wondering how your small business may be able to save on group health insurance while still providing quality coverage options for your employees.

Since there are a variety of small business health insurance plan types available, it’s always good to explore all of the options, in order to find the plans that fit your health care needs and budget at the same time. Considering options like HSAs, encouraging health and wellness of your employees, and shopping on a platform with multiple options are all ways that might help you save a buck without sacrificing the quality of your group health insurance plan. Continue reading to learn 3 great ways to save on group health insurance plans.

1. Health Savings Account (HSA)

A Health Savings Account (HSA) is a tax-favored, interest-earning savings account designed to be used with a high-deductible health insurance plan (HDHP) in order to pay for designated medical expenses. Since monthly premiums for HSA-compatible, high-deductible health plans tend to be lower than premiums for lower-deductible plans, selecting an HSA plan may help small businesses and their employees save pre-tax money.

Advantages of HSAs for small business owners and employees include:

  • Employees’ contributions to an HSA can be deducted from their pay on a pre-tax basis, providing a way to pay for out-of-pocket costs with pre-tax dollars.
  • Unused money in an HSA can roll over year to year, meaning that they can grow over time.
  • HSAs are connected to a specific person, not their job. This allows employees to own their HSA account and transfer their saved funds if they change jobs.
  • While all plans are different, an HSA may be able to pay for particular types of medical and health care expenses, such as dental visits, that medical insurance does not cover.

Note that not all high-deductible health plans are eligible to be used with an HSA, so be sure to choose an HSA plan that fits your small business health insurance needs.

2. Promote employee wellness

Workplace wellness programs can help your employees stay healthy. These initiatives are designed to promote healthier lifestyle choices among your workforce. Whether they are officially tracked and implemented or more informally encouraged, wellness programs can be based on a variety of goals, such as promoting fitness, tobacco cessation, weight loss, or stress management.

You don’t need a large budget to start a workplace wellness program for your small business. Employees may be motivated to participate through incentives for meeting goals, or through friendly competitions and team activities that might contribute to a more positive company culture over time.

Another potential benefit of workplace wellness programs is that they may contribute to greater employee engagement and retention. For instance, employees may show greater loyalty to employers that demonstrate that they care about the long-term health and well-being of their workers by offering popular employee benefits such as wellness initiatives and group health insurance.

3. Shop for group plans with eHealth

With eHealth, you can easily compare different plans and prices for group health insurance coverage. As the largest online private health marketplace, we offer a variety of tools and resources that allow you to conveniently consider all of your small business health insurance options in one place. Since health insurance prices are fixed by law, we will have the best prices on any product we sell.

Benefits of using eHealth to shop for group health insurance include:

  • Free group health insurance quotes – With the best selection of small business health insurance plans online, our no obligation quotes let you quickly review the key features of each plan.
  • Licensed health insurance brokers – Known for world-class customer service, our licensed agents can help answer your questions and provide personalized guidance and unbiased advice.
  • Long-term support and advocacy – We serve as your point of communication with the insurance company, even after you purchase a small business health insurance plan. We’ll be there for you when you have questions about claims, billing, or coverage.

Overall, eHealth can help you save money on group health insurance by empowering you to find affordable health coverage that meets the needs and preferences of you and your employees.

Visit eHealth.com today to find the right group health plan for your business.

This article is for general information, may not be updated after publication, and should not be relied on as medical advice. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice. Check with a medical professional for medical advice.

Do Small Businesses Have to Offer Fringe Benefits?

While most large employers tend to be legally required to offer fringe benefits, a small business usually does not have to offer certain fringe benefits such as health insurance. However, prioritizing fringe benefits may be worthwhile for a small business seeking to further improve its company culture for several reasons.

Continue reading to learn more about which kind of businesses are required to offer fringe benefits.

What are fringe benefits?

The IRS defines fringe benefits as forms of pay in addition to the stated compensation for the performance of work or services.

These are employer-sponsored benefits offered to employees as compensation for work-related activities or to promote job overall satisfaction.

Examples of common fringe benefits include:

  • Group health insurance
  • Vacations and holidays
  • Life insurance
  • Sick leave

The IRS tax guide for fringe benefits further explains which employee benefits are taxable and nontaxable. For example, group health insurance is a nontaxable fringe benefit, and employee health insurance premiums are usually tax deductible for small business employers.

Do small businesses have to offer fringe benefits?

According to the IRS and the Affordable Care Act (ACA) mandate for employers:

  • Employers with fewer than 50 full-time employees are not required to offer health insurance and certain other fringe benefits to their employees.
  • Employers with 50 or more full-time employees are often required to offer fringe benefits, including health insurance, to their workforce.

This means that small businesses typically do not have to offer specific types of fringe benefits that a large employer may legally be required to provide.

Which fringe benefits do employers have to offer?

Most employers are required to offer the following fringe benefits:

  • Social Security tax – All employers are required to pay into the Social Security program, which provides benefits to Americans who are retired, disabled, or survivors.
  • Workers’ compensationWorkers’ compensation insurance covers workplace- and employment-related injuries and illnesses.
  • Health insurance – A business with 50 or more full-time employees is required to provide health insurance. A small business with less than 50 full-time equivalent employees is not required to offer group health insurance coverage.
  • Unemployment insurance – All businesses pay into unemployment insurance, which is funded by employers in most states (although employees may pay directly for this in some states).
  • COBRA insurance – Also known as the Consolidated Omnibus Budget Reconciliation Act, COBRA requires group health plans to offer continuation coverage to eligible employees. COBRA does not apply if a small business does not offer a group health plan.
  • Family and medical leave – Employers with over 50 employees are required to offer job-protected family or medical leave. Small businesses usually are not required to offer this.
  • Civic obligations – Depending on the state, employers are required to provide unpaid time off to their employees in order to attend jury duty or jury service.
Fringe Benefit Required for a large business? Required for a small business?
Group health insurance Yes No
COBRA insurance Yes No
Family and medical leave Yes No
Social Security tax Yes Yes
Unemployment insurance Yes Yes
Worker’s Compensation Yes* Yes*
Civic obligations (i.e. jury duty) Yes* Yes*

*Workers’ compensation and jury duty rules vary by state law.

Overall, business size and state law determines which kind of employers are required to offer fringe benefits.

Fringe benefits and company culture

Even though your small business may not have to provide certain fringe benefits to your employees, doing so may contribute to several strategic advantages for your business, such as creating a more positive company culture, increasing employee retention, and assisting with recruiting.

  • Company culture – Current and prospective employees often view fringe benefits as a way to evaluate company culture. Offering popular and highly valued benefits could be an effective way to show that a company cares about the well-being of its employees.
  • Employee retention – Workers may be more likely to stay at a company with great benefits. Such perks, including group health coverage, may increase employee loyalty; reduce employee turnover, absenteeism, and sick days; and promote greater job satisfaction.
  • Recruiting – One of the best ways to create a competitive small business benefits package is to offer some of the top fringe benefits, such as group health insurance, or group dental and vision These benefits may help a company stand out and attract quality employees.

Ultimately, while a small business is required to offer fewer benefits than a large business, it may be worthwhile for a small employer to provide employee benefits to its workforce.

Find affordable small business health insurance with eHealth

eHealth makes it easy to shop for group health insurance plans for your small business. As the largest online private health exchange, we offer free group health quotes, world-class customer service, and the best selection of plans available.

Visit eHealth.com or speak with one of our licensed insurance agents today to see how you can find affordable health insurance for your small business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Should Your Small Business Offer Unlimited Time Off?

Overall, unlimited time off is one employee benefit that, like group health insurance, may cost you, but in many ways could potentially improve your small business’ company culture.

An unlimited time off policy allows employees to take any number of vacation and sick days as they need after getting manager approval. While this is a fairly uncommon employee benefit, the advantages of implementing an unlimited time off policy may include saving costs from reduced vacation liability, contributing toward a positive company culture, and helping to recruit and retain talented employees.

What does unlimited time off mean?

An unlimited time off policy, also known as discretionary time off and unlimited paid time off (PTO), typically means that employees are not allocated a specific number of days off. Instead, employees are allowed to use as many vacation and sick days as they need after getting approval from their manager and ensuring the completion of their performance goals.

While the specifications and limitations of unlimited time off policies vary by company and employer, you should know that this policy does not mean that workers can take time off or go on vacation unannounced.

What are the potential advantages of unlimited time off?

Unlimited time off could be a compelling alternative to a traditional vacation policy. The main pros of an unlimited time off policy may include:

  • Cost savings – Many employees do not end up using their paid vacation days, which may lead to the considerable financial and administrative liability of having to pay workers for their unused vacation time. Depending on the circumstances and state laws, small businesses may be able to reduce the costs of accrued vacation liability by offering unlimited time off to their employees.
  • Positive company culture – Employees may appreciate not only the greater flexibility that goes with an unlimited time off policy, but also the demonstration of trust shown to them by their employer. Such mutual goodwill and responsibility can be part of a positive company culture that rewards productive employees and respects work-life balance.
  • Recruitment and retention – According to the Society for Human Resource Management (SHRM), only 1-2 percent of companies currently provide an unlimited time off policy. Offering this employee benefit, along with other popular benefits such as group health insurance, can be a significant differentiator for small businesses that want to keep their best employees, reduce turnover, and attract quality prospective talent.

What are the potential disadvantages of unlimited time off?

Due to the nontraditional nature of an unlimited time off benefit, it may be difficult to put this policy into practice for small business employees. The primary drawbacks may include:

  • Implementation challenges – If a small business already has an established paid time off policy, it might be difficult to transition to an unlimited time off structure, especially if unused vacation time that has been accrued is not paid out to employees. Without schedule coordination, staff shortages might occur if too many employees are on vacation at the same time.
  • Management expectations – This benefit requires a significant amount of responsibility and trust between the employer and employee to avoid misuse or abuse. As a result, offering unlimited time off may be more successful in a small business that already has a strong company culture, or if the company’s leadership and management set clear guidelines for employees.
  • Occupational limits – Unlimited time off might not work as benefit for small business employees for all industries or types of jobs. Examples include non-exempt employees (who do not receive PTO) or unionized employees, or jobs which require being on the premises of the business during specific schedules, such as those in the retail or manufacturing industries.

The reality of unlimited time off for a small business

While there are many pros and cons that may go with an unlimited time off policy, the reality is that this perk remains a fairly uncommon benefit among small business employees.

If a company is concerned about the payout liability of accrued vacation time, it might consider exploring unlimited time off in the future. The per-employee liability from unused vacation days and paid time off was $2,226 in 2016, up from $1,898 in 2015, according to a survey from Project: Time Off. Ultimately, these concerns will depend on applicable state laws and individual company policies.

Source: Fractl survey / Harvard Business Review

A small business may also think that employees may take more vacation time under an unlimited time off policy. Small business owners may be surprised to learn that the average U.S. employee has only taken 54 percent of his or her vacation time or paid time off in the past six months, according to a Glassdoor survey.

Ultimately, it may make more sense to stay with a traditional incentive model where more vacation days are awarded to senior or long-term small business employees. Under an unlimited time off policy, a company may consider setting out clearly communicated vacation time recommendations for their employees to give them a better sense of what is an appropriate amount of time to take off from work.

Overall, as a rarely offered and fairly recent benefit, many companies are still working out the gray areas of their unlimited time off policies. However, as long as there are well-established approval guidelines in place, unlimited time off may be a worthwhile benefit to consider for responsible small business employees.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Should Your Small Business Offer Fringe Benefits?

Fringe benefits are types of additional compensation that employers may choose to offer to their employees. Examples of common fringe benefits include health insurance and paid vacation or time off. Group health insurance coverage is often one of the most valued employee benefits at a small business, and it may help build a positive company culture by providing access to lower premiums on average, enhancing recruitment and retention, and contributing to greater workforce productivity.

What are fringe benefits?

According to the IRS, fringe benefits are forms of pay or compensation in addition to the stated pay for the performance of work or services.

Employers often offer fringe benefits to their employees as work-related compensation or to increase job satisfaction and morale. You’ve probably already heard of some fringe benefits, such as health insurance or paid vacation and time off.

As per the IRS, fringe benefits can be divided into:

  • Taxable fringe benefits – These benefits are include in wages and gross income, and are reported on Form W-2, the Wage and Tax Statement, and generally subject to Federal income tax withholding, social security, and Medicare. They can also be partially taxable or tax deferred.
  • Nontaxable fringe benefits – These are excluded from wages. For example, employer-sponsored health insurance is a non-taxable or excludable fringe benefit.

You can learn more about related tax guidelines via the IRS tax guide to fringe benefits for 2019.

What are examples of fringe benefits?

Common examples of fringe benefits that a small business can choose to offer to its employees include:

If your small business has less than 50 employees, then it is typically optional whether you decide to offer fringe benefits to your workforce. If your company has more than 50 employees, then your business may be legally required to offer certain fringe benefits.

Why is small business health insurance the most valued employee benefit?

Group health insurance continues to be among the most popular fringe benefits offered to employees, and one of the benefits that employees care about most. Employer-sponsored health insurance could be an excellent way to help create a positive company culture at your small business while providing coverage for yourself, your employees, and their families.

Key reasons why group health insurance may contribute to building a vibrant company culture include:

  • Access to lower premiums – On average, small business health insurance coverage tends to be more affordable per person than individual health insurance. Employees may express greater job satisfaction when their company provides them access to lower-price health insurance. A satisfied workforce is ultimately a key factor that help creates a positive company culture.
  • Loyalty and retention – When employees know that their employer has invested in their long-term well-being with a health plan, they may be more likely to stick around. Reduced turnover may be a good sign of a company culture that inspires employee dedication and commitment.
  • Improved recruitment – According to a Randstad survey, 66 percent of workers agree that a strong benefits package is the largest determining factor when considering job offers. As one of the most appealing fringe benefits, group health insurance can help improve your small business’ recruiting strategy while cultivating a wellness-focused company culture.
  • Greater productivity – Healthy workers tend to be happier, more productive employees. With the peace of mind from knowing they have health insurance coverage, they may be more likely to be focused and engaged in their work. Healthier employees can also mean less sick days and absenteeism among your small business workforce.

You can learn about more great reasons to offer small business health insurance here.

Shop for affordable small business health insurance with eHealth

With eHealth, you can get free quotes for group health insurance plans based on your budget and coverage preferences. By comparing options from multiple health insurance providers, you can find the optimal small business health insurance for your company. eHealth also serves as your advocate and point of communication with the health insurance company, even after you have enrolled in coverage.

Visit eHealth.com or speak with one of our licensed health insurance agents to find the right group health plan for your small business today.

Does Your State Require You to Have Health Insurance?

Updated September 17, 2019

The Individual mandate law – which requires you to have health insurance – does not apply anymore in 2019 at the federal level, however there are a few states that have an individual mandate at the state level.

According to the commonwealthfund.org, if you live in the following states, you may have to pay a tax penalty for not having health insurance:

  • Massachusetts
  • New Jersey
  • Vermont
  • DC

What is the individual mandate?

In the past if you went without Affordable Care Act (ACA) compliant health insurance for more than two months, you would have to pay a significant tax penalty.

According to Kaiser Health News, the penalty for going without health insurance in 2018 was $695 per uninsured adult or 2.5% of your income, whichever amount was higher.

Now that the individual mandate has been repealed there is not tax penalty at the federal level. However, some states have put their own individual mandate laws in place at the state level to encourage people to purchase health insurance.

Massachusetts’ individual mandate

According to mass.gov, Massachusetts has required its residents to have health insurance or pay a fine since 2006. Massachusetts officials have said to have reached coverage rates as high as 97.5% in the state, in part due to the mandate.

In this state, the tax penalty is based on income level in relation to the Federal Poverty Line (FPL). The FPL is placed at a certain income per year by the government. Your eligibility for subsidies, and in this case for a fine, is based what percentage your annual income is of the FPL.

For 2018, the FPL is $12,140 for an Individual and $25,100 for a family of four.

Source: 2018 HHS poverty guidelines

For 2019, those making $150 and under of the poverty line the individual responsibility penalty does not apply.

For those who make 150.1% to 200% of the FPL, their fine will be the equivalent to half of the lowest price ConnectorCare health insurance plan. ConnectorCare is Massachusetts’ health insurance marketplace.

Those making over 300% of the FPL will be charged half of the lowest priced bronze premium (which are based on the prices as of January 1, 2019).

Penalties for married couples (with or without children) will equal the sum of the individual penalties for each spouse.

New Jersey’s individual mandate

After the federal individual mandate was set to be repealed, New Jersey decided to put one in place with a tax penalty at the state level which takes effect in 2019.

If you do not have health insurance or if you do not qualify for an exemption, you may have to pay the tax penalty for every month that you go without the minimum essential coverage.

The tax penalty is generally based on your household income (which include the income of any dependents) as well as family size. However, the penalty capped at the cost of the average statewide premium for bronze health insurance plans.

According to nj.gov, for an individual, the minimum tax penalty is $695 and the maximum is $3,012 for 2019. For a family of 5 with a household income of $200,000 or below the minimum tax penalty is $2,085 and the maximum is $9,500.

If you are not required to file a tax return for 2019 in NJ, then you are exempt from paying this tax fine.

Washington D.C.’s individual mandate

After the federal mandate was set to be repealed, Washington D.C. put an individual mandate in place for the district as a part of their Get Covered, Stay Covered campaign. This tax penalty went into effect for the year of 2019.

According to dchealthlink.com, the tax penalty for going without the minimum essential coverage in Washington D.C. for 2019 is $695 per adult and $347.50 per child, up to $2,085 per family or 2.5% of the household income that is over the federal tax filing threshold, whichever is greater.

For instance, a family of 4 with a household income of $98,000 will have to pay a tax penalty of $2,085 per month for going without ACA-compliant health insurance.

You may qualify for an exemption to this tax for if you’ve experienced something such as a financial hardship, eviction, or pregnancy.

California’s Individual Mandate

California is the latest state to implement an individual mandate law and impose the shared responsibility tax penalty for residents.

According to Covered California, the reasoning for restoring the individual mandate is a factor in keeping premiums on average 3.2% lower in the upcoming year. Covered California anticipates that this could leave to Californians saving an average of $167 per year on their health insurances premiums in 2020.

Those who choose not to purchase health insurance but can afford it, may be subjected to a tax penalty, which will be a part of their annual state tax filing. The penalty for Californians who go without health insurance may be 2.5% of household income or $696 per adult (this number will rise yearly with inflation), whichever is larger.

Vermont’s individual mandate

Vermont lawmakers passed an individual mandate law that will go into effect in 2020, however they did not develop a penalty for those who go without health insurance.

This does not mean there will not be a penalty. If you live in Vermont, keep an eye out in case lawmakers do decide to develop and implement a penalty for those going without minimum essential coverage in the future.

How do I avoid the individual mandate tax?

To avoid this tax, you can enroll in a health insurance plan during the open enrollment period. For 2020 coverage, the national open enrollment period will take place from November 1st 2019 through December 15th 2019.

If you lose your insurance in the middle of the year, you may qualify for a special enrollment period. Or, depending on which state you live in, you may be able to enroll in short-term health insurance to help fill any coverage gaps you may experience throughout the year.

eHealth, the nation’s first and largest online health insurance brokerage, sells both major medical plans and short-term health insurance plans to help fulfill whatever your coverage needs may be. Enter your zip code where applicable on this page to get started!

What Qualifies me for COBRA?

If your employer offers COBRA, you may have the option to keep your current health insurance coverage for up to 18 months, if your employment terminates at any point in the year.

What is COBRA?

COBRA, or the Consolidated Omnibus Budget Reconciliation Act, is a federal law that allows those who have quit or lost their job, to keep their employer-sponsored coverage for up to 18 months (and in some cases longer). The catch is that you will be paying for the coverage in total, rather than splitting it with your employer.

How do I qualify for COBRA?

You may qualify for COBRA if you experience a qualifying event that causes you to lose your employer sponsored health insurance. Some qualifying events include:

  • Quitting
  • Getting fired, unless it was for gross misconduct
  • Having your hours reduced which made you ineligible for benefits

Dependents can qualify for COBRA too. Some qualifying events that would allow dependents to qualify for COBRA include

  • The death of a covered employee
  • Losing dependent status as an adult child (turning 26)
  • Divorce or legal separation
  • A covered employee becoming eligible for Medicare

How expensive is COBRA?

One of the chief concerns for those considering opting into COBRA is the cost. When it comes to group – or employer sponsored – health insurance, your employer typically picks up most of the bill. In fact, according to the KFF, employers paid about 82% of the premium for single coverage and 71% of the premium for family coverage. On the other hand, if you opt in to COBRA, 100% of the bill is your responsibility, along with a portion of administrative fees.

On average, an employer sponsored health insurance plan for a single person cost $6,896 per year. Employers on average paid 82% for single person coverage, leaving the individual with only 18%of the bill, which was $1,241 a year on average.

An employer sponsored family plan cost $19,616 on average. On average employers paid 71% of the bill, leaving the employer with the remaining 29% of the bill, which was $5,689 a year on average.

The transition from having your plan be employer-sponsored to paying everything on your own can be quite a shock to those only used to paying a small percentage of their health insurance premium.

Those who opt into COBRA should make sure that they’re okay with paying 100% of their health insurance premiums and the administrative fee at least until the next open enrollment period. Once you opt into COBRA you cannot qualify for a special enrollment period if you choose to end your COBRA coverage early. Make sure that you can afford these payments so you are not left without health insurance in the middle of the coverage year.

What are my other options aside from COBRA?

If you decide that you don’t want to opt in to COBRA, you have other coverage options.

Loss of your employer sponsored insurance is a qualifying event that triggers a special enrollment period, this means that you don’t have to wait until the open enrollment period to enroll in a new plan.

During this special enrollment period you can purchase an individual or family plan through a state or federal exchange, or through an online brokerage such as eHealth. Some examples of qualifying life events include:

If you expect to get another job with health benefits or would prefer to wait until the open enrollment period to purchase a plan, in most states you can purchase short-term health insurance plans to fill any gaps in coverage that you experience.

Short-term plans generally have low premiums with applications getting approved as soon as next day. While the coverage that short-term plans offer is not as comprehensive as major medical plans, they still supply some coverage. This is a great option for those who’ve opted into COBRA, found that they had difficulty affording 100% of their premiums plus the administrative fee, and chose to end their COBRA coverage early.

eHealth, the first and largest online brokerage, offers a wide selection of short-term health insurance plans to choose from – along with other health insurance products – that may be right for you if you choose not to opt into COBRA or are looking for coverage for when your COBRA coverage runs out.

What is the “Subsidy Cliff”?

The term “Subsidy Cliff” refers to the steep drop off of health insurance subsidies for those with an annual income just above 400% of the Federal Poverty Line (FPL).

It’s not always easy to tell if your income is going to send you over the cliff, or not. Keep reading to fully understand the subsidy cliff, and make sure you have a good idea of whether or not you’ll receive financial help for the year.

How do subsidies work?

Those who do not receive their health insurance coverage through an employers or other government programs, may be eligible for Affordable Care Act (ACA) subsidies to help them afford their monthly premiums. The most common kind of subsidies are called advanced premium tax credits and are usually available to those with an annual income from 100% to 400% of the FPL.

Every year the government benchmarks the FPL at a particular income. Your eligibility for government assistance – such as ACA subsidies – is based on how much your income is above or below the FPL.

Source: 2018 HHS poverty guidelines

The above numbers are from 2018, which is what eligibility for ACA subsidies for the 2019 coverage year is based on.

Other factors such as age, location, and household size can seriously affect your eligibility for ACA subsidies.

The cut off for ACA subsidies is 400% of the FPL (which for the 2019 coverage year is $48,560 for an individual, and $100,400 for a family of 4).

Where does the Subsidy Cliff come in?

Once an individual or household’s annual income is 401% or more of the FPL they are likely no longer eligible for subsidies. Those who are not eligible for ACA premium tax credits must front the entire bill for their health insurance

There is currently no phase out of subsidies for those who make just over the FPL. This means that a slight change in income (1% change in income for the 2019 coverage year is $121.40) can cost a household thousands of dollars in subsidies.

Your subsidy cliff may be steeper depending on factors like where you live, how many people are in your family, and your age.

Source: KFF

Data found by the Kaiser Family Foundation (KFF), shows that since Rhode Island has the lowest average premiums for middle-class people who are ineligible for subsidies, the subsidy cliff is less steep for those living in this area. Without premiums, a 40-year-old with an annual income of $50,000 would pay about 5% of their income in premiums for the cheapest plan, on average.

While, for older people living in counties with high-premiums the subsidy cliff is much steeper. In Nebraska counties with the highest premiums, a 60-year-old making $50,000 per year would pay about 32% of their income for the cheapest plan, on average. While a 60-year-old living in the same county with an income of $45,000 per year would pay nothing for the same plan as they would qualify for subsidies that would completely cover their premiums.

In all, data from the KFF shows that the subsidy cliff is the steepest for older people making just above the 400% subsidy cut off who live in rural areas where premiums tend to be the highest.

The chart below shows the average percentage of yearly income a 60-year-old making 412% above the FPL would pay for the lowest-cost plan premium in their area. The darker the area, the steeper the subsidy cliff.

Affordability of Individual Market Premiums (2019)

Source: KFF

Report income changes as soon as possible

If you experience any income changes throughout the year, make sure you report them as soon as possible. You may become eligible for subsidies if you experience a drop in income or become ineligible if your income increases.

If you qualify for ACA subsidies, you report your expected income at the beginning of the year. If you end up making more than you originally reported, you may end up owing money back on your taxes. So, make sure you report any changes in income to avoid having an unexpectedly large tax bill at the end of the year.

Who is affected by the ACA ‘Subsidy Cliff’?

While premiums are mostly dropping slightly or holding steady on average for 2019, those who make just above the cut off for Affordable Care Act (ACA) subsidies are having – in some areas of the US severe – affordability challenges. This cutoff is referred to as the “subsidy cliff, and data from the Kaiser Family Foundation (KFF) shows that older people living in rural areas – where insurance premiums tend to be the highest – have the steepest subsidy cliff.

How do subsidies and the subsidy cliff work?

For those who do not receive health insurance coverage through an employer and who make a certain amount above the federal poverty line (FPL), subsidies called premium tax credits are available. These subsidies help these households afford the monthly cost of their health insurance.

Most people who purchase their coverage through exchanges receive premium tax credits to help afford their premiums.

Every year the government benchmarks the FPL at a particular income. Your eligibility for forms of government assistance, such as premium tax credits, are based on how much your annual income is above or below the FPL.

The above information in the chart is from the 2018 HHS poverty guidelines, which is what eligibility for ACA subsidies for the 2019 coverage year is based on.

Other factors such as age, location, and household size can seriously affect whether or not you will be eligible for ACA subsidies.

The cut off for ACA subsidies is 400% of the FPL (which for 2019 is $48,560 for an individual and $100,400 for a family of 4). This stiff cut off is responsible for the subsidy cliff.

There is currently no phase out for subsidies for those making just above 400% of the FPL which is why there is a steep subsidy cliff. Since there is no phase out, making slightly more income (as little as around $200 more per year) can cost an individual or household thousands of dollars in subsidies.

A slight increase in income can push an individual or a family over the subsidy cliff and end up costing them more money in the long run.

Who is affected most by the subsidy cliff?

Those who make just above the subsidy cut off are affected most by the subsidy cliff, especially older people who live in rural areas where premiums tend to be higher which makes their subsidy cliff much steeper.

Middle-income individuals and families who make just above the 400% cut off and are subjected to this subsidy cliff may struggle to afford their ACA plans.

The KFF analyzed 2019 premium data to show how affordable the lowest-cost marketplace plan is in each county with a focus on middle-class people with incomes are too high to qualify for ACA subsidies. They found that there was a substantial drop in affordability for health insurance premiums between those who made $45,000 per year and $50,000. They attribute this drop to those making $50,000 being at 412% of the FPL which makes them ineligible for subsidies. This drop in affordability is due to the subsidy cliff.

A 40-year-old man making $50,000 per year would spend more than 10% of their income on health insurance premiums for the cheapest available plan, while the same man making $45,000 per year would spend hardly anything as they would be eligible for subsidies.

This is an example of a somewhat small subsidy cliff, though it can still cause affordability challenges for those effected.

Affordability of Individual Market Premiums (2019) for 40-year-old with an Annual Income of $50K

Source: KFF

They found that for older people living in rural areas and other areas that have very high premiums, the subsidy cliff is even sharper.

A 60-year-old living in the 28 Nebraska counties with the highest premiums who makes $45,000 per year would pay nothing in monthly premiums with ACA subsidies. While the same person making $50,000 would have to pay 32% of their income on average for the lowest-cost plan available.

This is one of the most drastic examples of the subsidy cliff as there is a 30% difference in what health insurance would cost this individual. They go from paying almost nothing to paying a third of their income after experiencing a slight increase in salary.

Affordability of Individual Market Premiums (2019) for 60-year-old with an Annual Income of $50K

Source: KFF

Report your income changes as soon as possible

When it comes to ACA subsidies you report your expected income at the beginning of the year. If you experience an increase in income you may become ineligible for subsidies which you would have to pay back during tax season.

To avoid an unexpectedly large tax bill or to make sure you don’t miss out on becoming eligible for subsidies, report any changes in income as soon as possible.

Flexible Work Hours in a Small Business

Offering flexible work hours to your small business employees may serve as a cost-effective way to help recruit and retain the best workers. As a popular option to include in a benefits package, flexible work hours and alternative schedules can be agreed upon between an employer and their work staff to better accommodate the needs of employees.

When considering benefits like group health insurance, you may want to weigh the pros and cons of flexible work hours for your employees, especially since there may be little to no cost for your small business to implement this popular benefit.

Continue reading to learn about the advantages and disadvantages of flexible work hours in a small business.

What are flexible work hours?

According to the U.S. Department of Labor, flexible work hours serve as an alternative to a traditional work week schedule, letting employees change the times they arrive at or depart from work as a matter of agreement between them and their employer.

Examples of arrangements for flexible work hours may include:

  • Adjusted work arrival or departure times – Employees can arrive early and leave early, or arrive late and stay later, depending on their family schedules or if they prefer mornings or evenings.
  • Four-day work weeks – Employees could work four 10-hour days instead of five 8-hour days, completing the same amount of work (40 hours) across fewer days.
  • Working from home – Employees may work from home on certain predetermined days of the week. Workers might decide to do this on Fridays, or to avoid challenging commutes.

Understandably, such arrangements are highly desirable to employees with families, children, and dependents. According to a survey by FlexJobs, working parents who are considering a job opportunity are likely to prioritize work flexibility and work-life balance over other main factors, even above salary and health insurance benefits.

Source: FlexJobs survey

What are the pros of flexible work hours?

The primary advantages of a flexible work schedule may include:

  • Cost-effective – Small business employers can often provide the benefit of flexible work hours for little to no additional cost. By setting agreed-upon guidelines, employees can end up working the same amount of hours while potentially being more productive and engaged.
  • Retention – By allowing more flexible work schedules, employers may be better able to keep their best-performing employees. Workers often appreciate how telecommuting can allow them to avoid traffic and fulfill personal obligations such as medical appointments and family matters.
  • Recruitment – A company might attract more high-quality talent by offering the popular benefit of a flexible work schedule. Not only can this perk be a significant differentiator, it can also be a sign of a positive company culture to potential hires and future recruits.

Overall, a small business might consider offering flexible work hours in order to better accommodate the needs and preferences of its workers.

What are the cons of flexible work hours?

Disadvantages of a flexible work schedule may include:

  • Management challenges – It may be difficult to implement a flexible work policy unless an agreement been established between the employer and employees. To reduce challenges, you can set out clear expectations, such as deciding key hours during the day when off-site employees must be working and available to make decisions with their project teams.
  • Job type limitations – Flexible work hours might not make as much sense as an employee benefit for certain types of jobs. For instance, occupations that require being present for shifts or on-call daily for specific hours, such as customer service, sales, retail, manufacturing, or medical roles, may not have a flexible work schedule readily available.

Ultimately, if employees are still completing their work on-time and as scheduled, and do not necessarily need to be in the office to complete particular tasks or projects, offering flexible work hours in an employee benefits package may be a worthwhile option to consider.

Flexible hours in perspective

Besides offering group health insurance, flexible work hours can be another great way to help recruit and retain quality employees for your small business for minimal additional cost. With clearly communicated guidelines in place, your employees will likely appreciate having greater flexibility to complete their work while also having greater respect for their employer.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How Much Does Individual Health Insurance Cost?

According to eHealth, the average of an individual health insurance plan is $440 for an individual and $1,168 for a family.

How much does individual health insurance cost per month?

Individual health insurance is health insurance that you purchase on your own through a government or private exchange, not through an employer. Employer sponsored health insurance is referred to as group coverage.

The monthly payment that you make to your health insurance company to stay enrolled in your individual health insurance plan, is called a premium.

The average cost of individual health insurance premiums is $440 for an individual and &1,168 for a family, in 2018 according to eHealth.

Source: eHealth

Source: eHealth

Keep in mind that these numbers are averages and only represent the average cost for monthly premiums. The cost of your premium can vary greatly depending on where you live, how old you are, and how many dependents you have – if any.

The premium isn’t the only individual health insurance cost you need to worry about, you can also expect to have other out-of-pocket expenses such as:

  • A deductible
  • Copayments
  • Coinsurance

What is a deductible?

A deductible is the amount of money that you have to pay out-of-pocket for healthcare you receive before your individual health insurance kicks in and starts paying for you covered benefits. After you’ve reached this amount, your insurance will generally take over and pay for the rest of any healthcare you receive for the rest of the year so long as it is a covered benefit.

In 2018, the average deductible was $4,328 for an individual and $8,352 for families.

average deductible for individual coverage years 2014-2018 average deductible family coverage for 2014-2018

With an individual family plan you may have to meet two deductibles: an individual deductible and a family deductible. This is not true for all plans though, so make sure to check your plan details before buying and make sure you understand how these two deductibles work.

Generally, once you reach the individual deductible your individual health insurance will kick in and pay for the rest of the covered care that individual receives for the rest of the year. You will still have to pay out-of-pocket for care for other individuals until you meet their individual deductible – at which point your individual insurance will generally take over payment – or the family deductible – at which point your insurance will take over payment for all covered care your family receives throughout the rest of the year.

Are there individual health insurance plans with no or a low deductible?

There are, however, no-deductible plans on the market. Zero-deductible plans do not require you to meet a minimum balance before your individual health insurance kicks in. These plans typically come with higher premiums while plans with high deductibles typically have lower monthly premiums. You may also find that an HMO plan has no deductible. Zero-deductible plans may appeal to those who frequently visit healthcare providers or require many prescription medications.

What about individual health insurance plans with a low premium?

On the other hand, plans with lower monthly premiums typically have higher deductible. Higher deductible plans may appeal to those who are healthy, do not visit the doctor often, or do not have many dependents.

Just because these plans cost less per month doesn’t mean that they will always save you money in the long run. You may find yourself paying large amounts of money toward a large deductible if you incur an unforeseen medical expense.

When making the decision between a high premium plan with a low deductible and a low premium plan with a higher deducible consider the medical care you’ve had in the past, what you may need in the future, and if you’re planning on scheduling any procedures in the upcoming year.

What other out-of-pocket expenses can I expect with individual health insurance?

Along with your monthly premium you may have to pay copayments or coinsurances.

Copayments are a fixed amount that you pay for covered benefits after you’ve paid your deductible. So, let’s say you have a doctor’s office visit that costs $150 and you have a copayment of $15. If you:

  • Haven’t met your deductible, you’ll pay $150 at the time of our visit
  • Have met your deductible, you’ll pay your $20 copay and that’s it

Coinsurances are a percentage of covered health care service that you pay after you’ve paid your deductible. So, let’s say you have a doctor’s visit that’s $150 and a coinsurance of 15%. If you:

  • Haven’t met your deductible, you’ll pay $150 for the visit
  • Have met your deductible, you’ll pay 15% of $150 (which is $22.50)

Is there a limit on what I have to pay out-of-pocket?

Yes! There are limits to what you have to pay out-of-pocket for health care thanks to out of pocket maximums.

Out-of-pocket maximums, also known as out-of-pocket limits, are the most you have to pay for covered medical expenses in a year. After you spend this amount on deductibles, copayments, and coinsurance your individual health insurance plan will kick in and pay 100% of the cost of your covered benefits for the rest of the year.

According to Healthcare.gov, the out of pocket limit for a Marketplace plan is $7,900 for an individual and $15,800 for a family plan, in 2019.

However, keep in mind that out-of-pocket maximums do not include your premiums.

In general, plans with low monthly premiums usually have higher out-of-pocket maximums, while plans with higher premiums tend to have lower out-of-pocket limits.

What is the difference between the individual health insurance metallic categories?

All Affordable Care Act compliant plans are required to cover 10 essential benefits (which include benefits like hospitalization, maternity care, and prescriptions), however each health insurance company can choose how they want to cover these benefits. The metallic levels help buyers understand what percentage of those benefits – as well as potentially other health care benefits – their plan will cover.

Metallic levels

To help make it clear how much coverage you will receive when purchasing a given health insurance plan, plans are ranked from most to least coverage using metallic categories (bronze, silver, gold, platinum).

  • Bronze – on average, the insurance company pays for 60% of covered medical expenses and you will pay the remaining 40%
  • Silver – on average, the insurance company pays 70%, you pay 30%
  • Gold – on average, the insurance company pays 80%, you pay 20%
  • Platinum – on average, the insurance company pays 90%, you pay 10%

The percentage of the total average costs for covered benefits that a plan will pay is also referred to actuarial value.

Please note that the above numbers are averages for how healthcare costs are split between insurance companies and a typical population as published by healthcare.gov. Your costs will vary.

A Bronze plan may be right if you’re looking to protect yourself from a worst-case scenario medically, like a serious sickness or injury, since the premiums are low. However you will have to pay for a lot of routine medical care out-of-pocket since most of these plans have a high deductible.

According to eHealth, average premiums for individual plans were $374 with an average deductible of $7,148 in 2017. For family plans, the average premium was $903 with an average deductible of $12,044 in 2017.

According to eHealth, bronze plans are the most popular among eHealth customers (47%).

A Silver plan may be a good choice for you if you can afford a slightly higher premium than what you would get with a bronze plan so that more of your routine care – like physicals and preventative visits – are covered by insurance. Also, if you qualify for cost-sharing reductions you must enroll in a silver (or higher metallic level) plan to receive those cost-sharing reductions.

According to eHealth, the average premium for an individual silver plan was $418 with an average deductible of $2,758 for an individual in 2017. For family plans, the average premium was $1,061 with an average deductible of $5,424 in 2017.

According to eHealth, silver plans are the second most popular among eHealth customers (33%).

A Gold plan may the right choice for you if you are willing to pay more each month to have more costs covered when you receive medical care. If you or someone in your family requires a large amount of or frequent medical care than a gold plan may be a good choice for you.

According to eHealth, the average premium for an individual gold plan was $502 with an average deductible of $778 for an individual in 2017. For family plans, the average premium was $1,252 with a deductible of $1,835 in 2017.

A Platinum plan has the highest amount of actuarial value at 90%. Additionally, premium plans tend to have the highest premiums with very low deductibles – meaning your plan will kick in earlier in the year than other plans. This metallic plan is a good choice if you can pay a high monthly premium knowing that most of your medical bills will be covered. A platinum plan may be a good choice if you or a family member requires a large amount of or frequent medical care.

According to eHealth, the average premium for an individual plan was $575 with an average deductible of $37 in 2017. For family plans, the average premium was $1,472 with an average deductible of $140 in 2017.

What Is a Catastrophic health insurance plan?

For those looking for coverage who are on a tight budget, catastrophic plans may be a good option.

Catastrophic plans have low monthly premiums and very high deductibles. They are a great way to protect yourself from high medical costs and worst case scenarios – for example getting a serious illness or injury. However, you will end up paying most routine medical expenses yourself.

Keep in mind that you can’t use premium tax credit to reduce the cost of a catastrophic plan.

Catastrophic plans cover the same essential health benefits as other ACA-compliant plans and, like other plans, they cover certain preventative services at no cost. They will also cover at least 3 primary care visits before you reach your deductible per year.

Catastrophic plans are only eligible to those who:

  • Are under 30
  • Or a person of any age who qualifies for a hardship exemption or affordability exemption (which is based on marketplace or job-based insurance being unaffordable)

You will only be able to enroll in a catastrophic plan if you are under 30 and if you qualify for a hardship exemption (this includes affordability exemptions). If you are over 30 and wish to enroll in a catastrophic plan, you must submit an application to qualify for hardship or affordability exemption application and receive an exemption certificate number.

You may qualify for a hardship exemption if you:

  • Were homeless
  • Evicted or facing eviction
  • Experience domestic violence
  • Experienced the death of a family member
  • Experienced a fire, flood, or natural or human-caused disaster that caused damage to your property
  • Filed for bankruptcy
  • Had medical expenses you couldn’t pay

For a longer list of hardship exemptions, visit healthcare.gov. If you experienced another hardship not listed here or on healthcare.gov’s website, you can use this form to describe the hardship you experienced and apply for an exception.

What is an HSA?

An HSA, or a health savings account, is a tax-advantaged account (as the funds are contributed using pre-tax income) who are covered under individual health insurance – and group insurance – plans with a high deductible. These accounts help you save for out-of-pocket expenses and medical expenses that their plans do not cover.

Contributions are made into the account by you, or your employer, up to a maximum limit per year. The contributions are invested over time and may be used to pay certain qualified medical expenses – which include care such as dental, vision, over-the-counter medications, and other benefits not covered by your individual health insurance.

It is important to know that for 2019, the maximum contribution limit for an individual’s HSA is $3,500 and $7,000 for families. Individuals who are 55 or older by the end of the tax year can contribute $1,000 more to their HSAs.

You usually cannot use your HSA funds to pay your individual health insurance premium, but you can use this money to pay for expenses before you reach your deductible.

If you make a withdrawal from your HSA for a reason other than paying for a qualified medical expense, the withdrawal will be subject to income tax and an additional 20% penalty.

If you are 65 or older you will no longer be able to contribute to an HSA but you may withdraw funds without occurring a 20% penalty, however the withdrawal will be subject to income tax.

There are also FSAs, or flexible spending accounts, which are set up by an employer for an employee and generally all money set aside in the account must be used by the end of the plan year.

Can I get government assistance to help lower the cost of my individual health insurance?

Yes, you can receive government subsidies to help lower the cost of individual health insurance that are called premium tax credits and cost-sharing reductions.

You may receive one type of assistance – or both – depending on how much your income is above the federal poverty line (FPL).

Every year the government benchmarks the federal poverty line at a particular income (for example, $12,140 per year). Your eligibility for ACA subsides – and other forms of governmental assistance – is based on how much your income is above or below this number.

Those who make between 100% and 400% of the FPL per year may qualify for both premium tax credits and/or cost-sharing reductions.

2018 Poverty Guideline for the 48 Contiguous States and the District of Columbia

Persons in Family/Household 100% of  Federal Poverty Line 200% of FPL 300% of FPL 400% of FPL
1 $12,140 $24,280 $36,420 $48,560
2 $16,460 $32,920 $49,380 $65,840
3 $20,780 $41,560 $62,340 $83,120
4 $25,100 $50,200 $75,300 $100,400
5 $29,420 $58,840 $88,260 $117,680
6 $33,740 $67,480 $101,220 $133,880
7 $38,060 $76,120 $114,180 $152,280
8 $42,380 $84,760 $127,140 $169,520

Households with more than 8 members, add $4,320 for each additional person.

The above numbers are from the 2018 HHS poverty guidelines, which the Federal Register published on January 18, 2018. Eligibility for the ACA subsidies for 2019 are based on these guidelines for 2018.

Additionally, other factors such as age, household size, and location can seriously effect if you are eligible for ACA subsides.

There are two types of ACA subsides – which are also referred to as Obamacare subsides. The more common kind that people get are called “Advance Premium Credits”. Premium tax credits are subsides that you qualify for at the beginning of the year and help you pay for the cost of individual health insurance premiums.

Make sure that if you do receive advanced premium tax credits and experience a change in income that you report your change in income as soon as possible

When it comes to advanced tax credits, you report your projected income at the beginning of the year. If you end up making more than you originally reported, you could expect to owe money back on your taxes.

Be sure to report changes in income to make sure you don’t miss out on assistance if you become eligible or have to pay money back during tax season.

The second kind of subside is called the Cost-Sharing Reduction (CSR) subsidy. They are unlike advanced premium credits, CSR subsides

  • Only apply to coverage at the silver level
  • Mostly reduce out-of-pocket charges such as deductibles, co-pays, or coinsurances, but can also reduce the annual out-of-pocket limit

Additionally some groups of Native Americans may also qualify for additional cost-sharing subsides.

If you are interested in if you qualify for CSRs, you can find a CSR calculator on HealthCare.gov.

What other government assistance is available?

Depending on how much your household income is per year, you may qualify for government assistance to afford coverage for you and your family.

In all states, Medicaid provides health insurance for some low-income people and families. Some states have expanded Medicare to cover all people who make below a certain amount, some haven’t.

In all states, however, you can qualified for Medicaid based on income, household size, disability and other factors. The eligibility rules differ between states. Generally if you live in a state that has expanded Medicaid, you may qualify if your income is below the 133% of the poverty line.

You may qualify for CHIP, or the Children’s Health Insurance Program, if you have a difficult time affording health insurance for you and your family. CHIP is a federal-state effort to provide inexpensive or sometimes free health insurance for families with children.

If you make too much money to qualify for Medicaid but have an income below 200% of the FPL you may qualify for CHIP.

You also may be able to qualify for Medicare if you are 65 or older (even if you don’t want to retire) or if you are a younger person with a disability or have end-stage renal disease.

If you want to know if you are eligible for assistance, you can use this Healthcare.gov tool to see if you may qualify.

Additionally, there are other state and federal programs that you may be able to qualify if you have at least a family of four and make less than $99,000 per year.

How much does supplemental insurance cost?

In addition to an individual health insurance, you can receive additional coverage if you choose to purchase supplemental insurance products.

These plans offer you extra coverage for worst-case scenarios – such as serious illnesses or injuries – at low monthly costs.

A few examples of supplemental insurance include dental and vision insurance as well as critical illness insurance or disability insurance.

You may want to purchase supplemental insurance if you have a high risk job or hobby or if you want extra insurance for peace of mind.

Source: eHealth

Critical Illness or Disease Specific insurance is a type of supplemental insurance that provides cash benefit directly to you if you require treatment for a serious illness such as cancer. You do not have to spend this money on qualifying expenses you may spend it in any way you’d like. According to eHealth the average premium for critical illness insurance for 2019 was $34 for individuals and $63 for a family.

Accident health insurance or Accidental Death and Dismemberment Insurance is a kind of supplemental insurance that reimburses you for medical costs resulting for an accident. If you die, the benefits are paid to your beneficiaries. According to my family life insurance, the cost of accident insurance is generally anywhere from $25-$50 per month on average.

Start shopping with eHealth today for an individual health insurance plan that is right for your needs and your budget.

Who’s Buying Short Term Health Insurance?

Who is buying short term health insurance?

Short term health insurance is an option that is increasing in popularity for those looking for a cheap or temporary solution to their health insurance coverage needs.

According to a 2019 study by eHealth, those that are buying short term health insurance include:

  • Older enrollees looking for affordable coverage
  • Those looking to fill gaps in coverage
  • Those who missed the Obamacare open enrollment period

Why are people buying short term health insurance?

Short term coverage can be a great option for those who need a short-term solution to their health insurance needs.

According to an eHealth survey affordability is a key factor for many enrollees, particularly for those from ages 55-64. Many of the older people in this age group (70 percent) said that affordability was their primary reason for choosing short term health insurance.

Many of those 55-64 say they value lower premiums more than comprehensive benefits (about 88 percent). More than half of these adults said that they would be retaining their coverage for 7 months or longer.

What is short term health insurance?

Short term health insurance provides you with coverage for a limited amount of time. Up until 2019, short term coverage was limited to 3 months (or 90 days), but due to an executive order signed in August of 2018, short term plans have been extended. Depending on which state you live in, you may be able to have a short term health insurance plan for up to a year, with the chance to renew for up to three years.

Unlike Affordable Care Act (ACA) compliant plans, there is no open enrollment period for short term plans. You also don’t need to experience a qualifying life event to trigger a special enrollment period, so you can buy short term coverage year round.

This type of health insurance may be ideal for those who are between jobs, waiting for coverage to start, or missed the open enrollment period.

This is a great option for those who need fast coverage as well, with some plans beginning coverage just days after enrollment.

Keep in mind that short term plans typically do not provide as comprehensive of coverage as most major medical health insurance plans. Because these plans provide less coverage, they tend to be less expensive. Unlike ACA-compliant plans, which are required to cover the 10 essential benefits (such as maternity care, prescription drugs, and preventative visits to name a few), short term plans are not required to cover these benefits and they typically do not cover pre-existing conditions.

Source: eHealth

While the laws surrounding short term health plans have been changed at the federal level, access and length of short term plans may vary depending on where you live in the United States. There are a few states where short-term plans are not offered at all, while some states still offer short term plans, but limit them to just a couple months.

Is short term health insurance right for me?

Short term coverage may be right for you if:

  • You are waiting for your health insurance to kick in or to qualify for Medicare
  • You need coverage between jobs/employer-sponsored insurance
  • You missed the open enrollment period
  • You are between the ages of 55-64 and are looking for affordable short term coverage

According to [source] 9 in 10 enrollees said that they are very or somewhat satisfied with their short-term coverage that they purchased through eHealth even though their coverage is not as comprehensive as coverage available under ACA-compliant plans.

eHealth offers a wide selection of health insurance plans, including short term plans. We carry more than 3,600 short term plans from over 16 carriers. Visit eHealth’s short term health insurance page and enter your zip code to start shopping for an affordable plan that suits your needs and budget.

Everything to Know About Short Term Health Insurance

Short term health insurance plans refer to a type of health coverage that has a limited duration. While short term plans do not cover the minimum required covered benefits by the Affordable Care Act (ACA), they have some advantages that make them appealing to some.

Please note that short term plans are not the same as catastrophic health insurance plans. Catastrophic plans, which are also called high-deductible plans, have low premiums and high deductibles as well as high out-of-pocket costs but provide the same coverage as a health insurance plan.

Previously, short term plans only lasted three months, could only be renewed up to a year. Now, under the Trump Administration, short term plans are available to most Americans and last up to a year with the possibility of being renewed for two more years. Although federal laws for short term plans have limits of up to a year, with the chance to renew, your state may have different limitations or may not allow short term health insurance at all.

You can use eHealth to check the plan specifics for short term health insurance plans in your area.

How do short term health insurance plans work?

Unlike ACA plans, there is no open enrollment period for short term health insurance plans. You can enroll any time of the year when you need short term coverage.

Short term plans provide coverage quickly, with most applicants getting approved within 1-14 days, according to eHealth. The earliest short term coverage can take effect is the day after applying; depending on what your situation is you may want to choose a later effective date. Some details to keep in mind about short term plans:

  • If you are looking for coverage for not only yourself but your spouse or family, you can get dependents covered under short term health insurance.
  • Short term health insurance is medically underwritten (meaning the insurance provider looks into your health history), so you and all dependents will need to meet the medical requirements of the plan to get covered. You can renew short term health insurance two times (which could bring your total short term coverage limit for up to three years, if your state follows federal regulations), but whatever you’ve received treatment for under a preceding plan will be considered as a preexisting condition. You can also cancel your plan at any time without penalty.While you can get a federal subsidy to help afford ACA-compliant insurance, you will not be able to receive a subsidy to help pay for a short term plan, since short term plans are not ACA compliant.If you feel that you need more coverage, short term health insurance plans can be combined with other supplemental insurance plans – such as dental, vision, accident, and critical illness – to help round out your coverage.

Which states offer short term plans?

Due to controversy about short term insurance’s slim benefits, most states have their own laws about this kind of coverage. Some states simply set stricter limits for how long a person can be enrolled in a short term plan; this insures that people are using short term plans as temporary solutions, rather than depend upon it as their health insurance for years. Other states have banned short term plans altogether.

No plans are sold in these states:

  • California
  • New York
  • New Jersey
  • Rhode Island
  • Massachusetts

What does short term health insurance cover?

Short term plans are usually low-cost and low-coverage plans. Since short term coverage is limited in what it covers and how it covers, the plans are often less expensive than ACA-compliant plans. This is largely because ACA plans are required to offer 10 essential benefits, but short term plans do not have a standardized list of benefits must be covered.

The ACA requires qualifying health insurance plans to cover 10 essential benefits:

  • Ambulance services
  • Emergency services
  • Preventative care visits
  • Hospitalization
  • Laboratory services
  • Maternity and newborn care
  • Mental health and substance use disorder services
  • Rehabilitation services
  • Pediatric services (including oral and vision)
  • Prescription drugs

When it comes to short-term plans, covered benefits will differ from plan to plan, but it’s very likely that a short term plan will cover healthcare costs related to emergencies.

Source: eHealth Insurance 

Short-term plans vary greatly, so you may be able to find a plan that will cover prescription drugs while others do not.

Additionally, you can be denied coverage if you apply for a short term plan. Unlike ACA plans, which cannot consider preexisting conditions for enrollees, short term plans can deny you coverage based on your health.

While you may be rejected if you have a pre-existing condition, you also might find that you’re required to pay more for your plan due to pre-existing conditions, or that costs related to your pre-existing conditions are not covered.

There also may be a cap on how much the plan will cover you annually or in your lifetime. For instance if the plan covers hospitalizations, but only up to $5,000 you will have to pay for the rest of the services you get in the hospital.

How much does a short term health insurance plan cost?

Short term health insurance tends to be cheaper than regular health insurance plans, like ACA or major medical coverage. According to eHealth, short term health insurance plans tend to be 80 percent cheaper on average.

For instance, a 40-year-old female would pay a $50 monthly premium for short term coverage in comparison to $253 per month for the lowest priced bronze plan. A family of 3 would pay $116 a month for short term coverage verses $862 a month for the lowest priced bronze plan.

The cost of a short term plan for both the 40-year-old female and family of 3 is around 1-2% of the median income.

Is short term health insurance right for me?

Short term health insurance is a great option for those who…

  • Are looking to fill gaps in coverage
  • Are waiting for coverage to kick in
  • Missed the ACA open enrollment period

Get a quote now by visiting eHealth and entering your zip code. eHealth carries over 1,600 short term health insurance plans from over 16 carriers. If short term health insurance is right for you, start shopping with eHealth right now.

Creating a Company Culture: Which Benefits Do Your Employees Care About?

As a small business owner, you may be wondering what benefits you should offer to your employees, as well as what benefits can help create a positive company culture.

According to numerous studies, health insurance consistently ranks as the top employee benefit, so small business owners should focus on offering health coverage primarily.

Additionally, it’s important to know that you are offering benefits that your employees actually care about, since you’ll be spending your money in a smart way on benefits. You may also help bolster the company culture at your small business by better understanding your employee’s needs.

Continue reading to find out why health insurance is one of the top employee benefits for small businesses, as well as how health insurance may contribute to company culture.

What are the most popular employee benefits?

Many recent surveys have found that health insurance stands out as the most popular and desirable of work benefits.

  • According to a Fractl survey, health, dental, and vision insurance are the most desirable employee benefits, with 88 percent of the survey’s respondents saying they would give these benefits “some consideration” (34 percent) or “heavy consideration” (54 percent) when choosing between a high-paying job and a lower-paying job with better benefits.
  • According to a Glassdoor survey, nearly four in five, or 79 percent, of employees would prefer new or additional benefits to a pay increase. The survey found that 40 percent of respondents valued health insurance benefits (such as medical and dental plans) more than pay raises.

While other popular work benefits include flexible hours and more vacation time, the message is clear: health insurance matters most to employees.

One of the main reasons health coverage is important to employees is that small business health insurance may often be more affordable per person than individual health insurance plans. With access to lower premiums and deductibles on average, it’s easy to see why group health insurance is one of the most sought-after benefits.

Yet health insurance can mean more than just medical coverage: it may convey that workers are highly valued by their employer in a proven, concrete way.

Source: Fractl

How can relevant benefits help build company culture at a small business?

Company culture isn’t just a slogan or a mission statement. For your customers as well as your employees, company culture represents what your small business stands for, while also helping form your brand identity, practices, and values.

Making sure that you are offering benefits that your employees really care about can help promote a positive company culture at your small business by demonstrating that the health of your workforce is important to you. For instance, small business health insurance may play a significant role in building company culture in several important ways.

  • Job satisfaction and retention – With such a popular benefit as health coverage, employees are more likely to be satisfied with their jobs and to show loyalty toward their employer, which contributes to a developing a more positive company culture.
  • Productivity and engagement – Healthier employees are more likely to be productive, engaged, and less absent, which ends up benefiting both the overall company culture and the employer.
  • Stability and assurance – Offering health insurance can be a sign that a company prioritizes stability and continuity, and it may also give peace of mind to employees while providing them with an enhanced sense of job security.

Another way to cultivate a positive company culture could be establishing a reputation as an employer who is responsive to the needs and preferences of their employees, especially in terms of benefits.

According to a MetLife survey:

  • 74 percent of employees say that having benefits customized to meet their needs is important when considering taking a new job.
  • 72 percent of employees say that having the ability to customize their benefits would increase their loyalty to their current employer.

While you should always talk with your employees to find out what benefits they prefer, it’s a safe bet that health insurance coverage will probably rank highly on their list.

Finding affordable small business health insurance plans

eHealth can help you find the right group health insurance coverage for your small business. As the largest private online health insurance marketplace, we give you access to free small business health insurance quotes and side-by-side comparisons of health plans available from multiple leading insurance companies in your area.

Visit eHealth.com or speak with one of our licensed agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Creating a Company Culture: Assigning Office Tasks

As the owner of a small business or startup, you may be surprised to learn how company culture can play an important role in contributing to greater engagement and productivity among your employees.

How can a small business help create a vibrant culture at their company? Offering health insurance is probably one of the best ways to foster a positive company culture. In addition to group health coverage though, there are other smaller ways to create a positive company culture. If you’re in an office, creating some assigned duties around the office might be one way you could help build your company culture, without really spending much money.

Continue reading to learn about how assigning office tasks may help build a positive company culture at your small business.

How can assigning office tasks help foster a positive company culture?

Beyond completing their official responsibilities, assigning office tasks to your employees may help create a greater sense of community and belonging among your workforce. After all, who better to be in charge of promoting office culture at your small business than your trusted team of employees?

These office tasks might include placing people in charge of maintaining or taking care of the essential functions of the workplace, including:

  • Greeting visitors and onboarding new hires
  • Ordering food, snacks, drinks, and coffee
  • Managing and overseeing facilities and workspaces
  • Organizing office outings or celebrations like birthdays

By assigning these duties to one or two people each, employees can take ownership over office tasks in a way that facilitates autonomy and streamlines decision-making. Instead of losing time debating or worrying about small yet necessary day-to-day tasks, deciding on roles for specific tasks in advance may help a small business manage its office more efficiently while inspiring a cohesive and organized company culture.

Overall, having everyone participate in office tasks, including the small business owner or CEO, can help foster a greater sense of company culture and shared purpose by showing employees that you are all working together as part of the same enterprise.

Cut costs on office management

The great part about all of these office tasks is that they can be accomplished with little or no additional cost. As a small business or startup grows over time, the company might consider hiring an office manager to take on the responsibilities previously spread out through assigned office tasks. Until then, employees can help keep the workplace running smoothly by planning activities, organizing catering for events, ordering office supplies, or helping keep the office clean.

A small business might decide to assign tasks based on the skills and interests of your employees. For example, an employee passionate about the environment might want to start or maintain a recycling program for the office. Proactively finding specific ways your employees want to help out can help make office tasks fun instead of seeming like a chore or extra work.

Before implementing assigned office tasks, be sure to discuss this with employees to make sure that they are comfortable with the idea first. You can find out how they would want to participate and which tasks they would like to take charge of. You might also consider rotating roles or assignments every several months among employees.

With the addition of a few small tasks, you may find that your small business or startup could develop a more positive company culture as a result of sharing responsibilities with your office team.

How can health insurance encourage a positive company culture?

Offering group health insurance to your employees can demonstrate that their well-being is important to you as the business owner. In turn, this may encourage a positive company culture by showing your workers that they are valued members of your workforce and significant assets to your business.

Small business health insurance can help create a positive company culture in several ways:

  • Employee retention – When offered competitive top benefits such as health insurance, employees may feel a greater sense of loyalty toward their company. As a result, they may stay longer at an organization that they know respects them and compensates them fairly.
  • Employee engagement – Having employer-sponsored health coverage can give employees peace of mind in case of an unexpected illness or emergency, and may lead to less sick days. When employees aren’t worried about their health, they can be more engaged and productive.
  • Employer excellence – Offering medical coverage to employees can help a small business stand out as an employer of choice. Group health insurance can demonstrate that a company cares about worker wellness and has invested in the long-term health of its employees.

Ultimately, group health insurance may help promote a happy and healthy workplace, which, along with assigning office tasks, may contribute to greater involvement, investment, and engagement among your employees, all factors which can play a key role in creating a positive company culture.

To learn more about small business health insurance and to find free group health plan quotes, visit eHealth.com today, where we can help you find affordable health coverage options for yourself and your employees.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How to Save Money by Switching Small Business Health Insurance?

If you are thinking about switching your small business health insurance plan, you may have questions about how the process works.

For instance, due to rising costs, you may consider switching to a more affordable group plan while continuing to offer coverage for yourself and your employees. However, where do you begin?

First, the switching process usually starts by talking with a health insurance agent, either by speaking with your current one or contacting one of our licensed agents at eHealth. Second, you should know that you can shop for new small business health insurance coverage at any time of the year—there is no Open Enrollment Period for group health insurance plans.

Continue reading to find out more about switching to a new small business health insurance plan.

How does switching small business health insurance work?

When setting up small business health insurance coverage, employers usually commit to a certain group plan for one year. As the plan year draws to a close, the business’ health insurance broker may contact the employer to see if the company still has coverage that works for its employees, and may offer new health insurance quotes.

Reasons why a small business may consider switching group health plans include:

  • Going with a different insurance company due to rate changes
  • Choosing from different small business health insurance plan types
  • Selecting a different health plan metal level (like bronze, silver, or gold)

For instance, you and your employees may be able to save money by switching to a new small business health insurance plan with lower monthly premiums and a somewhat higher deductible.

On the other hand, a high premium yet lower deductible plan may be a financially smart choice in the long-term if you or employees anticipate a recurring need for medical services, including doctor’s visits, prescription medications, and specialist care. The most affordable plan will depend on what kind of care enrollees of the plan require.

When considering switching group health insurance, be sure to read through your contract to see if there are any fees or financial penalties related to changing or canceling the plan, as well as how the insurance company should be notified (sometimes by mailed letter or fax, depending on the contract).

Since changing your business’ health coverage is a major decision, you should always work with a licensed agent who can help you find the right health care solution for your company. An agent can also guide you through the important process of notifying your employees of how to sign up for new coverage.

Factors to consider when switching to new small business health insurance

Here are three important areas to think about when evaluating a new group health plan.

  • Cost – Getting new small business health insurance quotes at least once annually can help you check to see if you still have the right coverage for your company while making sure that your business is not paying more than it needs to.
  • Coverage – Depending on the health care needs of you and your employees, you may think about switching to a group plan with a lower monthly premium (if your workers rarely receive medical care) or lower deductible (if they pay too much out of pocket for medical services).
  • Workforce – If your business has grown significantly with the addition of new employees, it may make sense to explore a variety of additional group health insurance options that may be able to better meet the needs of all of your workers by giving them more choices to consider.

How can eHealth help me with switching to new small business health insurance?

eHealth can help you maintain your current group health plan or start switching to a new plan that fits your health care needs, even if you already have a broker or have purchased a plan from a health insurance company in the past. Since health insurance rates are regulated and do not vary by broker, there’s no additional cost to you.

With eHealth, you get:

  • World-class customer service – With dedicated account managers and licensed agents, eHealth is committed to helping your small business find the right group plan.
  • Best prices – We have the best prices on any product we sell. Prices are fixed by law, and you’ll pay the same price for the same ACA group health plan no matter where you buy.
  • Personal advocacy – eHealth serves as your advocate and point of communication with the insurance company. You can continue to contact us with questions about your plan, claims, or billing, even after enrolling in your new small business health insurance plan.

By using eHealth to compare quotes and consider all of your options, you may be able to save money by finding a more affordable plan.

You can learn more about setting up your new small business health insurance plan here.

Switching your small business health insurance can be a big decision. Fortunately, eHealth’s licensed agents are here to help answer your questions. Visit eHealth.com today to learn more about group health insurance plans and find the right coverage for your business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

9 Reasons to Offer Small Business Health Insurance

9 reasons to offer small business health insurance:

  1. Lower premiums – Group plans tend to be cheaper on average than individual plans.
  2. Tax incentives – Businesses can deduct the cost of premiums from their federal business taxes, and some small businesses may qualify for a tax credit.
  3. Improve hiring and recruiting – A robust benefits package can appeal to both new hires and current employees alike while setting businesses apart from competitors.
  4. Employee loyalty and retention – Offering group health insurance can help small businesses keep their top employees for the long term.
  5. Employee job satisfaction – Having happy employees who are content with their jobs and health benefits can make for happier employers.
  6. Healthier, more productive employees – When workers take less sick days and absences, they can retain focus and achieve more while having access to health care resources when needed.
  7. Foster a healthy company culture – Show your employees that their health is important to you by promoting a positive culture, encouraging wellness initiatives, and offering health coverage.
  8. Pre-tax benefit for employees – Another benefit of providing small business health insurance can be more after-tax money available for workers.
  9. Place health coverage within reach of employees – One reason employers offer group health insurance is to make medical coverage more accessible and affordable to their employees.

As a small business owner, you may be wondering whether you should offer health insurance to your employees. Deciding to offer small business health insurance can be a big decision for any company, and you may have questions about why you might provide health coverage as one of your employee benefits.

For example: offering health insurance helps your workers, but what are the benefits for the employer? Are there financial and tax advantages associated with group health insurance? Can offering small business health insurance enhance your ability to recruit and retain employees?

You may be surprised to learn that there are many ways that small business health insurance can help your company operate more strategically, efficiently, and effectively. Not only does a small business health insurance plan benefit employees, but employers might find that there are plenty of ways that a group plan helps them out as well.

Keep reading to learn 9 great reasons to offer small business health insurance.

1. Access to lower monthly premiums

From a cost perspective, it may make sense to offer small business health insurance due to the reduced price of a group health plan. Generally, small business health insurance plans tend to have lower per-person costs on average, compared to health coverage in the individual market.

According to a recent eHealth study:

  • In 2018, the average premium per-person through a small business plan ($409) was 7 percent lower than the average premium for an individual health insurance plan ($440).
  • The average individual deductible for small business health plans was 31 percent ($1,438) lower than the average deductible for individual health insurance coverage ($3,140 vs. $4,578).

Source: eHealth 2018 Small Business Health Insurance Report

This means that enrolling in a group health insurance plan can be more affordable than individual insurance not only for employees and their families, but for the business owner and his or her family as well.

Why are small business health insurance plans generally cheaper per person than individual plans?

Group health insurance plans can cost less per person than an individual health insurance plan due the advantage of having a larger risk pool, or having risks spread out across more people. In other words, group plans often cost less per person, on average.

According to the Small Business Administration (SBA), when a greater number of people pay for their health insurance in a group plan, average costs become more stable. As a result, the insurance company has more resources to draw from when someone needs medical care. This means that the high cost of any one person ends up having a smaller effect on the average cost as the group becomes larger.

This means that a larger group size may make your group health insurance plan cheaper. The eHealth study found that:

  • In 2018, the average monthly premium for small business groups with 5 or fewer employees was $419 per covered person.
  • The average monthly premium for small business groups with 6 to 29 employees was $364 per covered person, or 13 percent less.

Overall, group size and the number of employees receiving coverage can make a significant difference in terms of small business health insurance premiums.

The price of premiums for group coverage has been more stable than individual coverage

Not only are monthly premiums generally lower through small business health insurance plans than through individual plans; they also have not increased in price as significantly as individual premiums.

According to an eHealth study, the average per person premium for small business health coverage increased only 5 percent between 2015 and 2018, while individual premiums for those that buy their own coverage increased 54 percent in the same period (from $286 in 2015 to $440 in 2018).

The lower price of small business health insurance costs for both enrolled employees and employers can be an excellent reason to offer a group health plan to your workforce.

2. Benefit from tax incentives

Another financial advantage of providing small business health insurance are the tax benefits to the employer that come with a group plan.

There are several ways that a group health plan can result in tax advantages for your business:

  • Generally, employers can deduct 100 percent of the cost of monthly premiums they pay on qualifying group health plans from their federal business taxes.
  • Offering health insurance coverage to workers as part of their compensation package could also potentially mean that a business may benefit from reduced payroll taxes.
  • Employers can usually deduct HSA contributions from their small business taxes.

While group plans already tend to be more affordable than individual plans, the tax advantages from offering small business health insurance can further help your company in providing this highly valued and sought-after employee benefit.

Certain employers may qualify for the small business health care tax credit

Some small employers may benefit from the small business health care tax credit. Created by the Affordable Care Act (ACA), the tax credit is meant to encourage small business owners to offer group health insurance to their employees.

To qualify for the tax credit, a small business must meet all of the following requirements:

  • Your small business must have less than 25 full-time or full-time equivalent employees (to receive the maximum tax credit, your business must have less than 10 employees).
  • Your company must pay average wages of less than $50,000 annually per employee (adjusted for inflation).
  • You as the employer must pay at least 50 percent of your qualified employees’ health insurance premiums.
  • You must purchase your group health insurance coverage through the Small Business Health Options Program (SHOP) Marketplace or through a licensed health insurance agent who can enroll your business in a SHOP plan.

As of 2018, SHOP plans can be directly written through the carrier with the help of certified insurance brokers. eHealth’s licensed and SHOP-certified agents can enroll employers who qualify for the small business health care tax credit, conveniently allowing you to complete all the necessary steps through eHealth.

The small business health care tax credit can certainly be an excellent incentive to offer health coverage for qualified employers. Not only is the tax credit is available for two consecutive taxable years; it may also help your small business in keeping and attracting high-quality employees. However, keep in mind that this isn’t an easy credit to qualify for, and sometimes it is not worth it for a small business to pay for the price of an ACA plan just to try to get this tax credit.

3. Improve your hiring and recruitment strategy

Deciding to offer small business health insurance can serve as an essential part of an effective hiring strategy, and can help a company stand out as an employer of choice.

According to a recent eHealth study, 66 percent of small business owner survey respondents said that they offer medical employee benefits in order to help them hire and retain the best employees.

Source: eHealth 2018 Small Business Health Insurance Report

Many workers value employee benefits like health insurance

Several studies have shown that whether health insurance and other employee benefits are offered as part of a compensation package may often make or break a job offer for a prospective hire. For instance:

  • A 2017 LendingTree survey found that 33 percent of people have turned down a job due to a lack of benefits, and that over 32 percent of Americans would like to have improvements in their health insurance coverage.
  • A 2015 Glassdoor survey observed that 57 percent of U.S. job candidates said that benefits and perks are among their top considerations before accepting a job.
  • A 2016 survey by Fractl, a content marketing agency featured by the Harvard Business Review, noted that 88 percent of respondents said that being offered health insurance might tip them toward choosing a lower-paying job with better benefits over a high-paying job.

Source: Fractl / Harvard Business Review

The reality is that most prospective hires want quality employee benefits such as group health insurance. Overall, small employers who offer health coverage may be better positioned to recruit the best talent and attract employees who can help their business thrive.

Employee benefits may help small businesses stand out from competitors

It may be challenging to attract quality workers without popular benefits like medical coverage. As a result, offering group health insurance may also help small businesses stand out during the hiring process by beating offers from competitors who don’t offer employee benefits related to health care.

According to the Bureau of Labor Statistics, only 55 percent of private industry employees in small businesses with less than 100 employees were offered medical care employee benefits.

By providing group health insurance when competing employers don’t, you can substantially differentiate your business through demonstrating that you prioritize the well-being of your employees and recognize them as valuable assets to your company.

Ultimately, making health insurance part of worker compensation may help to create a robust and compelling employee benefits package that can have broad and lasting appeal to future hires and current employees alike.

4. Encourage employee loyalty and retention

Employee loyalty is often an extremely important consideration for a small business, and offering small business health insurance may be an effective way to help retain your company’s quality workers.

Not only can a group health plan demonstrate that you are offering employees what they are worth; it can also encourage your workers to stay with your company in the long term.

In addition to offering a group plan, small changes to the workplace can make a big difference toward improving employee retention. Some potentially low-cost ideas for small business owners include:

  • Flexible working arrangements, such as allowing employees to start work earlier or work from home during certain days of the week, may help inspire employee retention.
  • Promoting open communication, building effective teamwork strategies, and planning team-building outings may also play a role in improving employee loyalty.
  • Making minor adjustments to workspace layouts and lighting may contribute to a more comfortable work environment and help show employees that you care about their well-being.

While all employees have different work preferences, going the extra mile as an employer to create an accommodating workplace can show that you value your team and help with employee retention.

The value of employee loyalty

Sponsoring group health insurance coverage and other employee benefits can be an impactful strategy that highlights how you appreciate the dedication of your staff while also:

  • Helping to prevent workers from finding jobs elsewhere that provide the benefits they need.
  • Encouraging employee loyalty without increasing the pay or wage of each worker.

Indeed, salary increases may not be the only way to retain your current employees. According to a 2015 Glassdoor survey, nearly 4 in 5 (or 79 percent) of employees would prefer benefits or perks more than a pay raise, with 40 percent valuing health insurance benefits higher than a raise.

While you should always talk with your employees to find out their personal preferences for rewards, perks, and promotions, recognizing the popularity of health coverage could make it easier for your business to decide on which benefits employees want while also staying within your budget.

Turnover costs are a significant expense for small businesses

You may be wondering if retention is even really important for your small business. There’s plenty of quality workers out there who can replace employees that quit, right?

Unfortunately, it’s not usually true that hiring quality workers is easy. Given the time and cost required to train new employees, as well as the challenge of finding workers who are the right fit for your business, it may worthwhile to prioritize employee loyalty in order to help your small business run smoothly and efficiently.

According to an article by a leading human resources (HR) analyst at the accounting firm Deloitte, the “total costs” of losing an employee to turnover can be considerable, including the:

  • Cost of hiring, onboarding, and training new workers
  • Loss of productivity and engagement
  • Possibility of customer service errors
  • Often negative cultural impact to the organization

Employers often deal with significant expenses as a result of employee turnover. For instance, a Center for American Progress report found that, based on an analysis of 30 case studies in 11 research papers published between 1992 and 2007 which provided estimates of turnover costs, businesses spend about one-fifth (or about 21 percent) of a worker’s annual salary to replace that employee.

As a small business especially, you’re probably looking to save on costs wherever you can. You might find that offering small business health insurance is cheaper in the end, because you avoid extra costs due to high employee turnover.

Small business health insurance may help improve employee retention

The bottom line is that turnover costs are a real concern for small businesses. The good news is that group health insurance can be an effective way to promote employee retention.

A survey of U.S. workers by Willis Towers Watson, a multinational insurance advisory company, found that:

  • 46 percent of worker respondents agreed that health benefits were an important factor in their decision to work for their employer.
  • 55 percent of worker respondents considered the health benefits they were offered a good reason to keep working for their employer.

Generally, when workers have group health insurance, they may stay at their current jobs longer in order to retain their employee benefits. This creates a win for both employers and employees, since companies may maintain and increase employee retention while helping keep their workforce content.

5. Boost employee job satisfaction

Another great reason to offer small business health insurance is that it may play a significant role in helping maintain or increase employee job satisfaction.

According to a Glassdoor Economic Research survey, out of a list of 54 employee benefits, the following three basic employee benefits displayed the highest correlation with employee satisfaction:

  1. Health insurance
  2. Vacation/paid time off (PTO)
  3. Retirement planning options like 401(k)s and pensions

Health insurance coverage came out as the number one benefit related to keeping employees satisfied, and it’s not surprising given its popularity as an employment perk.

Source: Glassdoor

The importance of satisfied employees cannot be overstated: when your staff is content with their job, they will probably be happier with their employment and more likely to remain at your company.

How job satisfaction may benefit business owners

Happy employees can also mean happy employers. Workers who are generally satisfied with their jobs might express this in all sorts of relevant ways, including:

  • More helpful, enthusiastic, and improved interactions with customers and clients.
  • Greater likelihood of effective teamwork within a positive workplace environment.
  • Inspiring employees to improve their skill set through further training and education.

In essence, better attitude from employees may result in better results for your bottom line.

Taking the time to consider the importance of job satisfaction, while also exploring effective ways to motivate workers through employee benefits such as health insurance, could be a worthwhile pursuit for small businesses seeking ways to help their workforce reach its full potential.

And again, as a small business you’re probably looking to be as efficient and productive as possible. If you have satisfied employees, you’ll probably find that they’re more productive.

6. Healthier, more productive employees

When employees have group health insurance, they gain greater access to medical resources. Consequently, workers can rest assured that they can rely on their health care plan in case of a catastrophic illness or emergency.

For a small business, providing employees with the peace of mind that comes from health insurance can mean less sick days and absences and more productive and focused workers.

  • Reduced workplace absenteeism – According to a study by the Journal of Occupational and Environmental Medicine, having health insurance any time throughout the year is significantly associated with a lower likelihood and reduced number of missed workdays.
  • More productive workplaces – Generally, healthy employees tend to work more effectively and efficiently than employees who are ill. A working paper about the manufacturing industry by researchers from the Center for Economic Studies (part of the U.S. Census Bureau) provided evidence that health insurance offers may be positively associated with labor productivity.
  • Reduced labor costs – According to an article from the peer-reviewed healthcare journal Milbank Quarterly, another benefit to employers from having healthier workers may also be lower labor costs: unhealthy workers may retire or quit early, which could lead to expensive employee turnover. The article also mentions how short-term and long-term disability insurance and workers’ compensation costs might also be reduced as a result of healthier employees.

Depending on your industry, it may be more cost-effective in the long run to pay for employees’ health insurance rather than having to deal with the lost time and productivity resulting from their absence from the workplace.

Additionally, providing group health insurance may contribute to a faster recovery time or return to work due to greater employee access to medical care and health resources.

Ultimately, having healthy employees can contribute to greater workforce productivity, which may help bolster the success and stability of your small business.

7. Foster a healthy company culture

Providing small business health insurance can show your employees that their health is important to you. By offering a group health plan as an employee benefit, you can demonstrate that you value your employees and view them as an asset to your organization. This appreciation, in turn, could help to promote a positive and healthy company culture.

The benefits of a positive work culture

Drawing from a variety of studies, a Harvard Business Review article provided evidence of how positive work cultures are more productive for businesses over time. The HBR article discussed the worthwhile outcomes which may come from having a virtuous organizational culture, including:

  • Leading to an increase in positive emotion and well-being at companies.
  • Improving people’s relationships and amplifying their abilities and creativity.
  • Buffering against stress, helping employee resilience, and bolstering employee health.
  • Enhancing employee loyalty while bringing out their best strengths.
  • Contributing to higher levels of organizational effectiveness, including productivity, financial performance, customer satisfaction, and employee engagement.

Providing group health coverage could be one major way to promote a positive work culture. By investing in the well-being of employees, companies may be better able to encourage an environment of trust and a mindset of greater openness among their employees.

Plus, employers may also find that offering small business health insurance could help shape and improve their brand image, which may further bolster employee recruitment and retention efforts.

Increased attention to wellness

Beyond improving company culture and employee morale, another beneficial effect of a group health plan may be greater attention to wellness.

Offering group health coverage could be a starting point for workplace wellness programs or similar initiatives designed to incentivize and encourage healthier lifestyle choices among employees.

According to a study by the Centers for Disease Control and Prevention (CDC) which featured a high proportion of small employers (77.1 percent of respondents had fewer than 100 employees), most U.S. workplace health programs focused on physical activity, nutrition, and stress management.

The CDC study also found that:

  • Across the nation, almost 30 percent of worksites offered a type of program meant to address fitness, physical activity, or sedentary behavior.
  • 19 percent of worksites offered tobacco cessation programs.
  • About 17 percent of worksites offered an obesity or weight management program.

Whether a small business formally decides to implement a wellness program or a less formal initiative to address employee health, small business health insurance may serve as an excellent starting point for encouraging a positive company culture that promotes health and well-being.

8. Pre-tax benefit for employees

Providing group health insurance frequently means lower monthly premiums for employees, and the amount they contribute toward premiums can generally be paid from their pre-tax salary.

This can lead to considerable tax savings for your employees over time. How does this work?

  • When an employer offers a group health insurance plan, the company takes part of employees’ premiums out of their paycheck before taking out federal income and state taxes.
  • Stated differently, the employer can essentially lower the taxes that their employees have to pay through reducing the taxable income of their workers.
  • As a result, the tax payments that would have gone toward the government for that income can instead go toward compensating the company’s employees.

While this reason to offer a group health plan is fairly straightforward (who doesn’t want tax-advantaged dollars, right?), it is worthy of mention due to the significant tax advantages which may be available to your workforce.

Not only will your employees likely have a lower tax bill; they will also likely appreciate having access to a group health plan which may be more affordable than other coverage options.

9. Help put health coverage within reach of employees

Some small business owners may decide to offer a group plan in order to help put access to health insurance within reach of their employees.

According to a recent eHealth study, 26 percent of small business owners said they offered health benefits because employees couldn’t afford coverage on their own.

Source: eHealth 2018 Small Business Health Insurance Report

The eHealth study also found that most small businesses worry about the ability of employees to afford the cost of medical coverage and care.

  • 39 percent of small business owner respondents said that they were very concerned about employees’ ability to afford premiums and deductibles.
  • 38 percent of respondents said that they were are somewhat concerned.
  • 23 percent of respondents were not concerned about the ability of employees to afford premiums and deductibles.

Implementing a group health plan for your business may help some of your employees enroll in a more affordable plan than they might otherwise have access to on the individual market.

Health coverage and financial security

Providing group health insurance for your workers may also help them feel more secure, both financially and professionally.

According to a 2018 report by the Employee Benefit Research Institute (EBRI), health insurance topped the list of employee benefits that contributed to financial security, with 89 percent of employees saying that having health coverage helped them feel more economically secure.

Source: Employee Benefit Research Institute (EBRI)

Offering health coverage as an employee benefit may help your workforce feel less stressed financially and more confident in their ability to recover from a catastrophic injury or illness.

Overall, a group health plan may contribute to making insurance more affordable to a greater number of employees while also giving them the peace of mind that comes from knowing that they have medical coverage.

How to shop for small business health insurance

There are many excellent reasons to offer small business health insurance as an employee benefit, which may often result in significant advantages for both workers and employers. It’s smart to look around and weigh all the pros and cons of where you’re shopping for small business health plans.

The ease, simplicity, and value of eHealth

For all the right reasons, eHealth makes it easy to find group health insurance for your business. We let you quickly find and compare free small business health insurance quotes. Once you provide some information, including zip code and number of employees (including yourself), you instantly get access to a great selection of group health plans offered by multiple insurance companies.

eHealth is committed to helping you achieve your health coverage goals as a small business. Once you find a plan that works for you, our licensed insurance agents can guide you toward the next steps for implementing and enrolling in a group health plan, all with no broker fees.

After enrolling in your new small business health insurance plan, eHealth will still be available to help answer your questions for the entire time you have your plan, at no additional cost to you. eHealth will also be your advocate when you need to resolve questions with the insurance company.

For all your small business health insurance needs, visit eHealth.com or speak with one of our expert health insurance brokers today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

The Definitive Guide to Small Business Health Insurance Costs

Updated July 26, 2019

Some of the most common questions about small business health insurance revolve around the costs of group health coverage. While costs and specifications vary for each health plan, it is still important to understand the fundamental elements of the financial side of small business health insurance.

This guide is meant for both new and current small business owners, and provides an overview of the basic costs of small business health insurance while also reviewing related plan considerations.

What are the costs associated with small business health insurance?

According to the Affordable Care Act (ACA), businesses with 50 or more employees are required to offer group health insurance coverage. However, it is optional for small businesses with less than 50 full-time employees to offer a health plan to their workers.

This choice often leads to a difficult decision for many small business owners, as they first consider whether they want to offer group health insurance, and then whether or not their business can afford it.

As a result, most early questions about small business health insurance are about costs. The following sections will explore the primary costs of group health insurance, including:

  • Premiums
  • Deductibles
  • Copayments
  • Coinsurance
  • Out-of-pocket costs

What is a small business health insurance premium?

A premium is the price business owners or their employees pay to be enrolled in a group health plan.  Regardless of whether or not you use health services, the premium must be paid each month in order to stay with the plan.

As a monthly payment, the premium is usually shared or split between the employer and employees as part of the plan’s cost-sharing arrangement. In most states, employers are required to pay at least 50 percent of employee premiums, although minimum employer contributions may vary by state and insurance company.

While paying for the premium costs of qualified dependents is optional for small businesses, employees can still choose to add dependents to their group health plan.

Premium costs may vary based on the small business health insurance plan type. For example:

  • HMO plans tend to have lower premium costs, as well as the requirement of visiting a primary care physician before seeing a specialist.
  • PPO plans tend to have higher premium costs, although plan members can see a specialist without having to visit a primary care physician.

The metal levels of a group health insurance plan also determine the percentage of costs paid by the health insurance company under the plan.

Source: eHealth 2018 Small Business Health Insurance Report

What is a small business health insurance deductible?

A health insurance deductible is the annual amount a person enrolled in a health plan has to pay out of pocket until the health insurance company begins to pay for medical claims.

Often, there tends to be an inverse relationship between premiums and deductibles. A small business health insurance plan may have a lower premium and higher deductible, or a higher premium and lower deductible. Either option might make sense depending on the different medical needs, budget, and coverage preferences of your workforce.

  • Overall healthy employees may prefer a low premium, high deductible plan. Since they anticipate fewer medical expenses and may not need to meet the plan’s deductible, their main cost may be their monthly premiums. However, they should try to make sure to have an affordable deductible in case of an emergency or unanticipated illness.
  • Employees who need to visit the doctor more regularly, or who require prescription medications, may find a high premium, low deductible plan to be a smart choice financially. Although they would pay more per month, being able to meet their deductible means that the insurance company can start to cover their medical claims sooner.

It is also important to know that deductibles may vary based on the plan type. HMO plans may have a lower (or no) deductible, while many PPO plans have a deductible. If you’re curious, you can read more about all the different plan types such as HMO, PPO, EPO plans and more.

Source: eHealth 2018 Small Business Health Insurance Report

A helpful rule to keep in mind is trying to keep your deductible to less than 5 percent of your gross annual income if possible.

What is a small business health insurance copayment?

A copayment is a specific cost you may be required to pay for medical supplies or services through your group health plan. Also known as a copay, an example would be an employee paying $25 for a visit to the doctor’s office or a prescription medication, after which the insurance company may cover the remaining charges.

Other examples of health services that usually require copays may include:

  • Different types of therapy
  • Specialist office visits
  • ER or ambulance services

Remember that it is employees who cover the costs of copayments, not their employers. If your employees need to visit the doctor’s office often, then they may benefit from choosing a group health plan with predictable and affordable copayments. The only cost that the employer shares is the cost of employees’ monthly premiums.

Typically, most HMO plans have copayments due to contractual agreements with health care providers. Other types of small business health insurance plans, such as PPO plans, POS plans, and EPO plans, also may have copayments among their associated costs.

Usually, the copay is for in-network medical services only. Going to an out-of-network provider could mean that the copayment may not apply, and that the full amount or coinsurance percentage of the bill may need to be paid.

How does coinsurance work?

Coinsurance is the percentage of a covered medical service you may be responsible to pay under your health insurance plan after satisfying your deductible. The amount you pay for coinsurance depends on the final bill from the health insurance provider.

In other words, the health insurance company may only cover a certain percentage of charges for health care services. For instance, if the insurance company pays for 80 percent of charges for an x-ray, your employees would be required to pay for the other 20 percent (the coinsurance in this example), even after meeting their annual deductible.

What are out-of-pocket costs?

Out-of-pocket costs are generally payments you personally make for medical services, while your plan’s out-of-pocket maximum is the annual limit of how much you share costs with your health insurance company through your health plan. This is a set threshold, similar to your deductible, but a higher amount. Once you’ve met it, health insurance companies will generally pay 100 percent of any covered health care costs for the rest of the year.

The deductibles, copayments, and coinsurance that employees pay go toward meeting the out-of-pocket maximums of their group health plan. After your small business’ workers spend their out-of-pocket maximums, the health insurance company will typically begin to pay for the rest of the year’s covered medical expenses, while employees will still need to pay their portion of monthly premiums.

Payments which usually do not go toward meeting an enrollee’s out-of-pocket maximum include:

  • Monthly premiums
  • Out-of-network balance-billed charges
  • Services not covered by the health plan

It is also important to know that there is typically no copayment for covered medical services in a group plan once an employee has reached his or her out-of-pocket maximum, for his or her specific plan. The out-of-pocket maximum will not be a sum of everyone covered under the small business group plan policy, but rather will be specific to each enrollee.

Learn more about small business health insurance costs

With eHealth, you can easily compare costs between group health insurance plans offered by different top insurance companies, allowing you to find the right plan for your small business.

Our helpful licensed insurance agents can answer your questions about small business health insurance costs while providing unbiased advice for choosing the optimal group health plan for your budget.

We know that health insurance is an important long-term investment, which is why our agents are committed to continuing to serve as your advocate and point of communication with the insurance company even after you purchase a health plan.

Visit eHealth.com today to learn how to get reliable, quality health coverage for your employees.

This article is for general information only and not intended to provide any tax or legal advice. Always consult your tax and legal advisors to understand your specific tax and compliance situation.

Can I Get Group Health Insurance?

Wondering if you can get group health insurance? The answer usually depends on whether your small business has employees.

While a business owner with no employees usually would not be eligible for group health insurance, you may be surprised to learn that some entrepreneurs may have access to group health insurance rates through membership organizations. These organizations include unions, professional groups, or trade associations.

Read further to learn about how certain membership organizations may offer group health coverage.

How do membership organizations relate to group health insurance?

While a small business with at least one qualified full-time equivalent employee can get group health insurance, a self-employed business owner or sole proprietor with no employees usually would not be eligible for a group health plan. Instead, a sole proprietor could enroll in an individual health insurance plan.

Employers sponsor most group health insurance plans, with many people enrolling directly in their company’s health plan or through a spouse’s company’s plan.

However, in some cases, group health insurance coverage may be available to solo business owners, entrepreneurs, or freelancers through membership organizations based on a shared trade, occupation, or industry. Being a member of these groups may provide access to professional services as well as health plans with more affordable premiums.

Examples of membership organizations with group health plans or supplemental health benefits include:

  • AARP Health
  • Affiliated Workers Association (AWA)
  • Writers Guild of America
  • Association for Computing Machinery
  • The Freelancers Union

Keep in mind that although many membership organizations have rigorous eligibility guidelines, one of the significant advantages of being part of a group or union may be benefiting from competitive rates for group health insurance. You can also find affordable health plans by comparing prices through online private marketplaces like eHealth.

What are other types of membership organizations that may offer group health insurance?

All sorts of fields and industries have membership organizations. Whether they serve graphic designers, actors, or booksellers, these organizations can help their members advance in their field while also providing them with guidance and resources.

Here are some other types of professional organizations that may offer access to group health insurance plans.

  • Industry groups
  • Alumni associations
  • Regional chambers of commerce

While not all membership organizations offer group health insurance coverage, many provide useful benefits, programs, and select discounts for their members in other areas, such as car insurance, travel, or arts and entertainment. You should also be sure to consider the cost of membership when looking at benefits offered by these professional or trade groups.

Overall, you should remember that you may be eligible for small business health insurance if you have at least one full-time equivalent employee. Otherwise, depending on your industry, you may have access to a group health plan or supplemental health benefits through a membership organization.

You can learn more about the requirements for getting a group health insurance plan here.

Find the right group health insurance with eHealth

eHealth can help you find affordable group or individual health insurance plans. We make it easy to shop for health coverage with our free, no-obligation health quotes, online tools, and licensed agents. By using eHealth’s website to compare plans from multiple health insurance companies in your area, you can save time while finding plans that fit your needs and budget.

With over 10,000 plans from over 180 companies, we are committed to providing you with the best selection of health plans available online. Trusted by over 5 million customers, we also serve as your advocate and point of communication even after you have purchased your health plan.

Learn more about group health insurance at eHealth.com, or speak with one of our licensed insurance agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How Can Small Business Health Insurance Help Your Business Strategy?

Running a small business can be exciting as well as challenging, especially when thinking about your company’s long-term strategy. Achieving primary goals and objectives is important for any company, and offering health insurance benefits can be a great way to help your company grow.

Offering small business health insurance may support your business strategy by contributing to recruiting and retaining better employees while promoting a positive company culture.

Continue reading to learn 3 ways that group health insurance may help your company’s strategy.

1. Better employees

Employing a skilled workforce can be an important part of implementing your business strategy, and offering small business health insurance can help attract quality employees to your company.

A group health plan may be part of an effective recruiting strategy. A recent eHealth report found that 66 percent of small businesses offered group medical benefits to help them hire and retain the best employees.

In a competitive marketplace for the best talent, providing small business health insurance may contribute to finding the right people to fulfill your business objectives.

  • Offering group health insurance, along with other employee benefits, can help create an engaging total benefits package for both new and current employees.
  • Health coverage may make or break an employment offer among potential hires. No one wants to lose a good prospective employee due to whether medical benefits were part of their offer.
  • Having small business health insurance may help a company stand out from competitors, especially those who do not offer health insurance or other employee benefits to their workers.

Overall, offering small business health insurance may be a strategic way to recruit better employees.

2. Greater employee retention

Having a sound business strategy can be a great way to help jumpstart your company’s future growth, but without experienced employees to carry out that strategy, it may be difficult to move forward.

After investing significant time and resources to train your employees with valuable skills and knowledge of company policies, offering  health insurance as a benefit can show your workers that you are committed to supporting their well-being at your organization for the long term.

You may be surprised to learn that there are several effective ways that a group health plan may promote employee retention.

  • Employee loyalty – Employer-sponsored medical benefits may boost employee loyalty to an organization. Loyal, engaged employees will probably be more likely to remain with their company while working hard to support the best interests of the business.
  • Greater job satisfaction – Making sure that your employees are satisfied with their jobs can be key to keeping your workforce motivated. Group health insurance is one of the most popular employee benefits, and offering health coverage may be an effective way to satisfy employees.
  • Reduce turnover costs – Turnover costs are a major expense for employers, and a headache that most small business owners would prefer to avoid. Plus, many employees value job security. Group health plans can encourage workers to stay while saving on training costs for employers.

Perhaps the best way to retain employees is demonstrating that you value and appreciate their service to your company. One great way to convey that the health of your employees is important to you could be enrolling your organization in a small business health insurance plan.

3. Building a healthy company culture

Besides providing a great product or service, having a proactive and supportive company culture can be a relevant factor in achieving your small business strategy.

Company culture is important, not only because it represents the organization’s values, principles, and practices to employees, but also because it plays a critical role in shaping your small business’s brand.

Here are a few ideas about how to promote a healthy company culture with group health coverage.

  • While a group plan provides your employees with coverage when they need medical care, implementing a workplace wellness program at your company can inspire your workers to make healthier choices daily and encourage healthy living as part of your company’s values.
  • Providing medical coverage and other benefits to your workforce can communicate trustworthiness, stability, and confidence toward your employees. These principles may lend themselves toward creating a culture of trust within your organization while also helping your business stand out as an employer of choice.
  • Health insurance may contribute to helping workers perform at their best. When employees stay healthy, they tend to be more productive, engaged, and take less sick days. Overall, this could add up to a positive culture, better customer service, and greater focus on business initiatives that help support your company’s business strategy.

Ultimately, offering small business health insurance may be an effective way to help your company grow while creating a culture that values the health and well-being of your greatest asset: your employees.

Find group health insurance that works for your company’s strategy

With eHealth, you can find small business health insurance plans that fit your needs and budget. Our website and licensed health insurance agents make it easy to compare and shop for group health insurance from the top health care providers in your area.

Visit eHealth.com today and see how we can help you save time and money by finding the optimal small business health insurance plan for your company.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Who is Eligible for Group Health Insurance?

As a small business owner, you may be wondering whether you and your company are eligible for group health insurance. Typically, a business needs at least one qualified, full-time equivalent employee besides the business owner in order to be eligible for group health insurance.

Also, depending on your situation, other factors that help determine if a business can enroll in group coverage may include business type, employee status, and the level of workforce health plan participation.

Continue reading to learn about how eligibility works for group health insurance.

Group coverage basics

Group health insurance, also known as small group insurance or small business health insurance, is available to companies seeking to provide medical coverage to their employees under one policy.

By federal law, qualified small businesses are guaranteed group health insurance if they decide to buy it. Small businesses also cannot be denied coverage based on the health of their employees, if you’re enrolling in an ACA-compliant plan.

Generally, to be eligible for group health insurance, a business must fulfill two main requirements:

  1. The business must have at least one qualified full-time or full-time equivalent employee other than the business owner or a spouse.
  2. The company must be considered a legal business entity according to its state’s regulations.

According to the Affordable Care Act (ACA), a small business is defined as a business having between 1 to 50 employees. By having at least one qualified employee (who is neither yourself nor a spouse), your business would likely be eligible for group health insurance.

While the definition of a group or employee varies by state, it is important for you to know that a qualified full-time or full-time equivalent employee is usually considered to be someone who works at least 30 hours per week, according to the IRS.

Generally, if an employer decides to offer health insurance to any of their full-time employees, then the employer must offer health coverage to all of their full-time employees.

Oftentimes, there will be a requirement that a minimum percentage or number of employees participate in a group health insurance plan. Once a group is enrolled in a health plan, the employer must contribute to employee premiums as part of the plan’s cost-sharing arrangement. Generally, most states require employers to pay at least 50 percent of the monthly premiums for their employees.

Who is usually not eligible for group health insurance?

A sole proprietor with no employees usually would not be eligible for group health insurance. The self-employed owner of a sole proprietorship could still enroll in an individual health insurance plan.

If you have a family business and are looking for group health coverage, a spouse typically cannot count as the company’s only employee. However, if the business has other employees (who may also be members of your family), your spouse can enroll in the plan.

Qualified dependents can only enroll in a group health plan if an employee is already enrolled in the plan. While small business employers have the option to decide whether they will contribute to the cost of health insurance premiums for dependents, employees can still add dependents to their plan.

Finding affordable group health insurance

Although all health plans have different terms and conditions, these group coverage basics may help you in deciding if your small business is eligible for group health insurance.

If you have questions about whether your group is eligible for small business medical coverage, you can call eHealth’s licensed health insurance agents with no obligation or cost to you. Our representatives can help answer your questions and provide you with unbiased advice for choosing the right health plan for your business. You can also get free quotes on small business health insurance from us.

We are also committed to supporting you after have purchased your group health insurance plan by serving as the communication point between you and the insurance company.

With our free group health insurance quotes, eHealth empowers you to compare health plans from multiple health insurance companies so you can find the best option for your budget and coverage preferences. Compare group health insurance plans for free at eHealth.com today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Which ACA plan should you choose?

What are the different types of ACA plans?

There are 4 main types of Affordable Care Act, or ACA, health insurance plans:

  • PPOs – or Preferred Provider Organization Plans
  • POSs – or Point-Of-Service Plans
  • HMOs – or Health Maintenance Organization Plans
  • EPOs – or Exclusive Provider Organization Plans

Factors such as your budget, where you live, and the kind of health care you require are important to consider when choosing from ACA plans.

What do all the ACA plans have in common?

All ACA plans are mandated to cover 10 essential benefits. These 10 essential benefits include health care services such as:

  • Emergency services
  • Hospitalization
  • Out-patient services
  • Maternity and newborn care
  • Mental health, behavioral health, and substance use disorder services
  • Prescription Drugs
  • Rehabilitative and habilitative services
  • Laboratory services
  • Pediatric services, including oral and vision care
  • Preventative and wellness services and chronic disease management

According to Familiesusa.org, before the ACA’s essential health benefits, millions of people did not have coverage for maternity, substance use treatment, mental health care, or prescription drugs.

So long as you purchase an ACA plan, these 10 health care benefits will be covered in some shape or form. However, keep in mind that insurance companies are free to choose how they cover these benefits. This means, you may still have to meet a deductible, pay a copayment, etc…so always be sure to check plan details!

All ACA plans are all also eligible for government subsidies. If you buy a plan that is not ACA-compliant, you won’t be able to apply for subsidies. But keep in mind that you still may not get subsidies, even if you do choose an ACA plan. You can get subsidy estimates on eHealth while searching for plans, so you can have an idea of how much financial support you’ll be getting.

PPOs (Preferred Provider Organization Plans)

Preferred Provider Organization plans, also called PPOs, are one of the most popular plan types for individuals and families. PPOs allow you to visit whatever in-network health care provider you’d like without requiring a referral from a primary care provider.

In-network care will be covered at a higher benefit level than any care you receive out-of-network.

You can expect PPO plans to require you to pay an annual deductible before the insurance company kicks in. Additionally, you may also have a co-pay (according to eHealth, co-pays are usually around $10-$30) or coinsurance that you have to pay for certain health care services.

A PPO plan may be the right ACA plan for you if:

  • You want to freedom to choose almost any medical facility or provider for your needs
  • You want some coverage if you choose to go out-of-network
  • You don’t want to have to receive a referral first from your primary care provider in order to see a specialist

HMOs (Health Maintenance Organization Plans)

HMO, or Health Maintenance Organization, plans offer a wide range of healthcare services through a network of providers who agree to supply these services to members. You’re likely to have coverage for a broad range of preventative healthcare services than you would through another plan.

As of 2018, HMOs have emerged as the most popular aca plan amongst eHealth shoppers. According to a recent study, 53% of shoppers selected an HMO plan in 2017.

You will be required to choose a primary care physician (PCP) who will take care of most of your health care needs. Your PCP will need to refer you to a specialist if you decide you want to see one.

While HMOs typically have lower out of pocket costs, you may be required to pay a deductible before your coverage starts but your co-pays will likely be minimal. Keep in mind that with an HMO you will likely have no coverage for any care you receive out-of-network or for services you receive without a proper referral from your PCP.

A HMO plan may be the right ACA plan for you if:

  • You’re shopping for an ACA plan with a low monthly premium
  • You want an ACA plan with little or no deductible and don’t mind having an out-of-pocket limit
  • You need preventative care services

POSs (Point of Service Plans)

A Point of Service Plan, or POS, has some qualities of an HMO and PPO with benefit levels depending on if you receive care in or out-of-network. You can think of a POS plan as a sort of HMO/PPO hybrid.

Similar to an HMO plan, with a POS plan you will have to designate a PCP who will make referrals to in-network specialists when you require it. Typically services received through your PCP are typically not subject to a deductible or preventative care benefits are usually included.

Similar to a PPO plan, you may receive care from providers who are out of your provider network but with greater out of pocket costs. You may also be responsible for paying a co-pay, coinsurance, or an annual deductible.

A POS plan may be the right ACA plan for you if:

  • You are willing to coordinate your care through your designated primary care physician
  • Your preferred doctor participates within the plan network

EPOs (Exclusive Provider Organization Plans)

With an Exclusive Provider Organization plan, or EPO, you may exclusively use the care providers – this includes doctors, specialists, and hospitals – within the plan network, but you cannot go out-of-network and receive coverage.

An EPO plan may be the right ACA plan for you if:

  • You do not want to have to get a referral to see a specialist
  • Your preferred providers are in-network
  • You want to receive a much lower negotiated monthly premium than what you would get with an HMO or a PPO plan

When Should You Rely on Urgent Care?

Whether you’ve felt the sudden onset of a sore throat or suffered a minor injury on a weekend, you’ve probably wondered whether or not you should try to get an appointment with your primary care provider or go to an urgent care facility.

Keep reading to see information about what urgent care is, some of the suggested times to go there instead of the ER or a doctor’s office, and the costs that might be associated with certain visits to health care facilities, but do not rely on this article as medical advice. eHealth is a private online health insurance exchange, and we are not an official source of medical advice.

When should I go to urgent care?

Going to an urgent care facility for treatment may appeal to those who:

  • Have non-life threatening symptoms of an illness that need to be addressed same day
  • Have minor non-life threatening injuries that need to be addressed same day
  • Need a prescription, minor injury, or other treatment same day and cannot get an appointment with their primary care physician

Urgent care is a great option for those who need treatment same day for a non-threatening injury or illness. If you need care on a weekend or after your primary care provider’s hours of operation, urgent care may be your best option as they usually have evening and weekend hours.

Most urgent care facilities typically will take in walk-ins, however some allow you to make an appointment in advance online.

Most urgent care facilities have x-ray machines and can perform some services that you can typically get from a primary care provider or emergency room. However, urgent care facilities lack the equipment and staff to treat life threatening conditions.

In the event that you experience a life threatening illness or injury, you should consider visiting the ER, and not an urgent care facility.

Additionally, according to an article published in JAMA Internal Medicine, relying on urgent care facilities may lead to inappropriate treatment. This article states that retail clinics and other urgent care facilities prescribe more unnecessary antibiotics than any other setting. Antibiotic prescriptions will not help a viral infection and can cause harm through side effects and, in cases of overuse, can lead to bacterial resistance.

Are urgent care visits covered by my insurance?

While all ACA compliant plans are required to cover 10 essential benefits, including emergency care, urgent care may not be considered emergency care in some cases.

However, most plans do cover urgent care center visits. Patients can be expect to pay a copay or deductible for visits to urgent care facilities. According to Debt.com, urgent care visits cost around $150 on average, which is usually covered but you may pay a copay from anywhere from $35 to $100, on average. They are cheaper than ER visits which mark up their cost upwards of 1000 percent, according to a Johns Hopkins study.

In some cases, your insurance may not cover urgent care or an urgent care facility may choose not to accept your insurance even if your insurance would cover your visit otherwise.

If you’re not sure whether or not your health insurance plan covers urgent care visits, check your plan details as soon as possible, or ideally before you enroll in your health insurance plan.

When should I go to my primary care physician?

It is recommended that you go to you primary care provider over urgent care when you can as a study conducted by the University of Michigan Health System showed that continuity of care has shown to increase patient satisfaction.

While you may not have access to a primary care physician during nights or weekends, unlike urgent care, primary care physicians can offer you continuity of care and other services that urgent care simply cannot.

Unlike urgent care, primary care physicians can

  • Keep and update your medical history
  • Has access to medical records and health history which helps ensure you get appropriate and consistent care
  • Develop a relationship with patient; help reach health goals
  • Coordinate treatment with specialists if needed
  • Provide preventative care

Are primary care provider visits covered by my insurance?

Yes, primary care provider visits are usually covered by your insurance. The ACA requires health plans to cover 10 essential benefits, this includes preventative and wellness services as well as chronic disease management. If you choose a plan such as short term, or accident insurance, you will likely not get covered for primary care visits.

Keep in mind that health insurance companies choose how they cover these benefits, so check plan details before enrolling in a plan, or assuming that your health insurance plan covers primary care visits.

Typically with an ACA or major medical health insurance plan, you can expect your doctor visit to be covered with a copay, or else you will pay for it out of pocket and the cost will go towards your deductible.

Additionally, if you are uninsured physician’s offices typically accept cash, check, and credit cards, along with insurance for payment.

This article is for general information and should not be relied on as medical advice.  Check with a medical professional for medical advice. eHealth is a private online health insurance exchange where individuals, families and small businesses can compare health insurance plans with various levels of coverage. eHealth not an official source of information for healthcare advice or information.

What You Should Know About CBD

CBD is the big buzz in the health industry right now. It’s legal in many states and as a result, it’s becoming readily available and can even be found in local grocery stores, doctors’ offices, and coffee shops. Many people claim that that CBD can help with a variety of health-related issues, ranging from insomnia to anxiety. Although the benefits of CBD are not medically proven, we’ve addressed the top questions floating around about CBD, and reviewed some of the claims people have made about what CBD can do.

1. What is CBD?

CBD is short for cannabidiol, which is a chemical compound from the cannabis plant. It’s a naturally occurring substance that’s used in products like oils and edibles to impart a feeling of relaxation and calm. While CBD is a component of marijuana, by itself it does not cause a “high.”

2. Does CBD cause a “high”?

CBD alone should not cause any type of “high” like smoking marijuana would. The cannabis plant is made up of two main players: CBD and THC. CBD is the non-psychoactive portion of the plant. THC is the portion of the plant that causes a psychoactive reaction, the “high.”

There is also a risk though that CBD could cause a side effect, for reasons unknown. You never know how your body will react to a new supplement

3. Is CBD legal?

CBD is in a legal grey area. CBD that is extracted from hemp (which must have an extremely low level of THC, thus not causing a “high”) has only been legal nationwide since the Farm Act was enacted in December of 2018.

CBD that is extracted from other cannabis plants is still illegal on the federal level, but is legal under certain state laws.

4. What are the benefits of CBD?

The benefits of CBD are still being studied. Currently, there is only one CBD medication currently FDA-approved – Epidiolex.

However, many people swear by CBD and say that it has helped them with a wide range of health conditions, like insomnia, back pain, osteoarthritis, even cancer.

Although there isn’t a lot of scientific evidence to support the supposed benefits of CBD, there is a growing amount of anecdotal evidence as seen by the increasing number of people who use is regularly.

5. Should I consider using CBD?

That’s definitely something you should consult your doctor about. Some doctors will recommend it as part of a treatment plan, while other health professionals are still on the fence.

The verdict is still out on the benefits of CBD.

This article is for general information and should not be relied on as medical advice.  Check with a medical professional for medical advice. eHealth is a private online health insurance exchange where individuals, families and small businesses can compare health insurance products from brand-name insurers side by side and purchase and enroll in coverage online and over the phone, and not an official source of information for healthcare advice or information on CBD.

5 Reasons Your Business Needs a Website

Whether your business is small, large or in-between, well established or brand new, it’s crucial for your business to have an online presence. A website is critical for growth, brand awareness and building trust with your consumers. These days building a business website or ecommerce marketplace is much easier than it’s ever been. There are many cost effective, easy-to-use online services available for those inexperienced in code and design. Most of these platforms provide ready to use templates that cover a very wide range of industries.

Still not convinced? Here’s 5 reasons why every business could benefit from building a website.

1. It provides visual proof and legitimacy.

Think about it, how else will prospective customers know you exist? You can’t rely on third-party rating sites alone–most consumers now rely on a digital presence to make their decisions. While you can’t control what others say about you on social media channels, with your own website you can control the narrative and influence public perception by creating your own story about your business.

2. Your competitors all likely have company websites.

By not having a digital presence, you’re missing out on an opportunity to be competitive. You’re giving shoppers a reason to buy from another brand. Checking your competitor’s digital presence and activity is an important play in setting your brand above the rest. Familiarizing yourself with design trends within your industry is important, but applying those ideas while keeping your brand and messaging your own is key.

3. It’s too easy not to. No excuses.

You don’t need extensive coding or technical skills. Because most website-building platforms offer online tutorials and community-based support, almost anyone can get a basic website up and running in a surprisingly short amount of time. These online platforms even make it easy for those with no experienced in design by providing a wide range of templates in every style you can imagine.

4. It keeps your consumers informed.

Websites are the number one communication tool for businesses today. They can serve as digital bulletin board to keep consumers informed about new products, services, and discounts. If done right, these actions can lead to better engagement, increased revenue, and even improve customer retention.

5. It’s a good way to acquire leads.

A website is the best lead generation tool. Most consumers perform online research before making a purchase. If you have a company website, you have a bigger chance of being visibly seen by potential customers.  In addition, if you opt to collect site visitors’ emails you gain the opportunity to start email marketing to help you reach new customers and generate repeat business.

Can I Get Health Insurance Through My LLC?

As a small business owner, you may be wondering whether you can get small business health insurance through your LLC. The short answer is that while you usually cannot get small business health insurance through your LLC, you can still enroll in individual health insurance coverage for yourself.

You can generally deduct the cost of individual health insurance from your taxes as a self-employed LLC member, although this ultimately depends on several factors, including the tax classification of the LLC and for whom the deduction is being taken out for.

Continue reading to learn about how health insurance works for LLCs.

What is an LLC?

A limited liability company, commonly abbreviated as LLC, is a business structure with both “pass-through” taxation and legal liability separate from its owner.

  • Like a sole proprietorship, an LLC has “pass-through taxation,” which means that the income and loss of the business is reported on the personal income tax form of the business owner. This means that an LLC does not constitute a separate entity for tax purposes, according to the IRS.
  • According to LegalZoom, unlike a sole proprietorship, an LLC has separate legal liability (like a corporation). If a suit was filed against your LLC, then the LLC itself would be sued, not you as the individual. As a result, in most cases the plaintiff would only be entitled to recover the LLC’s business assets, not your personal property or assets.

The owners of an LLC are called members. Single-member LLCs are taxed as sole proprietorships, while multiple-member LLCs are taxed as partnerships.

An LLC can also decide to be taxed as a corporation or S corporation, and its members would then pay taxes like shareholders of a corporation or S corporation owners.

Can you get health insurance through your LLC?

You usually cannot get small business health insurance or a group plan through your LLC if you have no employees, although you can still get individual health insurance as an LLC owner or member.

If your LLC does not have employees besides yourself, you would most likely be a sole proprietor and could only enroll in individual health insurance, not small business health insurance.

However, sole proprietorships with one employee besides the business owner can usually qualify for group health coverage.

In other words, single-member LLCs would likely only qualify for individual health insurance instead of group health insurance.

Can an LLC deduct health insurance premiums?

Getting a health insurance LLC deduction depends on whether the deduction is being taken out for non-member employees or members of the LLC, as well as the legal and tax status of the LLC and whether the LLC is classified as a sole proprietorship, partnership, or corporation. According to LegalZoom:

  • For non-member employees – An LLC can deduct the cost of medical insurance for all employees who are not members of the LLC. This deduction can also include the amount the LLC pays for employees to have qualified long-term health coverage.
  • For the self-employed – Members of an LLC are considered self-employed if their LLC is a sole proprietorship or partnership. While self-employed business owners can deduct the cost of acquiring health insurance for themselves, a spouse, and qualified dependents, they may or may not be able to qualify for small business health insurance. For example, sole proprietors usually would not qualify for a group plan unless they have employees, but a sole proprietor could still enroll in an individual health insurance plan.
  • For corporations – If shareholders of an LLC receive corporate tax treatment, they would not be considered eligible to receive health insurance from the business unless they are bona fide employees. If a corporation provides health insurance to non-employee shareholders, then the company could not take this deduction on their corporate tax return.

Overall, self-employed LLC members can usually deduct health insurance as a business expense.

eHealth can help you get health insurance for your LLC

With eHealth, you can shop for health insurance that fits the needs of your LLC. Whether you are a business owner with employees and are looking for small business health insurance, or are a sole proprietor seeking individual health insurance, eHealth makes it easy to find the right health plan for your cost and coverage preferences.

Visit eHealth.com or speak with one of our licensed health insurance agents today to find the optimal health care solution for your small business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How Much is the Cheapest Small Business Health Insurance?

If you are an employer or entrepreneur, you may be wondering how much the cheapest small business health insurance is. After all, it’s a smart move to consider all of your options while keeping in mind your budget and cost preferences.

While the cost of a group plan ultimately depends on a variety of factors, you may be able to find cheap health insurance for your small business that could be more affordable than purchasing health insurance by yourself.

Continue reading to learn about how you can find the cheapest small business health insurance out there.

The cheapest small business health insurance may be more affordable than individual coverage

According to a recent eHealth study, the average per-person costs of small business health insurance are lower compared to individual health insurance.

Source: eHealth 2018 Small Business Health Insurance Report

  • The average premium per-person through a small business plan was 7 percent lower than the average premium for an individual plan in 2018.
  • The average individual deductible per person for small business plans was 31 percent ($1,438) lower than the average deductible for individual coverage in 2018.

Due to the advantage of having a larger risk pool (larger number of people enrolled in a medical plan, who help to better spread out the cost of risks for the insurer), a group plan can be a cheaper health insurance option for a small business than an individual plan bought by each individual employee and employer.

While it probably comes as a pleasant advantage that small business health insurance may already be cheaper on average per person than individual coverage, it’s still good to know some tips and tricks to finding the cheapest insurance that still meets your group’s health care needs.

What factors can help make small business health insurance more affordable?

All health insurance plans have different specifications and features, and insurance costs will vary among different companies. Finding the cheapest small business health insurance for your organization usually depends on a variety of factors. These considerations may include:

  • Your small business’ location
  • The number and ages of your employees
  • The type of group plan coverage your business wants
  • Extra health benefits you may include, like dental or vision plans

According to the Kaiser Family Foundation, insurers cannot look at employee health when they set rates for Affordable Care Act (ACA) plans, as per the policies of the ACA; however, this is only true for ACA plans, since short-term health plans can look into your health and turn down applicants or charge more based on health status or pre-existing condition.

Beyond considering the price of group plans, small businesses may also need to take time to administer health plan benefits or outsource the administrative side to a third party.

Group plan types and metal levels can help illustrate the role that premiums, deductibles, and out-of-pocket costs play in the cheapest small business health insurance.

How do plan types contribute to cheap health insurance?

From the perspective of minimizing costs, the cheapest small business health insurance plans generally tend to be plans with lower monthly premiums and higher annual deductibles. This is usually because your primary cost from month to month would be your premium, unless you require medical care; in that case, the cost of those health services would then be added to your monthly expense. On the other hand, if you or your employees require frequent doctor’s visits, medication, and various health care services consistently, it may be financially smarter to pay for the high premium and benefit from the access to care after reaching your deductible.

If you or employees require more regular access to medical care though appointments or prescription medications, then a high premium, low deductible plan or a plan with affordable copayments may be a more cost-effective and cheaper option in the long run depending on your health care needs.

Reviewing plan types can be an effective way to select the cheapest small business health insurance. While HMO plans generally tend to have lower monthly premiums and out-of-pocket costs than PPO plans, you may be surprised to learn that many small business owners also chose POS plans in 2018, according to a recent eHealth study.

Source: eHealth 2018 Small Business Health Insurance Report

In fact, POS and HMO plans account for almost three quarters of all group  insurance plans selected in 2018.

This may be due to both the lower premiums of HMO plans and the greater flexibility of POS plans (which combine features found in both PPO and HMO plans).

How do plan metal levels contribute to cheap health insurance?

Metal levels refer to the actuarial value (AV) of a health plan, meaning the percentage of total average costs for covered benefits that the health insurance company will pay.

For instance, a Silver level plan has a 70 percent actuarial value, which means that the insurer would pay an average of 70 percent of all of the plan’s medical costs, and you would be responsible for paying 30 percent of covered medical expenses until you reached the plan’s out-of-pocket maximum limit.

While a Bronze level plan may be a cost-effective option as you shop for the cheapest small business health insurance, it may be worthwhile to consider the benefits of other metallic heath plan levels.

A recent eHealth study found that small businesses decided to choose Silver and Gold metal level plans by a significant margin in 2018.

Source: eHealth 2018 Small Business Health Insurance Report

Ultimately, just because a plan is the cheapest does not always mean it will be the best fit for your company’s needs. As a small business owner, be sure to consider the specifications and cost structure of each plan, as well as consult with your employees to find out what they would want in a group plan.

eHealth can help you find affordable insurance

If you are looking for the cheapest small business health insurance, eHealth can help you find affordable options that work within your budget.

With eHealth, you can quickly find and compare free quotes for group plans based on your cost and coverage preferences, while benefiting from a great selection of the top insurance companies available in your area.

Visit eHealth.com today or speak with one of our licensed health insurance agents to discover affordable health insurance solutions for small businesses.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

6 Best Small Business Health Insurance Providers of 2019

Best Small Business Health Insurance Providers of 2019

One of the advantages of shopping for group plans though eHealth is the great selection of options available to you. eHealth helps you choose group plans from the top small business health insurance providers in your area, allowing you to compare free quotes from multiple health insurance companies all in one place to find the best value plan for your business.

For small businesses with between 2 and 50 employees, eHealth provides the largest private online marketplace for group health insurance plans, providing you with access to options from the best health insurance providers out there.

eHealth carries group plans from all of the following top health insurance providers, as well as other leading health insurance companies. Continue reading to learn more about 6 small business health insurance providers of 2019 offered at eHealth.

Blue Cross Blue Shield

Blue Cross Blue Shield (BCBS) could easily be considered one of the top health insurance providers due to the scale of its nationwide network, which consists of 36 independent, locally operated health insurance companies that cover millions of people in every ZIP code and all 50 U.S. states.

Blue Cross Blue Shield is a popular health insurance provider among many small business owners for a variety of reasons.

  • National coverage – BCBS shield companies insure 106 million health plan members, and one in three Americans.
  • Relied on by small employers – Blue Cross Blue Shield companies insure 7.3 million employees of small businesses.
  • Popularity of plans – BCBS offers the BlueCard® PPO, which is one of the nation’s leading PPO networks, and partners with 96 percent of U.S. hospitals and 95 percent of U.S. physicians.

Overall, Blue Cross Blue Shield provides small business owners and employees with access to a wide network of doctors and hospitals across the country.

UnitedHealthcare

As the largest of the nation’s health insurance providers, UnitedHealthcare (UHC) serves all 50 U.S. states and provides coverage to millions of people. UnitedHealthcare’s services stand out in several ways that are relevant to the needs of small business owners and employees.

  • UnitedHealthcare’s network includes over 895,000 physicians, health care professionals, and 5,600 hospitals.
  • UnitedHealth invests about $3.5 billion annually in technology and innovation.
  • Most UHC plans include Virtual Visits, which allow members to consult with doctors through their computer, tablet, or mobile device.

Small business health insurance plan options offered by UnitedHealthCare include:

  • UnitedHealthcare Choice – Includes fixed copayments and lower out-of-pocket costs for network care.
  • UnitedHealthcare Choice Plus – Offers the same features as the Choice plan while additionally providing coverage for out-of-network physicians.
  • UnitedHealthcare Options PPO – Includes the freedom to choose any doctor without referrals. Going to a network physician may result in cost savings, while an out-of-network physician may have higher costs.

The scale of UnitedHealthcare’s network, along with the UHC’s technology initiatives, make the company a strong choice for small business group plans among health insurance providers.

Humana

As one of the largest health insurance providers in the nation, Humana provides integrated medical coverage for over 16 million members. Headquartered in Louisville, Kentucky, Humana was also ranked #1 in Fortune’s “Social Responsibility” category.

Small business health insurance plan options offered through Humana include:

  • Canopy Health Plan – For small businesses with between two to 50 employees, this straightforward plan features higher deductibles and copays for basic services.
  • Simplicity Health Plan – This plan may be optimal for small businesses who prioritize low costs and want to know their health care costs up front.
  • Copay Health Plan – As a more traditional health insurance plan, this plan may be a good fit for small businesses who want employee coverage for routine care and other covered services.
  • High Deductible Health Plan – The HDHP could be a good option for generally healthy employees who receive annual preventative care and also need full medical coverage in case of a major health care event.

Humana offers health insurance plans designed with affordability and flexibility in mind for small businesses.

Kaiser Permanente

As the largest managed care organization in the United States, Kaiser Permanente offers health insurance in eight U.S. states and the District of Columbia. Kaiser Permanente has received awards and recognitions from J.D. Power for member satisfaction, and the California Healthcare Quality Report Card gave Kaiser Permanente four out of four stars for its Northern and Southern California regions.

Kaiser Permanente consists of the Kaiser Foundation Health Plan, Inc. (KFHP) as well as its regional operating subsidiaries; regional Permanente Medical Groups; and Kaiser Foundation Hospitals.

Kaiser Permanente offers a variety of small business health insurance plans, including:

  • Traditional HMO plans
  • Deductible HMO plans with lower premiums
  • HRA and HSA-Qualified plans
  • POS plans
  • PPO plans

The advantage of choosing Kaiser Permanente is that the company provides affordable options for small businesses through the convenience of being part of a managed care organization.

Anthem

Anthem is the largest for-profit managed health care company within the Blue Cross Blue Shield Association of 36 individual companies, serving 14 U.S. states and providing a variety of health plans to 40 million members.

Formed in 2004 through the merger of Anthem, Inc. and WellPoint Health Networks Inc. (which started in the 1940s), the company assumed the corporate name Anthem, Inc. in 2014.

As an industry leader among health insurance providers, Anthem offers a wide range of group plans for small businesses, including many which are HSA-compatible. In addition to large medical networks of physicians and specialists, Anthem provides the BlueCard® program for nationwide access to hospitals and doctors.

Aetna

Founded in 1853, Aetna has been named on Fortune’s World’s Most Admired Companies list, and ranked No. 4 in the “Health Care: Insurance and Managed Care” category.

Aetna’s health care network includes:

  • 2 million in-network health care professionals
  • 690,000 primary care doctors and specialists
  • 5,700 hospitals across the country

Aetna health insurance provides health coverage for approximately:

  • 1 million medical members
  • 7 million dental members
  • 1 million pharmacy benefit management services members

Aetna can be a great choice among health insurance providers for a small business because of its nationwide network, quality specialists, and integrated health benefits solutions.

Shop for the best small business health insurance providers with eHealth

eHealth can help you find the right small business health insurance solution for your company. Our online marketplace allows you to compare plans from multiple health insurance providers to find affordable solutions customized for your small business.

It’s easy to get started with our no cost, no obligation quotes. By providing the zip code and number of employees for your business, you can shop for group plans available from top health insurance providers in your area. We can help you navigate the application and implementation process, and we’ll continue to act as your advocate and point of communication even after you’ve enrolled.

Visit eHealth.com or speak with one of our licensed health insurance agents today, and you can find which small business health insurance plans we offer in your area from these top health insurance providers. Keep in mind that this article is for general information of top health insurance providers in 2019, and all of the plans listed in this article may not be available on eHealth or in your area.

The exact definitions and terms of use for each insurance plan may vary, so be sure to carefully review the terms of any plan you choose to buy. Each insurance plan periodically updates its list of in-network doctors and providers, so always double check coverage with both the plan and the doctor or provider before incurring medical expenses.

How Much is Health Insurance for a Small Business Owner?

As a small business owner, you may be wondering how much health insurance is for yourself and your employees. Beyond the cost of group plans in general, what are the average costs of small business health insurance from the perspective of the employer? And how can small business owners get affordable health insurance plans?

Continue reading for answers to these questions as well as an overview of how much health insurance is for small business owners.

How much is health insurance for a small business owner?

Determining how much it costs for a small business owner to purchase health insurance for himself or herself, as well as the company’s employees, depends on several key factors, including the workforce’s size, age, and location. The level of cost-sharing and employer contributions to monthly employee premiums also helps determine how much health insurance will cost for small business owners.

According to an eHealth report, small businesses with fewer than 30 employees paid an average of $409 per person for premiums in 2018. Small business owners also spent an average of $3,140 per person for deductibles in 2018.

What else should a small business owner know about how much health insurance is?

While the cost of health insurance itself forms a major part of health care expenses for the employer, there are also related considerations which a small business owner should keep in mind.

  • Depending on the situation, small business owners may need to spend time administering their group health plan or pay an outsourced third party to manage the administration of health benefits for their employees.
  • Certain factors may offset the total dollar cost of health insurance coverage for a small business owner. One consideration is employer contributions, or the percentage of employee premiums that are split between the company and its workers.
  • Potential tax breaks, including the small business health care tax credit for qualified companies and how small business owners can deduct employee premium costs from their federal business taxes, may also offset the cost of group health insurance for the employer.

Although all health plans are different, remembering these important administrative, financial, and tax factors can be helpful for a small business owner when evaluating their costs and options for group health insurance.

Can small business health insurance have lower costs than individual health insurance?

Small business health insurance plans generally have lower average per person costs compared to individual health plan coverage.

  • The eHealth report found that, in 2018, the average monthly premium through a group plan was 7 percent lower than an individual health insurance plan’s average premium ($409 vs. $440).
  • The eHealth study also found that, in 2018, the average deductible per person for small business plans was 31 percent ($1,438) lower than the average deductible for individual health insurance coverage ($3,140 vs. $4,578).

Source: eHealth 2018 Small Business Health Insurance Report

This is good news if you are a small business owner who wants to provide health insurance for yourself and your family, as well as your employees. Depending on your budget and medical preferences, a group health plan may be a more affordable option for offering health coverage through your business.

How to get group health insurance for small business owners

You can get free small business health insurance quotes from eHealth. By quickly entering in your company’s zip code and number of employees, you can instantly compare group plans from a wide selection of top health providers available in your area.

As a small business owner, you can also speak with one of our licensed agents, who can help you navigate the health insurance shopping, application, and implementation process from start to finish. The difference you get with using eHealth is that we continue to support you, even after you have bought your plan. We’ll serve as the communication point between you and the insurance provider.

Visit eHealth.com and find the right small business health insurance for your company today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Can I get Health Insurance Without a Job

The simple answer: no, you do not need a job to get health insurance. If you’re hoping to get group health insurance, then the answer is yes, you do need to have an employer or else be the owner of a business with at least one employee. But if you’re shopping for individual or family health insurance, your employment status will n not prevent you from getting coverage.

If you are unemployed, your employer doesn’t offer health insurance, or you do not qualify for benefits offered at your job, you still have a few health insurance coverage options:

  • COBRA
  • Medicaid, Medicare, CHIP
  • Affordable Care Act (ACA) insurance
  • Individual or family health insurance

The majority of Americans do get their health insurance through their employer. According to a 2017 survey by the Kaiser Family Foundation (KFF) about half (49%) of Americans get employee sponsored health insurance.

Employer vs non-group insurance

[2017 kff Survey Data]

But just because you’re in the minority doesn’t mean that finding health insurance that’s right for you, your situation, and your budget has to be hard or expensive.

COBRA

If you lose your health benefits, you may qualify for COBRA which allows you to continue group health benefits provided by your group plan for limited period time.

Circumstances that may trigger COBRA are:

  • Job loss
  • Reduction in hours that cause a loss in coverage
  • Divorce or separation from a covered employee
  • The death of a covered employee
  • The employee becomes entitled to Medicare
  • The death of a covered employee
  • Or a dependent of a covered employee ceases to be a dependent under the terms of the plan (an adult child turning 26, for example)

If you’ve experienced any of these you may be eligible for COBRA.

However, with COBRA you will have to pay the total premium, rather than split it with your former employer. With group insurance, your employer typically pays the majority of the bill; according to the KFF the employer paid about 82% of the premium for single coverage and 71% for family coverage. You will have to pay 100% of the premium with COBRA.

After one of these qualifying events, you’ll usually have 60 days to decide whether or not you’ll opt into your former employer’s COBRA benefits.

Medicaid, Medicare, CHIP

Depending on how hold you are, if you have children, and what your income is you may be eligible for government health insurance programs.

You may be eligible for Medicare if you are 65 or older (even if you’re not ready to retire), a younger person with a disability, or have End-Stage Renal Disease.

If you are a low-income person or family you may be eligible for Medicaid. If you are a low-income family with children you may be eligible for CHIP.

ACA insurance

Obamacare is another option you have if you make too much money per year to qualify for Medicaid or CHIP.

These plans are what you can find on the government Marketplace or your state’s health insurance exchanges, depending on where you live. ACA compliant plans are required to cover 10 basic benefits:

  • Care before and after a child is born
  • Preventative visits
  • Outpatient services
  • Emergency room visits
  • Inpatient care (care in hospital)
  • Prescription drugs
  • Mental health and substance use disorder services
  • Lab services
  • Pediatric services, including oral and vision care
  • Rehabilitative and facilitative services

Individual private health insurance

Individual private health insurance is just industry jargon for a plan you buy yourself off of a non-government exchange.

Shopping on private exchange, like eHealth, allows you to have more variety in your coverage options. You have the option of shopping for ACA plans like on the Marketplace or state exchanges, and you’ll even be able to apply for subsidies through eHealth by proxy. If you find that subsidies aren’t an option for you, and the fully-loaded ACA plans are too expensive, you’ll also be able to shop for alternative individual and family plans that may offer less benefits, but be within in your price range.

Short term health insurance

One option for people looking for a temporary, affordable solution is short term health insurance. If you’re experiencing a short lapse in coverage due to job loss or ineligibility for benefits, a short term health insurance plan may be a good option for you.

Short term health insurance plans are meant to help you bridge gaps in your health insurance coverage, until you can find a more long-term solution. They tend to be much cheaper than major medical health insurance premiums, however they do not have the same level of coverage.

If you decide that short term health insurance coverage is for you or are looking to shop for health insurance through a private marketplace, then enter your zip code on this page to start browsing coverage through eHealth.

Obamacare Premiums Unaffordable for Many Middle-Income People in 2019

Many middle-income Americans are having a difficult time affording their Obamacare premiums.

In a recent study conducted by the Kaiser Family Foundation (KFF) found that while premiums for ACA marketplace plans have mostly held steady (with the 2018 average for family coverage being $1,191 and the 2019 average being $1,154, according to eHealth), middle income Americans are still having trouble affording their coverage.

According to healthcare.gov, 2019 health insurance is unaffordable if it costs more than 9.89% of a household’s modified adjusted gross income (MAGI) to pay for the lowest cost plan possible.

The FPL and the “subsidy cliff”

Those who make between 100% and 400% of the federal poverty line (FPL) may be eligible for ACA subsides to help pay their premiums and, in some cases, their out of pocket expenses (such as copayments and deductibles). If you fall outside of this, even if it’s just making 401% of the FPL, then you might find yourself falling off the subsidy cliff.

2018 Poverty Guideline for the 48 Contiguous States and the District of Columbia

Persons in Family/Household 100% of  Federal Poverty Line 200% of FPL 300% of FPL 400% of FPL
1 $12,140 $24,280 $36,420 $48,560
2 $16,460 $32,920 $49,380 $65,840
3 $20,780 $41,560 $62,340 $83,120
4 $25,100 $50,200 $75,300 $100,400
5 $29,420 $58,840 $88,260 $117,680
6 $33,740 $67,480 $101,220 $133,880
7 $38,060 $76,120 $114,180 $152,280
8 $42,380 $84,760 $127,140 $169,520

2018 HHS poverty guidelines which the Federal Reister published on January 18,2018. Elligability for ACA subsides for 2019 are based on these guidelines.

Those who make above 400% of the federal poverty line (FPL) and who aren’t eligible for premium tax credits are dealing with something called the “subsidy cliff”, which refers to how there is a steep drop off in government assistance. There is no subsidy phase out for those making 401% and above the FPL.

This means that people making just over 400% of the FPL are completely responsible for the full cost of their insurance premiums.

“If you qualify for Obamacare subsides, you may be happy with your health insurance premiums – but the fact is that, for some families, earing just a couple hundred dollars more per year can make you ineligible for subsides and raise your health insurance costs by thousands of dollars,” said eHealth CEO Scott Flanders. This means, those couple extra dollars could cost you hundreds, or even thousands, due to not getting subsidies for your ACA health insurance plan.

Shopping outside of state/federal marketplaces

If you find yourself falling off the subsidy cliff (or find that ACA insurance plans are too expensive for any other reason), you’re probably going to benefit from a private marketplace like eHealth. On our online marketplace, we offer ACA plans along with many other alternatives that you’ll likely find are more affordable. Keep in mind, a more affordable health insurance plan will likely mean less benefits are covered, but being covered by a plan with less benefits is probably a better option than not being able to afford health insurance at all. Whether it’s due to the subsidy cliff, or something else, many middle-income individuals and families are shopping outside of government exchanges to find their insurance.

Private exchanges – such as eHealth – offer a wider selection of health insurance plans than government exchanges. Some people may find they can save money by buying an off-market plan through a private exchange.

It takes as little as providing your zip code to get quotes on all different kinds of plans at eHealth. You’ll find that it’s incredibly easy to compare prices for plans with eHealth, in order to find something that is right for your health care needs and budge

Opting for short term health insurance

Another option people are looking into is short term health insurance plans. These plans offer coverage for short amounts of time (anywhere from a few months to a year, with the chance to renew, depending on where you live) at a lower rate than most major medical plans.

According to eHealth, there has been an increase in people interested in buying short term health insurance rather than buying  ACA coverage.

Keep in mind that these plans offer less coverage than most major medical plans and may not cover the 10 essential benefits ACA plans are mandated by law to cover. However, if you do opt to purchase a short term health insurance plan you will not incur a tax penalty at the federal level as the individual mandate tax penalty no longer applies from 2019 on.

If you are interested in a short term plan, eHealth carries over 3,600 plans from over 16 carriers.

Start your health insurance plan comparison journey instantly with free quotes on eHealth.

Is It Ok to be Uninsured?

There is no law or rule about not having health insurance – the tax penalty for not having health insurance has also been removed at the federal level, so there’s no longer a fine for being uninsured – but you do face risks if you choose to go uninsured.

What are the risks of being uninsured?

The risks of going uninsured are primarily cost related. Some of the main risks that you could face by going uninsured are:

  • Steep healthcare costs – Without health insurance you may get charged much more for care that would otherwise be covered by your plan.
  • Difficulty paying off expensive medical bills – Since you might be charged out-of-pocket full price for any healthcare you receive while not having insurance, you may find that you’re quickly drowning in medical bills.
  • State tax penalties – While the individual responsibility penalty was repealed and no longer applies from 2019 on at the federal level, there are states with their own health insurance penalties. Check in to see if your state still has a state-level individual mandate that could affect you if you’re uninsured.
  • Not seeking or postponing receiving healthcare – According to a Kaiser Family Foundation (KFF) survey, almost a fourth (about 24%) of the uninsured hesitate seeking needed healthcare due to the high cost of uninsured healthcare. By hesitating to put your health first, you run the risk of health issues becoming worse over time.
  • Unable to afford needed medication – Because of rising prescription drug prices in the US, many prescription drugs are incredibly expensive, especially without a health insurance plan to help out. According to the KFF, about 19% of uninsured people will delay or not purchase needed drugs due to the cost.

Why do people go uninsured?

A lot of people go uninsured because of financial reasons.

According to a 2017 KFF survey, most uninsured individuals who are uninsured, go without health insurance because the cost is too high – about 45%. At 22%, the second most common reason uninsured people go without health insurance is because they lost their job or changed employers and because of that they lost their employer sponsored insurance.

Other groups of people said that they were uninsured because they lost their eligibility for Medicaid or lost coverage through their spouse, parent, or because of another status change.

Only about 2% of those surveyed cited that they had no need for healthcare coverage as their reason for being uninsured.

Can I get insured after losing coverage through employer, family member, or Medicaid?

If you lose coverage through a spouse, parent, or become ineligible for Medicaid you can get insured.

These losses of coverage are examples of qualifying life events which make allow you to be eligible for something called a special enrollment period. A special enrollment period allows you to enroll in major medical health insurance plans outside of the open enrollment period (which for 2019 coverage was ran from November 1st through December 15th of 2018 and will run from November 1st through December 15th for coverage starting in 2020).

If you qualify for a special enrollment period – which typically last 60 days – you will have to prove that you experienced a qualifying life event.

However, if you lose coverage through an employer or family member and you believe that you may qualify for Medicaid, you can apply anytime throughout the year as Medicaid and CHIP – two government programs seeking to provide low-cost or free health insurance to low-income individuals and families – do not have open enrollment periods.

Even if you do not think that you will qualify for Medicaid or CHIP based on income alone, apply anyway especially if you are disabled, have children or are pregnant.

How do I get affordable coverage?

If cost is what is keeping you from purchasing coverage, you should be happy to know that there are Affordable Care Act subsidies that you may qualify for.

Qualification for subsides is base off of your yearly income and what percentage you make above the federal poverty line (FPL). If you make between 100% of the FPL and 400% you may qualify for some assistance in paying your monthly insurance premium.

You can still qualify for subsides if you choose to buy through an online brokerage like eHealth, as long as you’re choosing an ACA-plan with the ten essential benefits included. eHealth allows you to affordable compare plans that aren’t on the government exchanges so that you can find the right health insurance for your budget and your needs.

Start shopping on eHealth to find the right kind of coverage that will protect your finances from the costs that come with being uninsured.

How to Find Cheap Health Insurance

When it comes to shopping for cheap health insurance, cost is one of the biggest factors people consider when making a decision. According to a 2017 Kaiser Family Foundation (KFF) survey, cost is also one of the reasons why almost half of the uninsured population (45%) doesn’t have health insurance.

Going uninsured may not be your cheapest option especially if you are hit with an unexpected full-priced healthcare bill. For instance, according to costhelper.com the cost of an emergency visit can range anywhere from $150-$3,000 and can be much more if you required an ambulance.

Is health insurance always expensive?

Health insurance doesn’t have to be out of your price range. There are cheap health insurance plans on the market and ways that middle to low-income individuals and families can receive government assistance to help offset the cost.

Here are 5 steps to finding cheap health insurance that suits your needs:

  • Figure out what your budget is
  • Look at your healthcare needs, past and present
  • Learn if you are eligible for alternate options
  • Look at your income to see if you are eligible for federal subsides
  • Compare plans and choose the right one for you

Figure out what your budget is

Unlike with rent or mortgage payments – which people like to cap at 1/3 of their income – there is no rule of thumb about how much of your income you want to spend on health insurance. Spending on health insurance is a highly subjective subject. Part of this is because health insurance isn’t just comprised of the set monthly cost (premium), but also has costs that will add up depending on how you use your plan and how much health care you need.

Depending on how much health care you need the percentage of what you should spend on a premium may increase or decrease.

Regardless of budget you should be able to find cheap health insurance that covers your needs.

Look at your healthcare needs, both past and present

A great way to assess the level of coverage you need is by looking back at your past health care needs. This should give you a good idea of what your year in healthcare looks like, allow that to inform your decision about the level of coverage you’ll need.

Also look ahead to your potential future needs. Are you or your partner pregnant or looking to become pregnant? Are there any procedures or services that you need to schedule for the upcoming year? The answer to these questions may help inform your decision about if you should opt for a plan with a high deductible and a low premium, or a low deductible and a high premium.

While a low premium plan may seem like the most cheap health insurance plans, depending on the amount of care you require you may want to consider a plan with a higher premium and a low deductible. A higher set monthly cost usually means that you reach your deductible faster, and pay less out of pocket for each time you require care.

Keep in mind that due to the Affordable Care Act (ACA), all individual health insurance plans – even cheap health insurance plans – must cover 10 health benefits:

  • Emergency room visits
  • Lab tests
  • Inpatient care in hospital
  • Care before and after birth
  • Mental health and substance use disorder services
  • Prescription drugs
  • Outpatient Care
  • Care to help you recover from an injury or deal with a disability or chronic condition
  • Preventative care
  • Dental and vision care for children

. It’s important to check your plan details carefully before purchasing with the assumption that certain things will be covered differently than you thought. Each plan has its own terms and limitations, so be sure to check the official plan documents to understand how that specific plan works.  This article is only for general education.”

Learn if you are eligible for alternative options

If you are a low-income individual or family, you may be able to qualify for Medicaid or CHIP (if you have children), which are government programs that seek to offer free or cheap health insurance to those who would struggle to afford coverage otherwise.

Look at your income to see if you are eligible for federal subsidies

Depending on how much your yearly income is in comparison to the federal poverty line (FPL), you may qualify for Obamacare subsidies to help you pay your monthly premium – these are called premium tax credits. You may also qualify for help paying for your out-of-pocket expenses, like deductibles and copayments – these are called cost-sharing reduction payments (CSR).

According to the US Department of Health and Human Services (HHS), the 2019 federal poverty guidelines are as follows:

Household Size 100% of the FPL 400% of the FPL
1 $12,490 $49,960
2 $16,910 $67,640
3 $21,330 $85,320
4 $25,750 $103,000
5 $30,170 $120,680
6 $34,590 $138,360
7 $39,010 $156,040
8 $43,430 $173,720

Source: 2019 HHS FPL guidelines published in Federal Register

If you make between 100% and 400% of the FPL you may be eligible for premium tax credits. If you make 250% or under, you may be eligible for CSR payments.

Compare plans and choose the right one for you

Once have a good idea of what your budget is, what your needs are, and if you qualify for government assistance it’s time to compare plans.

eHealth is one of the largest online health insurance brokers and carries plans that you may not be able to get on government exchanges. eHealth allows you to compare over 13,000 plans from over 180 carriers and you can get help from our insurance agents. The best part is that it’s all completely free, the help you get through eHealth is at no cost to you and any plan you buy through eHealth is guaranteed to be the same price as the same plan purchase elsewhere.

If you’re looking for cheap health insurance, try shopping with eHealth.

This article is for general information and may not be updated after publication.

Employee Benefits in a Small Business

As a small business owner considering group health insurance, one question on your mind might be whether you should offer additional employee benefits besides health insurance. You may also be wondering how many small businesses provide employee benefits beyond health insurance, as well as what kind of benefits are most commonly offered by employers.

Continue reading to learn about employee benefits in a small business.

Do small businesses offering employee health insurance offer other benefits?

According to a recent eHealth survey of small business owners, most small businesses that offer group health coverage to their employees also provided additional benefits, such as dental and vision plans, 401(k) plans, life insurance, and paid family leave.

Source: eHealth 2018 Small Business Health Insurance Report

Some useful insights from the report include:

  • Dental and vision are the most popular employee benefits – Over half of small businesses offer dental plans, with vision plans being the second most common employee benefit.
  • Retirement-related benefits are an important consideration – Almost a quarter of small businesses offered a 401(k) plan to their employees.
  • Fewer businesses decide to offer non-medical benefits – Life insurance and paid family leave were less commonly offered as employee benefits.

When evaluating employee benefits as well as group health insurance, you should always consider budget and coverage preferences for yourself as the business owner as well as your employees. You could consider discussing options with your staff to find out how much they would want to spend for improved access to dentists and optometrists or a retirement plan.

The value of dental and vision plans as employee benefits

Even though dental and vision insurance plans are not required for small businesses, these employee benefits are still frequently offered by employers. Many vision and dental plans come in the form of add-ons (also referred to as ancillary benefits) to group health insurance plans. If your small business decides to include dental and vision insurance, you can create a compelling benefits package that more fully covers both you and your employees.

If you’re confused about your options for adding dental insurance to your small business employee benefits, you can read up on the types of small group dental plans to offer.

Are dental and vision plans affordable as employee benefits?

Another reason why dental and vision insurance plans remain popular may be their low cost. Health insurance plans can often cost hundreds of dollars per person in premiums every month, but dental and vision plans starting at as little as $12 a month per individual on eHealth.

Regardless of the cost of small business dental and vision plans, your company can limit your actual costs in several ways:

  • Your small business can usually deduct the cost of health care-related expenses for employees from your federal business taxes.
  • As a small business owner, you can ask your employees to pay a share of their monthly premiums.
  • These employee benefits may contribute to improving overall motivation and morale.

While offering additional benefits means contributing a greater amount to each worker’s monthly vision and dental premium, your small business may be able to better attract and keep quality employees through offering more comprehensive coverage.

The importance of employee benefits in a small business

Although group health insurance is one of the most highly valued employee benefits, offering other benefits could help your small business stand out as an employer of choice. A total compensation package that includes multiple employee benefits may be a worthwhile investment for recruiting and retaining potential hires interested in joining your company.

eHealth can help you find affordable small business health insurance plans, as well as dental and vision plans, for your employees. Visit eHealth.com or speak with one of our licensed health insurance agents to discover if offering employee health benefits is the right choice for your business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Can I Afford to Offer Small Business Health Insurance?

You may be aware that, as an employer with less than 50 full-time employees, you are not required to offer small business health insurance. What you may not know is that group health insurance may be more affordable than you think.

Continue reading to find out how you may be able to afford small business health insurance.

Key considerations on how to afford group health insurance

Here are some key points to consider if you are thinking about whether your small business can afford to offer group health insurance.

  • First, consider your budget and coverage preferences, as well as the level of interest among your employees in enrolling in group health coverage.
  • Next, think about what type of small business health insurance plan would work best for you and your employees, based on your anticipated level of medical needs.
  • What percentage of employee premiums can you afford to pay as an employer? Most states usually require businesses to pay at least 50 percent of employee premiums.
  • It is important to remember that your small business can usually deduct the cost of employee premiums from your federal business taxes. You may also be able to qualify for the small business health care tax credit, which could help your company afford group health insurance.

After evaluating these initial questions, you may be wondering what offering small business health insurance will look like for your company in the long-term. For instance, will the cost of group health coverage affect your ability to afford paying or hiring employees? You may be surprised to learn how other small business owners answered this question.

Most small businesses say offering health coverage has not impacted hiring or compensation

According to a recent eHealth study, most small business owners say that offering group health insurance has not harmed their ability to afford hiring and rewarding their workers.

  • Over half (53 percent) of the small business survey’s respondents say that sponsoring a group health insurance plan for their employees has not prevented them from offering raises to their current employees or hiring new workers.
  • 30 percent of small businesses say that offering health coverage has made it harder for them to hire new workers or increase employee wages.

Source: eHealth 2018 Small Business Health Insurance Report

Overall, a significant portion of small businesses were able to afford offering small business health insurance without having to scale back their hiring or level of employee compensation.

Comparing plans can help you find affordable small business health insurance

While upfront costs are probably one of the first considerations a small business has when thinking about how to afford group health insurance, selecting the cheapest plan isn’t always the most optimal way to save money. Taking the time to compare plans is an important part of deciding on whether you can afford small business health insurance.

For instance, some people may prefer a plan with lower monthly premiums, while other people might be better able to afford a plan with somewhat higher premiums but with a lower annual deductible and a greater amount of contributions from the health insurance company.

eHealth makes comparing small business health insurance plans fast and easy through our free instant quotes. You should still read the group health insurance plan details from the insurance company in order to fully understand the specifications of each coverage option you consider.

Use eHealth to help you decide if you can afford small business health insurance

Although only you can decide whether your company can afford to offer small business health insurance, investing the time to ask the right questions about cost and coverage preferences at the beginning of the process can help you make the best decision.

You can use eHealth’s online marketplace to compare plans from multiple health insurance companies to find the right choice for your business. To learn more about what your options are when it comes to affordable group health insurance coverage, visit eHealth.com today or speak with one of our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Reasons to Offer Small Business Health Insurance

Employers often decide to offer small business health insurance for many reasons. As one of the top employee benefits, group health insurance is not only prized by employees, but also seen as a significant and valuable asset by many small business owners.

Continue reading to find out the reasons why employers offer small business health insurance, as well as the most important factors business owners consider when selecting a group health plan.

What is the number one reason why employers offer small business health insurance?

According to a recent eHealth survey, although companies offered health insurance for a variety of reasons, 66 percent of small businesses decided to provide a group health plan in order to recruit and retain the best workers. A supermajority of business owners prioritized attracting top talent to their organization as the primary rationale for choosing to offer small business health insurance.

Source: eHealth 2018 Small Business Health Insurance Report

The eHealth survey also found that 51 percent of small business owners said that hiring and retaining the best workers was the single most important factor that prompted them to offer health insurance coverage to their employees. A sense of moral responsibility was the second most important reason, although it was chosen by only 20 percent of respondents.

There are many compelling and strategic reasons why focusing on quality employees is a top factor for offering small business health insurance. For instance:

  • Becoming a more desirable employer – A company can be seen as an employer of choice to potential hires by offering attractive employee benefits such as group health insurance.
  • Differentiate from the competition – A small business can stand out from competing companies that do not offer either health insurance or other popular benefits to their employees.
  • Improving loyalty and retention – Hiring the right new employees can be expensive, and finding employee replacements can be time-consuming. Group health insurance may contribute to keeping an organization’s highest quality workers on board for the long run.

Overall, deciding to offer small business health insurance can help employers demonstrate that they value their employees while also keeping their best interests in mind.

What are other top reasons to offer small business health insurance?

In addition to recruiting and retaining the best workers, employers also had other compelling reasons to offer health insurance as one of their employee benefits.

  • Moral responsibility – According to the eHealth survey, 43 percent of small business owners felt a moral obligation to support the livelihood of their workers through providing group health insurance, viewing it as a necessity that their employees should not live without.
  • Encourages efficiency – 27 percent of small businesses said offering health coverage promoted greater productivity among their employees. This may have to do with workers taking less sick days, or having the assurance of knowing they have access to medical care if needed.
  • Workers cannot afford it on their own – 26 percent of small employers realized that their employees would not be able to afford health coverage on their own, and decided that providing group health insurance was the best path for helping them manage medical costs.
  • Tax benefits – 11 percent of employers chose to offer small business health insurance due to tax benefits. Even though this reason was not cited as frequently, tax savings are still an important consideration, especially in terms deducting the cost of premiums and potential tax credits.

While small businesses had many reasons to sponsor employee health coverage, a combination of moral and economic justifications most broadly characterized employer decisions to offer small business health insurance.

What is the most important factor when selecting a small business health insurance plan?

When choosing a health plan, small businesses prioritized affordability and cost as their primary considerations, according the eHealth survey.

Source: eHealth 2018 Small Business Health Insurance Report

Small business owners in the survey conveyed how strategic financial reasons related to budget and coverage preferences drove their decision-making when evaluating group health coverage.

  • Affordable employer-sponsored coverage – 34 percent of small business owners selected a group health plan due to the affordability of monthly premiums. This may be due to how employers cover the expense of employee health care through cost-sharing with workers.
  • Managing out-of-pocket costs – 30 percent of employers said that affordable out-of-pocket costs, such as copays and deductibles, were the most important factor when choosing a plan. Such costs are especially important to consider for those who need more frequent medical services, including office visits and prescription medications.
  • Affordability of employee cost-sharing – 11 percent of small businesses replied that the affordability of monthly premiums for employees was the top factor they considered when looking at health plans. Workers need to make these payments to keep their group coverage.
  • Robust health care network – 10 percent of small business owners cited the importance of having a strong network of medical providers. Benefiting from preferred hospitals and specialist care centers is always a significant factor when deciding on any group health insurance plan.

Ultimately, most employers sought to balance managing costs with maintaining the quality of medical care for themselves and their employees.

Every small business has a unique reason to offer health insurance

You may have been surprised to learn the many reasons why employers decide to offer health benefits to their employees. While each company has its own unique preferences, most business owners believe that affordable group health coverage could help improve the success of their employment and hiring strategies while also keeping their workers’ medical needs in mind.

Whatever your reason may be for offering small business health insurance, eHealth can help you find the right coverage that fits the goals of your company and employees. To find out how your small business can enroll in a group health plan, visit eHealth.com or speak with one of our licensed health insurance agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Can a Bigger Group Size Make My Plan Cheaper?

As a small business owner, you may be wondering how group size may affect the cost of your group health plan. With small business health insurance, you may be surprised to learn that group size (meaning the number of people who enroll in a group plan) can make a significant difference in the price of health coverage.

The answer is that, in many cases, having a bigger group size can make your group health insurance plan cheaper. Continue reading to learn how this works in small business health insurance.

Can a bigger group size really make small business health insurance cheaper?

According to a recent eHealth study, group size can have a notable impact on the cost of monthly premiums:

  • In 2018, the average monthly premium for small business groups with 5 or less employees was $419 per covered person.
  • The average monthly premium for small business groups with 6 to 29 employees was $364 per covered person, or 13 percent less than the smaller group.

Yes, a larger group size may mean less costly and more affordable small business health insurance. But why is this the case? It turns out that one of the key theories of insurance can help explain this effect.

The risk pool advantage explains why a larger group size can mean a cheaper group plan

The U.S. Small Business Administration (SBA) has provided an overview of how a larger risk pool from a bigger group size can end up resulting in lower premiums.

  • A core theory of health insurance, the risk pool advantage, essentially means that when more people are enrolled in a group plan, the risks are spread out more evenly across all members of the plan.
  • Since the enrollees in the group plan pay premiums to maintain their coverage, the insurance company has more funds and resources available to draw from when one of the group plan members needs medical care.
  • As a consequence, the high cost of any one person who needs care is balanced out by the larger pool of group plan members who have already contributed and paid into the insurance plan.

Overall, if a small employer has a significant number of full-time employees, then the company may benefit from their larger group size when enrolling in small business health insurance.

Risk pools and group size also explain why group plans may be cheaper than individual plans

The risk pool advantage that comes from a larger group size can also shed light on how small business health insurance plans have lower average costs per person compared to individual health insurance plans.

According to an eHealth study:

  • In 2018, the average premium per person through a small business health insurance plan was 7 percent lower than the average premium for an individual plan ($409 vs. $440).
  • The average individual deductible for small business health insurance plans was 31 percent ($1,438) lower than the average deductible for individual coverage ($3,140 vs. $4,578).

Although you should understand that each health insurance plan has its own terms and limitations as specified in official plan documents, you may find it useful to know that a small business health insurance plan may frequently be a less expensive option than an individual health insurance plan.

Group size can make an important difference in group plan costs

When considering small business health insurance, you want to make sure that you are aware of the major factors that influence the cost of health coverage. Knowing the significance of group size as it relates to group plan costs can help you in making the decision of whether to offer a group plan that may benefit both your employees and yourself as the business owner.

eHealth can help you quickly and easily find free small business health insurance quotes. To learn more about your group plan options, visit eHealth.com or speak with one our licensed insurance brokers.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Setting Up Your New Small Business Health Insurance Plan

If you have made the decision to offer health insurance as a small business owner, then congratulations! This is a big moment for your company, and you and your employees may soon have the benefit of expanded access to essential health care and medical services.

However, you may still have questions about actually setting up your new small business health insurance plan. The good news is that you don’t really have to set it up, because eHealth makes it easy to implement your new group health plan.

Whether you are just starting out with small business health insurance, or making the switch to a more effective group plan, eHealth’s brokers simplify the complex setup and onboarding process in a streamlined and efficient way.

Continue reading to learn how eHealth can help you conveniently set up your new small business health insurance plan.

eHealth’s brokers are with you every step of the way

eHealth’s registered brokers help guide you through the entire process of setting up your group health plan. From the beginning, our licensed health insurance agents apply their professional knowledge and expertise to answering all of your questions.

One of the advantages of using eHealth is that our brokers give unbiased advice. They can enable you to choose from the best selection of health plans available on the market from multiple insurance companies, allowing you to find the right policy for your business.

After choosing coverage that works for your company, the first step in setting up your new small business health insurance plan is submitting your application, which should only take about 15 minutes.

To get started, just type in the following information:

  • Your business type
  • The location of your business
  • Who you want to offer coverage to
  • Your employees’ ages, number of dependents, and email addresses

eHealth needs this information in order to present you with accurate rates for group health coverage.

Your employees will then have the option to enroll in or decline health insurance coverage through a quick online and mobile-friendly application that eHealth will email to them.

As a business owner, consider how much you want your company to contribute to paying for monthly employee premiums. In most states, an employer must contribute 50 percent to employee premiums.

You’ll then be asked to verify your business type by providing the business tax forms last filed; these can be uploaded in the application.

After you have provided all necessary information and documents, you will review final rates, provide your payment, and e-sign.

To better serve your needs, you will have a small business account manager reach out to you to help your business finish the final steps for enrolling in your group health coverage.

Your account manager will provide tailored support as he or she assists with choosing a start date for your health insurance plan and follows up with you in case there are any additional requirements from the health insurance company.

Can eHealth answer my questions after enrolling in a group plan?

Once your small business is approved, you will receive official documentation from the health insurance company, which confirms when your group medical coverage will begin. After that start date and the completion of your enrollment, you and your employees can begin to use your plan’s health care benefits. eHealth will continue to support your business after enrolling in a group plan. For instance, our agents can help you to quickly add and remove employees to your new health insurance policy.

We also serve as your advocate, even after you are done shopping and have bought your small business health insurance plan. By serving as the middle man between you and the health insurance company, we can assist you with resolving issues related to medical claims, all at no additional cost to you.

Due to your health insurance agent’s relationship with the insurance company, he or she can clarify your benefits and provide guidance related to helping clear up billing disputes. This free support from eHealth’s agents may reduce headaches when you need to deal with the insurance company, freeing up the resources you need to focus on what matters most for your small business.

eHealth makes it easy to shop for small business health insurance

We respect your time. When you work with eHealth, you can rest assured you will receive an excellent selection of options while benefiting from world-class customer service.

Visit eHealth today to quickly and easily find free group health insurance quotes. You can also speak directly with eHealth’s licensed agents to discover how your company can enroll in a plan optimized for you and your employees.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

How Many Americans Get Health Insurance from their Employer?

Ever wonder how many Americans have group health insurance? As a small business owner, this might be one of the questions on your mind if you are thinking about offering employer-sponsored health insurance to your employees and their dependents. As an employee of a small business, you may be interested in knowing whether or not it’s the norm to be offered health insurance from your employer.

You may be surprised to learn that group health insurance is more common than you may think. Continue reading to find out how many people have employer-sponsored health insurance coverage in the United States.

How many Americans get health insurance from their employer?

According to recent data from the Kaiser Family Foundation (KFF), about 156,199,800 Americans, or around 49 percent of the country’s total population, receive employer-sponsored health insurance (also called group health insurance).

Employer-sponsored health insurance coverage of the U.S. population by state percentage

Source: The Kaiser Family Foundation.

The KFF data about employer-sponsored health insurance statistics by state generally suggests that states in the Midwest and Northeast regions have among the highest percentage of people in the nation benefiting from group health insurance coverage.

Keep reading to get a closer look at some relevant facts and figures about group health insurance, including which states have the most people insured by their employers and the highest percentage of people receiving employer-sponsored health insurance.

Top 5 states with the most people covered by group health insurance

The five states with the greatest total number of people covered by employer-sponsored health insurance are:

  1. California – 18,253,400 people or 47 percent of the state population.
  2. Texas – 13,126,800 or 48 percent of the state population.
  3. New York – 9,536,300 or 49 percent of the state population.
  4. Florida – 8,155,800 or 40 percent of the state population.
  5. Illinois – 6,675,200 or 53 percent of the state population.

Source: KFF data.

Some of the largest and most economically robust states in the nation correspondingly have almost half or over half of their citizens benefiting from employer-sponsored health coverage.

Which states have the highest percentage of people covered by group health insurance?

The states with the greatest percentage of residents who have employer-sponsored health insurance coverage are:

  1. Utah – 60 percent of state residents.
  2. North Dakota – 58 percent of state residents.
  3. Minnesota/New Hampshire/Wisconsin – Tied at 57 percent for people in each of these three states.
  4. Maryland/New Jersey/Nebraska – Tied at 56 percent for people in each of these three states.
  5. Iowa/Massachusetts/Kansas – Tied at 55 percent for residents in each of these three states.

Source: KFF data.

Each of these states has more than half of its people covered by group health insurance.

Should small businesses offer group health insurance in their state?

Although offering small business health insurance is optional for small businesses with less than 50 full-time equivalent employees, there are several reasons you may consider providing group health insurance to your employees based on market and industry trends in your state or neighboring states.

  • Your small business could begin by looking at the percentage of people in your state who have employer-sponsored health insurance coverage.
  • Depending on the situation and competition, if a high percentage of similar businesses are offering group health insurance in your state, you may want to consider doing so too.
  • Employer-sponsored health insurance is highly prized among employees, and offering insurance coverage as a benefit may help you stand out as a desirable employer of choice.
  • If a relatively low percentage of businesses in your local area offer group health insurance, then providing employer-sponsored coverage to your workers may lend your company a competitive advantage by being better able to recruit and retain quality employees.

While the practices of competing and neighboring local or state businesses are only one of many important factors to take into account while considering employer-sponsored health insurance, they nevertheless may serve as a helpful starting point for your decision-making process.

Group health insurance across America in perspective

Around half of the nation’s population enjoys the benefit of employer-sponsored health insurance. Even though Americans have health coverage from a variety of different sources, group health insurance provided by their companies and businesses forms a major part of the country’s health care landscape.

If you are considering offering employer-sponsored health insurance to your employees, then you have come to the right place. eHealth can help you find small business health insurance that best fits the needs of your company. Visit eHealth.com or speak with one of our registered insurance agents today.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Can I Still Get Health Insurance for 2019?

Open enrollment is over and many people are left wondering if they can still get health insurance for 2019.

There are a few circumstances under which you can still get health insurance this year, which include:

  • Experiencing a life event that qualifies you for a special enrollment period
  • Qualifying for Medicaid or CHIP
  • Applying for short term health insurance

Qualifying life events and special enrollment periods

There are some life events that you may experience that qualify you for special enrollment periods, which allow you to still get health insurance outside of the open enrollment period.

Some examples of qualifying life events include:

  • Changes in household – Some changes in household include marriage, divorce, death, or birth or adoption of a child
  • Changes in residence – A few examples of changes in residence include moving outside of your coverage area, moving to a new state, moving to or from where you’re attending college, or moving from a country to the US.
    *Note that vacationing or moving for only for medical treatment usually do not count as a qualifying life event and may not trigger a special enrollment period.
  • Loss of health insurance – A few instances in which you might lose health insurance include job loss, loss of eligibility for Medicaid or CHIP, or loss of coverage through a family member. Another example of this is when you turn 26 or are no longer a dependent which would make you ineligible to be covered through your parents.
  • Other changes – other life events that would allow you to still get health insurance after open enrollment would be becoming a US citizen, leaving incarceration, and starting/ending service as an AmeriCorps, VISTA, or NCC member.
    *Note that there are other complicated life events that may trigger a special enrollment period.

If you have one of these or another qualifying life event, you will be eligible to still get health insurance through a special enrollment period.

Keep in mind that you will have to be able to prove that you’ve experienced one of these life events.

Special enrollment periods usually last around 60 days. During that time, you are still able to get health insurance through your state’s market place, directly from an insurance company, or through an online broker – like eHealth!

Ehealth has plans that aren’t offered on government exchanges and allows you to compare coverage options side by side.

Medicaid or CHIP

Unlike other health insurance plans, Medicaid and CHIP do not have open enrollment periods. This means that you can still get health insurance through these government programs.

These programs provide free or low-cost health insurance for low-income individuals, families, children, pregnant women, elderly, and those with disabilities.

Note that Medicaid and CHIP may have different names in your state.

Even if you don’t think that you qualify for Medicaid or CHIP by income you should still apply. You may qualify if you have children, are pregnant, or have a disability. If you believe you might qualify for Medicaid or CHIP, make sure to visit their websites to see more details.

Short term health insurance

Even if you don’t qualify for Medicaid or CHIP and haven’t had a qualifying life event to trigger a special enrollment period, you still may be able to get health insurance.

Short term health insurance provides coverage for a short period of time – some plans last from a few months to a year depending on your state’s regulations – and they provide coverage fast with some plans approving your application as soon as next day.

This is a great option if you’re looking to fill gaps in coverage or get covered if you’ve missed the open enrollment period.

There is no open enrollment period for short term health insurance you can apply any time you may find yourself needing health insurance.

While there is no set list of standardized benefits like there is with Affordable Care Act (ACA) plans and you will not receive the same level of care as you would with a major medical plan, they do offer some coverage at lower monthly rates.

If you think short term health insurance is right for you, eHealth offers over 3,600 short term plans from more than 16 carriers that will keep you covered and help you save money. Get a quote from eHealth, today.

Health Insurance Subsides 2019: Are They Still Available?

Can I still get a healthcare subsidy in 2019?

The answer is yes!

It’s important to understand that there are two different kinds of subsidies out there, and they operate in different ways.

First off, both of the types of Obamacare subsidies in 2018 both still rely on federal poverty guidelines (FPL). In order to receive these subsides you must earn between 100% and 400% of the FPL. If your household incomes is 401% or above, you will not qualify for these subsides..

For 2019 the federal poverty guidelines are as follows:

Household Size 100% of the FPL 400% of the FPL
1 $12,490 $49,960
2 $16,910 $67,640
3 $21,330 $85,320
4 $25,750 $103,000
5 $30,170 $120,680
6 $34,590 $138,360
7 $39,010 $156,040
8 $43,430 $173,720

Source: 2019 HHS FPL guidelines published in Federal Register


Cost-sharing reduction (CSR) payments

The CSR subside faced some changes in 2017. These Obamacare subsides are only available to families earning 250% and bleow the FPL. These subsides help lower the amount you have to pay for deductibles, copayments and coinsurance.

CSR payments are also referred to as “extra savings”

If you qualify for extra savings, you must enroll a silver plan. You will also have a lower out-of-pocket maximum, which help control how much you spend on healthcare before your insurance kicks in. Once you’ve reached this maxiumum, your health insurance will cover 100% of the cost of all covered care.

You also may be elligable for more cost-sharing reductions if you are a member of a federally recognized tribe or are an Alaska Native Claims Settlement Act (ANCA) Corporation shareholder.

Advance premium tax credits (APTC)

This Obamacare subsidy is still around in 2018 and hasn’t seen any changes since its inception. These credits are made available to people earning 400% or less of the FPL..

These subsidies are what most people know about, maybe because they deal with one of the most important costs associated with health insurance plans: the monthly premium. Your plan’s premium is the set cost you’ll be required to pay every month in order to continue being covered under your plan.

What has changed about CSR subsidies?

In compliance with President Trump’s executive order signed on October 12, 2017, the government will no longer pay for cost-sharing reduction subsidies (but APTC subsidies will still be funded by the government for now).

What most people don’t understand is that the government pulling out of CSR subsidies doesn’t affect them directly. Under the Affordable Care Act (ACA) insurance companies are still legally required to offer CSR subsidies to those who qualify.

How is this going to affect the health insurance market?

Although people still have access to CSR subsidies, it doesn’t mean that prices will stay the same. The cost increases will likely reach customers through a trickle effect.

As the Kaiser Family Foundation reports, insurance companies have built this loss into the prices of their plans for the 2018 open enrollment—meaning while both subsidies are still available,  we will likely see a hike in plan prices, since the insurance companies are having to make up for less help from the government.

No one can say for sure how one thing or another will affect the entire health insurance market. The trends of prices depend, in part, on the people buying them, and people are not always as predictable as we want them to be.

If you are planning on purchasing a plan or changing your coverage during the 2019 Open Enrollment Period for coverage beginning in 2020, make sure to check eHealth for more updates surrounding the health insurance market.

Is There a Special Enrollment Period for the Uninsured in 2019?

It may not be too late to get covered

In the past, if you went uninsured throughout the coverage year you may have had to pay a tax penalty, called the individual mandate penalty. However, the Affordable Care Act (ACA) has been changed slightly. One of these changes included the repeal of the federal individual mandate tax!

In 2015, the Centers for Medicare and Medicaid Services announced that there would be a special enrollment period for those who paid their ACA penalty for being uninsured, who were uninsured in 2015, and who were unaware of the tax penalty until after filing their returns.

Since the shared responsibility payment has been repealed, there is no tax penalty and will be no special enrollment period in 2019.

Depending on where you live, you may have to pay for going uninsured as some states have legislation enforcing a tax at the state level.

Read on to find the answers to your questions about finding coverage in 2019 if you missed the open enrollment period and are uninsured:

QUESTION: Has the health insurance enrollment period (or Obamacare enrollment period) been extended?

ANSWER: No.

Open enrollment for the 2019 coverage year ran from November 1st, 2018 through December 15th, 2018.

Open enrollment for the 2020 coverage year will run from November 1st 2019 through December 15th 2019.

Q: Where can I shop for coverage during open enrollment?

A: During open enrollment anyone can purchase health insurance through their state or federal market place, directly from an insurance company, or from private brokerages – like eHealth!

eHealth allows you to compare plan options from multiple insurance carriers side-by-side with plans that aren’t offered on government exchanges. Start looking now before open enrollment for the 2020 coverage year or if you experienced a qualifying life event and are eligible for a special enrollment period.

Q:  Can I still get coverage for 2019?

A: While Open Enrollment is over and there is no nationwide special enrollment period, you still can get covered in a few different ways.

One way is if you qualify for a special enrollment period after experiencing a qualifying life event. Some examples of qualifying life events include the birth of a child, marriage, or loss of coverage through a parent or spouse.

You can also get coverage through Medicaid or CHIP. Medicaid and CHIP are programs that provide cheap or free health insurance to low-income household. Medicaid and CHIP do not have open enrollment periods which allows people to apply year round for coverage. Even if you don’t think your income qualifies, you should still apply especially if you are pregnant or disabled.

Additionally, you can get short term health insurance. These plans allow people to fill gaps in coverage. In some states, short term health insurance can last up to a year depending on legislation. You can also receive coverage quickly with some plans approving your application next day!

eHealth provides thousands of short term health insurance plans from hundreds of different providers. If you’re looking to fill a gap in coverage because you missed open enrollment, check out eHealth’s options.

While there is no nationwide special enrollment period this year, there is fortunately no tax penalty at the federal level for not having health insurance. Make sure to check with your state as some areas do have penalties at the state level.

Though you will not lose money to the tax penalty for going uninsured, your wallet may get hit hard with unexpected and expensive healthcare costs that you might incur over the year.

Check and see if you are eligible for Medicade or CHIP (which may be called different things in your state), if you have or will experience a qualifying life event in the coming months, or apply for short term health insurance with the help of eHealth to try and get some form of health insurance coverage for the rest of 2019.

Can You Have Two Health Insurance Plans?

Yes. You can have two health insurance plans! Having two health insurance plans is perfectly legal and many people have two under certain circumstances.

Why would I have two plans?

There are a few different reasons why someone might have two health insurance plans:

  • You are an adult child (under the age of 26) who receives coverage through their parents and their employer
  • You are a couple who both receive health insurance through their respective employers
  • You are a child with two parents that have health insurance and have you as a dependent under their respective insurance plans.

How does having two plans work?

Having two insurance plans doesn’t mean you get reimbursed twice for a doctor’s visit or two bottles of medication.

Coordination of benefits is the process in which someone with two health insurance plans can receive coverage.

The way that this works is that one plan becomes your primary and one plan becomes your secondary. Your primary plan will be the plan that you receive through your employer.

If you are a child with two parents who insure them under their respective family plans, your primary is decided by something called “the birthday rule”. Your primary insurance plan will come from whichever parent whose birthday comes first in the calendar year.

Primary Secondary
Your employer-sponsored plan Your parent’s plan
Your employer-sponsored plan Your spouse’s plan

For a child covered by respective family plans, use the birthday rule to determine their primary and secondary insurance.

In the event you make a health insurance claim, your primary insurance plan will act as if you had no secondary plan and provide you with your benefits. Then your secondary insurance plan kicks in and covers the rest of the cost if it’s covered and necessary.

Keep in mind that you will have to pay both deductibles for your plans. Your secondary insurance cannot pay toward your primary’s deductible.

Regardless of whether you have two plans, health insurance companies still follow the same rules regarding how they pay for the care you receive. This may mean that even though you have two plans you could still end up paying an out-of-pocket cost.

An instance in which you may have to pay an out-of-pocket cost would be if you received care from a provider charging more than what your insurance company(s) may consider reasonable or customary. Since your insurance only pays for what they believe to be a reasonable cost, your secondary plan would not be required to pay for something if they felt it was unreasonable.

Benefits of Duel Coverage

Having two health insurance plans often means saving money. Having duel coverage allows people to have access to both of their plans to cover their healthcare costs.

The combined coverage cannot exceed 100% of the cost, however this means that people with two plans may not have to pay an out-of-pocket expenses or if they do it’s less than what they would have to pay with only one plan.

Additionally, since you have coverage through your parent’s plan or your partner’s plan you don’t have to worry about going uninsured if you lose your job and the health insurance that comes with it or choose to change jobs.

Should you keep two health insurance plans?

Having two health insurance plans is a fantastic way to maximize benefits and potentially receive more coverage if you only have one plan.

There is a good chance that you can stay covered under your parent’s or spouse’s insurance at little to no cost to them (some employee-sponsored plans offer family coverage at a flat rate, not per dependent).

If you think you could save money by waiving your access to one plan, consider how the coordination of benefits functions, the medical care you’ve received in the past, and the care you may need in the future.

How Many Americans Buy Their Own Health Insurance?

How many people buy individual health insurance?

The majority of people in the U.S. don’t buy their own health insurance. Most people get their insurance through an employer, which is also referred to as group insurance or employer-sponsored insurance.

According to a 2017 Kaiser Family Foundation (KFF) survey, almost half (49%) of people have employer-sponsored insurance.

So, how many people buy their insurance on their own? According to the same 2017 KFF survey only around 7% of people buy individual health insurance.

Employer vs non-group insurance

[2017 KFF Survey Data]

However, just because you’re in the minority buying individual health insurance doesn’t mean that you’re at a disadvantage, that it should be difficult, or wildly expensive!

What are the advantages to buying individual health insurance?

While employee-sponsored health insurance is the norm for about half the population, there are plenty of advantages to buying your own health insurance instead of going through your employers.

Some benefits to getting individual health insurance is:

  • Your policy isn’t tied to your job so you can change employers without losing coverage
  • While your employer doesn’t split the cost with you, you may qualify for state or federal assistance in order to afford your individual health insurance
  • You choose the insurance company and the plan that covers your healthcare needs
  • You choose the insurance plan with the network that includes your preferred doctors, healthcare providers, and hospitals.

How much does individual health insurance cost?

According to eHealth’s data, the average monthly cost for health insurance was $440 for an individual and $1,168 for a family in 2018.

These numbers are averages, the cost of your monthly premium may vary greatly depending on where you live, the size of your family, and by other factors of the like.

While most employers will split the cost of a premium with their employee, those buying their own individual health insurance may qualify for government assistance in paying for their health insurance depending on how much they make above the federal poverty line.

What to keep in mind while shopping for your own health insurance

When you’re shopping for insurance, you should look back on the healthcare you’ve received previously. Allow the amount of care you’ve received in the past to help inform your decision on what plan to buy.

For instance, if you take a medication regularly or have required a lot of prescription medications in the past, you may want to look for a plan that has coverage to help you offset the costs of prescription medications.

Consider the type of care you’ve had in the past and the care you may receive in the future (such as certain procedures and surgeries you may schedule in the coming year) when you’re shopping for your 2020 health insurance.

Where to shop for health insurance?

Shopping through a government-run exchange is not your only option for buying health insurance. During the open enrollment period – which for coverage beginning in 2020, runs from November 1st 2019 to December 15th 2019 – you can shop through the state or federal marketplace as well as directly from the insurance company or through a broker like eHealth.

eHealth not only sells plans that you can’t find on a government exchanges, but allows you to compare plans side-by-side to find the plan with the coverage that’s right for your needs and your budget. Plus, the help that you get from eHealth online and from speaking with our representatives is free. The plan you purchase through eHealth are guaranteed to be the same price as the same plan sold anywhere else.

To start shopping for individual health insurance that’s right for you, enter your zip code where prompted on this page.

Employer Health Insurance Requirements

As a small business employer, you may be wondering what your health insurance requirements are. What are the criteria your small business needs to fulfill in order to offer health insurance, and what are your obligations toward your employees?

Continue reading to learn about employer health insurance requirements.

Are employers required to offer health insurance?

The provisions of the Affordable Care Act (ACA) determine whether an employer is required to offer health insurance or not. In most states, small businesses with under 50 full-time or full-time equivalent (FTE) employees have no legal requirement to offer health insurance. However, if a small business does decide to offer medical coverage, then it must meet the following health insurance requirements.

  • The health insurance coverage must be offered to all full-time employees. Typically, full-time employees are defined as those who work 30 or more hours per week.
  • A small business has no obligation to offer health insurance to part-time employees (usually defined as employees who work less than 30 hours per week).
  • However, if an employer offers insurance to at least one part-time employee, then the small business must offer group coverage to all part-time employees.

Conversely, an employer with 50 or more full-time or full-time equivalent employees is considered to be an applicable large employer (ALE), and is legally required to offer health insurance to all of its workers, as per the ACA’s health insurance requirements related to employer shared responsibility provisions.

What are contribution and cost-sharing requirements for employers?

Since group health insurance plans are a form of employer-sponsored coverage, this means that a business is required to share the cost of health insurance with employees. Typically, this cost-sharing element of health insurance requirements refers to a small business splitting monthly premium costs with workers.

In most states, employers are required to contribute or pay for at least 50 percent of each employee’s health insurance premiums, although this depends on the state the business is located in.

Are employers required to offer health insurance to employee dependents?

Health insurance plans generally allow qualified dependents to be added to any plan. However, for group health insurance plans, it is optional for employers to pay for the health insurance coverage of employee dependents. In most cases, employees can still add qualified dependents to their health plan, regardless of whether their employer decides to contribute to dependents’ premiums.

What documents are required for an employer to offer health insurance?

In order to meet health insurance requirements, a small business must provide copies of all relevant legal, tax, and accounting information when applying for group coverage. Employers are required to submit certain forms of documentation, including:

  • Proof of business location
  • Proof of business type
  • Payroll documentation

This standard information is used to verify and authenticate the legitimacy of a small business, and much of it is available through a previous year’s business tax filings. Ensuring that your company provides the right documentation can help streamline the process of meeting the health insurance requirements needed to offer group coverage to your employees.

Employer health insurance requirements summarized

Although small businesses with fewer than 50 employees are not required to offer health insurance, most workers highly value group health coverage and tend to sign up if group plans are available. There are also benefits for employers as well: business owners and their families may be able to enroll in their company’s health plan along with their employees, and they may benefit from business tax deductions.

eHealth’s licensed agents can answer your questions about employer health insurance requirements, and can help you find the right group health plan for your business. You can also quickly find and compare free quotes for small business health insurance by visiting eHealth.com.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Should My Small Business Offer a Workplace Wellness Program?

As a business owner, you may have heard of workplace wellness programs. Workplace wellness has increasingly become a popular topic among employers, and wellness programs can help get employees excited about making healthier lifestyle choices. How do these wellness programs work, and what are their benefits for a small business?

Continue reading to learn about workplace wellness programs and why your business might consider them.

What is a workplace wellness program?

A workplace wellness program is an initiative designed to encourage the health and fitness of employees, and is generally offered by either an employer or a health insurance plan. Workplace wellness programs usually provide participation incentives for employees, such as premium discounts, gym memberships, and cash rewards.

Generally, there are two types of workplace wellness programs: participatory and health-contingent.

  • Participatory wellness programs either do not provide rewards or do not have any conditions for giving rewards based on fulfilling a certain health standard or outcome. These could include employee reimbursements for the cost of gym programs or diagnostic testing programs.
  • Health-contingent wellness programs require employees to fulfill a certain health standard or outcome to receive a reward. Unlike participatory programs, health-contingent programs are subject to five key requirements set out in the Affordable Care Act (ACA).

The ACA created new financial incentives for employers to offer wellness programs in order to promote healthier workplaces. According to the U.S. Department of Labor, the maximum reward to employers who use a health-contingent workplace wellness program plan is usually limited to 30 percent of the cost of employee-only health coverage (or 50 percent for wellness programs designed to reduce or prevent tobacco usage).

What are examples of workplace wellness programs?

Many options are available for small businesses interested in workplace wellness programs. Examples of workplace wellness programs include:

  • Preventative health screenings
  • Programs to quit smoking
  • Diet and weight loss programs
  • Diabetes management programs
  • Monthly, no-cost health seminars

These activities can motivate employees to make better long-term health decisions related to fitness and nutrition through short-term incentives, rewards, and recognition. Employers may also view these programs as investments in potentially improving workplace productivity and collaboration.

What are the benefits of wellness programs for small business owners?

There are several great reasons for business owners to offer workplace wellness programs. In addition to the financial incentives mentioned above, wellness programs can help companies promote a healthier working environment for their employees.

  • Differentiate your business – Offering a wellness program may allow your company to stand out as an employer that highly values its employees, thereby setting your business apart from competitors. Such programs could also boost morale and convey the culture of your business.
  • Recruit quality employees – Workplace wellness programs may attract talented, quality workers. Potential hires often consider wellness programs as part of a total benefits package, along with vacation time and a group health insurance plan, when they evaluate their job offers.
  • Employee retention – Implementing a workplace wellness program could help your business retain your current workers through enhanced engagement and job satisfaction. Depending on their impact, wellness programs may also lead to overall happier and healthier employees.
  • Stress reduction – Workplace wellness initiatives related to personal fitness, for example, may contribute to reducing employee stress. Reduced workplace stress could improve company culture and promote a more focused, positive, and productive mindset among your employees.

Before your company begins a wellness program, you should discuss the topic with your employees to find out their degree of interest in participating in the program’s activities. Regardless of whether your business decides to start a workplace wellness program, prioritizing the health and well-being of your employees is always an important consideration for the success of any small business.

Benefits beyond workplace wellness programs

While not all small business health insurance plans offer discounts for workplace wellness programs, such initiatives are popular enough in the modern workplace that they may be worthy of your time and consideration, and are another benefit that employers should absolutely consider offering to their employees.

eHealth can help you find the right health insurance plan for your small business, including group plans with workplace wellness programs. Visit eHealth today or speak with one of our licensed health insurance agents to learn how you can quickly find and compare quotes for group health coverage from the best selection of small business health insurance plans available online.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Small Business Health Insurance Copayment

Wondering what a small business health insurance copayment is? Or how copayments are part of cost-sharing in insurance plans? Or how a copayment impacts your group health plan? Continue reading to learn about copayments for small business health insurance.

What is a copayment?

A copayment, also referred to as a copay, is a specific charge that your small business health insurance plan may require you to pay for a certain medical service or supply. A common example of a copayment would be a $25 charge for a doctor’s office visit or brand-name drug prescription, after which the health insurance company may pay for the remainder of the charges.

How does a copayment relate to cost sharing for small business health insurance?

The copayment is a cost paid for by the employee—not shared by employers.

The term “cost-sharing” refers to how health care costs are shared between the health insurance company and the insurance policy holder.

Your group health plan information may list your copayment, allowing you to know in advance exactly how much you will have to pay for medical services. For example, if your group health plan says that you have a $25 copayment for doctor’s office visits, you will pay that fee each time you go visit the doctor.

Depending on the circumstances, you may or may not have a copayment. In some cases, you may still have to pay a copayment even after you have met your annual deductible. Other medical services, such as yearly preventative care checkups, well-woman visits, and childhood immunizations are typically not subject to copays, and are usually covered with no out-of-pocket cost to the insurance policy holder. A copayment is also likely to be capped by the health plan’s annual out-of-pocket maximum limit.

What medical services have a copayment?

There are many medical services which may often require a copayment. Such services include:

Medical Services Generally Requiring Copayments
Doctors and Prescriptions Therapy Services Psychology & Emergency
Primary Care Physician Visits* Physical Therapy Mental Health Services
Specialist Office Visits Occupational Therapy Drug Counseling
Prescription Medications Speech Therapy Ambulance or ER Services

*For non-preventative care

Frequently, there will be a health insurance copayment for in-network medical services only. If you go to a medical provider outside of the insurance company’s network list, the copayment may not apply, and you may need to pay the bill’s full amount or a coinsurance percentage.

What types of health insurance plans have copays?

HMO health insurance plans and other managed care plans generally have a copayment as part of their cost-sharing arrangement. Health insurance companies that offer HMO plans usually have contractual agreements with health care providers. These agreements let the insurance company pay fixed fees for essential health services, allowing them to better predict costs and provide a copayment system to health plan members.

Other small business health insurance plan types, such as PPO plans, EPO plans, and POS plans, may also have a copayment as part of their structure, in addition to coinsurance and annual deductibles.

How does a copayment impact employees in a group health plan?

If you are a small business owner considering a group health insurance plan, you want to make sure that you enroll in the most effective coverage for you and your employees.

  • If your employees tend be older, have families, or have more frequent medical needs for doctor’s visits and prescriptions, they may prefer a health plan with a lower, more affordable, and more consistent copayment.
  • If your employees tend to be relatively young and healthy and not visit the doctor very often, then they may have less concern about copays compared to the cost of monthly premiums.

Overall, your small business should try to find a group health plan that meets the needs of your workers while remaining within their budget. Be sure to discuss health coverage preferences with your employees prior to selecting a small business health insurance plan.

Small business health insurance copayments in perspective

A copayment serves as an important factor to consider in any health insurance plan. If you have questions about a group health plan’s copayment or finding more information on health plans, you can visit eHealth.com or speak with eHealth’s licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

The 2019 Obamacare Open Enrollment Period: What You Need to Know

The nationwide enrollment period for individual and family health insurance for 2020 will begin November 1, 2019.

To help you understand open enrollment and make the most of it, we’ve compiled answers to some of the most common questions we receive from health insurance shoppers like you.

What is the Obamacare open enrollment period?

The Obamacare law (also known as the Affordable Care Act or ACA) created specific nationwide open enrollment periods during which you can enroll in individual and family major medical health insurance plans. Open enrollment is your chance to sign up for a new health insurance plan or compare your options in the market.

When does the Obamacare open enrollment period happen?

Open enrollment for coverage for 2020, is scheduled to begin on November 1, 2019 and continue through December 15, 2019 in most states.

Where can I shop for health insurance during open enrollment?

During open enrollment you can shop for new individual or family health insurance plans through different sources, including government-run health insurance exchanges, health insurance companies themselves, or through private online health insurance agents and brokers, like eHealth

If I enroll in a new plan, when does my coverage start?

In most cases, coverage under a new plan selected during the 2020 open enrollment period can begin no sooner than January 1, 2020.

What if I have employer-based health insurance?

If you have employer-based health insurance, you don’t need to worry about the Obamacare open enrollment period, though the company you work for may have an enrollment period of its own. Open enrollment for employer-based coverage usually happens around the fall of each year, though dates vary.

I already have a health insurance plan. Should I re-shop during open enrollment?

It’s a good idea to review your coverage options each open enrollment period. Some plans are cancelled or may raise their rates in the new year, and new plans may become available. The health insurance plan you had last year may no longer be the best match for your needs or budget. Additionally, your medical needs may have changed in the past year, which could make a new plan with different benefits offerings more appropriate.

Do I need to reapply for subsidies during open enrollment?

The Obamacare law makes government-funded subsidies available to qualifying individuals and families with taxable income of no more than 400% of the federal poverty level (according to the U.S. department of health and human services, 400% of the FPL about $12,490 for a single person or $103,000 for a family of four in 2019 in the contiguous US). These subsidies effectively reduce the amount that you need to pay from your own pocket toward your monthly health insurance premiums.

In addition to enrolling in coverage, you’re also able to apply for government subsidies during open enrollment. If you already have subsidies, it may be a good idea to reapply in case your income or other factors have changed. If you receive too little in subsidies, you may have to pay more upfront for your insurance premiums.

If you receive too much in subsidies, you may have to pay back the extra amount when you file your tax return. Depending on the preferences you selected when your last applied for subsidies, your subsidies may not automatically continue into the new year.

What happens if I miss the Obamacare open enrollment period?

If you miss the open enrollment period you may run the risk of going without coverage throughout 2020.

Outside open enrollment, you may only be able to apply for individual and family health insurance coverage when you experience a qualifying life event. Under the Obamacare law, qualifying life events include things like marriage or divorce, the birth or adoption of a child, moving to a new coverage area, or major changes to your income that make you eligible for subsidies.

When you experience a qualifying life event, you generally trigger a 60-day special enrollment period and need to provide certain documentation and meet other criteria related to that qualifying life event.

While there is no federal tax penalty for going without coverage starting in 2019, you may be hit hard financially by expensive or unexpected healthcare costs if you go uninsured.

Where can I turn for personal help and advice during open enrollment?

If you’re looking for personal help and advice in picking out a new health insurance plan for 2020, consider working with a licensed health insurance agent, like those at eHealth.com.

Unlike the “navigators” who staff government-run health insurance exchanges, licensed agents are legally able to make personalized plan recommendations based on your budget and medical needs.

Should disputes arise about billing or benefits under your plan, licensed agents can serve as your advocate to the insurance company.

Also, keep in mind that enrolling in a health insurance plan through an agent does not make the plan any more expensive to you because all insurance plan prices are set by law.

How Can I Avoid an Obamacare Tax Penalty in 2019?

Tax penalty repeal

How Can I Avoid an Obamacare Tax Penalty in 2019?

In the past if you went without Obamacare-compliant health insurance for more than two consecutive months during the year, you were sometimes subjected to a significant tax penalty. According to healthcare.gov, the penalty for 2018 (paid when you filed 2018’s taxes in 2019) was $695 per adult or 2.5% of your taxable income – whichever was greater!

Since the Affordable Care Act (the “ACA” or “Obamacare”) became law, a lot of people have learned about the uninsured tax penalty the hard way – by paying it.

Now that the individual mandate has been repealed there is no federal tax penalty for forgoing coverage from 2019 on. While there is no tax penalty at the federal level, some states have penalties of their own.

State-level health insurance penalties

It is still important to look at your state’s requirements for health insurance. There are a handful of states that have their own health insurance penalties for those who go without state-law compliant coverage.

According to iHealthAgents some places that have health insurance penalties are:

  • Massachusetts: Their health insurance penalty was implemented in 2006. In the past, if a penalty was paid at the federal level they did not charge one at the state level.
    However, they will start charging the state fee now that the federal penalty was repealed.
  • New Jersey: In 2019, the state of New Jersey will enforce a health insurance penalty.
  • Vermont: In 2020, Vermont’s health insurance penalty will go into effect.
  • District of Columbia: In 2019, the D.C.’s health insurance penalty will go into effect.

If there is no Obamacare fine, do I still need health insurance?

While the health insurance penalty is no longer in effect from 2019 on, your wallet can still be hit hard by uninsured and unexpected medical expenses. It’s still important to get coverage to protect your finances even though there is no fine.

eHealth offers a wide range of Obamacare-compliant plans to protect your health and your wallet from expensive or unexpected medical costs, as well as alternative options for those who require less benefits to be covered. While eHealth is a private online marketplace, you can still qualify for federal assistance to help pay your monthly insurance premium.

Generally, if you make up to 400% of the federal poverty line (FPL) – which is $12,490 for an individual, and $25,750 for a family of four in 2019 – you should qualify for some government assistance in paying for your health insurance.

If you are looking for insurance outside of the open-enrollment-period or a special-enrollment period, you may qualify for short-term health insurance which will provide some protection during a lapse in health insurance coverage. However, if you are in a state with a state-level tax penalty short-term health insurance may not protect you from being fined.

ACA-compliant insurance

You have a few options when it comes to health insurance that is compliant with Obamacare. This health insurance will help cover your healthcare needs and keep you from getting charged a tax penalty at the state level.

  • Individually purchased health insurance – Whether you buy it through a licensed agent, a government-run exchange, directly from the insurance company, or a private online marketplace (like eHealth), Obamacare-compliant major medical individual and family health insurance plans should protect you against any state-level penalties. All major medical health insurance plans (that is, all traditional health insurance plans) are now Obamacare-compliant and will provide you with the coverage required under the law.
  • Health insurance bought with government subsidies – Under Obamacare, people with a taxable income of up to 400% of the federal poverty level may qualify for government subsidies when they purchase health insurance. With subsidies, you’re still getting Obamacare-compliant major medical health insurance – but you’re also getting help paying for it.
  • Employer-based health insurance – Most employer-based health insurance plans are major medical health insurance plans and should also protect you from any state-level tax penalties.
  • Medicare or Medicaid – If you’re enrolled in Medicare or Medicaid, you should not need to worry about state tax penalties for going uninsured. Medicare and Medicaid provide you with coverage that’s compliant with Obamacare.
  • Other government-sponsored health insurance – If you are covered under U.S. military health insurance or CHIP or other government health insurance programs, you should not need to worry about any state-level penalties.

Non ACA-Compliant Insurance

Not all forms of insurance are ACA-compliant or are even health insurance, for that matter. Here are a few forms of insurance that aren’t ACA-compliant and may not protect you from a state-level health insurance penalty.

  • Short term health insurance– Short term health insurance plans do just what the name suggests – they provide you with a measure of protection against unexpected medical costs for a limited period of time. Some people find short term plans attractive because they tend to cost less than a major medical health insurance plan and you can enroll in a short term plan year-round (something not true of Obamacare-compliant plans; see below).
    However, short term health insurance plans do not comply with the minimum essential coverage requirements of Obamacare. They generally do not provide you with coverage for things like preventive care, pre-existing medical conditions, or maternity care
    Short term plans can be particularly valuable if you’re between the coverage periods for different major medical health plans – but short term plans do not meet your coverage requirements under the law. They may not protect you from state-level health insurance penalties.
  • Accident or critical illness insurance– These are not traditional health insurance plans. Instead, these are insurance plans that pay you a defined amount of money in case of a specific injury or qualifying medical diagnosis.
    They do not provide the minimum essential coverage required by Obamacare, and they should not be considered as a substitute for health insurance.
    Accident and critical illness insurance plans can be a valuable addition to a major medical health insurance plan, but they are not health insurance and will not protect you from state-level fines.
  • Life insurance– Some people imagine that a life insurance policy is all they need under Obamacare. In fact, life insurance plans are not health insurance plans and do not meet the coverage requirements of the Affordable Care Act.
    A life insurance policy is not health insurance.
  • Dental and vision insurance– Dental and vision insurance can be great to have. On their own, however, they will not cover medical care outside of dental and vision-related costs.

A note about Obamacare’s open enrollment period

As mentioned above, you may not be able to purchase Obamacare-compliant health insurance coverage at just any time of year. Generally speaking, you’ll need to enroll in coverage during the annual open enrollment period, or when you have a qualifying life event.

The Obamacare open enrollment period for 2020 health insurance plans is scheduled to begin on November 1, 2019 and continue through December 15, 2019. Generally speaking, your coverage under any new plan selected during this open enrollment can begin no sooner than January 1, 2020.

Outside of open enrollment, you may trigger a special enrollment period for yourself when you experience a qualifying life event. These events include marriage, divorce, the birth or adoption of a child, a permanent move to a new coverage area, or the loss of qualifying coverage, etc.

When you experience a qualifying life event, you generally have 60 days to enroll in a new Obamacare-compliant health insurance plan. You typically need to provide proof of the qualifying event and otherwise meet the specific conditions that apply to your qualifying life event.

BCBS Individual and Family Plans in Texas

About the Blue Cross and Blue Shield of Texas

A.M. Best Rating A as of 9/20/2018

The Blue Cross and Blue Shield of Texas (BCBSTX) was originally founded in 1929 by Dr. Justin Ford Kimball as the nation’s first hospital pre-payment plan.

The Blue Cross and Blue Shield of Texas’ coverage area spans all 50 states. Their network includes about 51,000 healthcare providers and 658 hospitals in Texas. Nationally, those covered by Blue Cross and Blue Shield of Texas plans have access to more than 745,000 healthcare providers and 6,300 hospitals across the U.S.

Buying individual and family health insurance from Blue Cross Blue Shield in Texas

Purchasing individual health insurance may be right for you if

  • You are self employed
  • Your employer does not offer a group plan
  • Your employer offers a group plan, but it doesn’t cover your spouse or any dependents
  • You are enrolled in a health insurance plan, but the premiums are too high
  • You are enrolled in a health insurance plan, but your healthcare needs have changed

Finding affordable health insurance in Texas

When purchasing individual plans, you should consider getting quotes for plans that cover you together and separately to find what is most affordable for you.

According to eHealth, depending on the insurance company Texas individual and family insurance rates can be based on the age of the youngest person on the policy. Some couples with a large age difference may find they save money on premiums by applying for the same plan rather than separate plans.

However, couples with a small age difference may find they may save money by applying for separate health insurance plans.

Before purchasing a plan, make sure you consider your healthcare needs – and the needs of your spouse or any dependents – to make sure you find a plan that covers the services you need.

BCBS plans in Texas through eHealth

Applying for Texas health insurance through eHealth allows you to compare a variety of health insurance plans, including Blue Cross and Blue Shield. We sell a number of other plans that you can compare with BCBS to make sure you’re finding the most affordable plan that covers your healthcare needs. You can compare Texas healthcare plans side by side, receive quotes, and apply online through eHealth.

The help that you receive through eHealth costs you nothing. In other words, the plan that you purchase through eHealth is guaranteed to be the same price as the same plan sold through any other brokerage or marketplace.

The cost of health insurance plans are set, no matter where you’re purchasing them from.

Can You Buy Your Own Health Insurance?

Yes, you can buy your own health insurance and you don’t have to get coverage through your employer.

Depending on where you work, you may have the option of getting employer-sponsored health insurance. This is called group coverage. According to Medical Mutual, due to changing economic conditions, some employers have chosen or been forced to cut group insurance as an employer-sponsored benefit. This has led to a growing number of people looking elsewhere to get covered.

While employer-sponsored health insurance may still be an option for you, you may still consider buying individual health insurance.

What are the advantages of individual health insurance?

With employer-sponsored health insurance, your employer does the shopping for you. They choose your coverage options and you choose from there. However, when shopping for your own health insurance – which is also called individual health insurance – you’re in charge of choosing your health insurance plan.

Some benefits to getting individual health insurance are:

  • You choose the insurance company and the plan that best suits your needs
  • Your coverage is not tied to your job, so you can change jobs without potentially losing your health insurance
  • You choose a network that includes your preferred doctors and other healthcare providers
  • You may qualify for federal assistance in order to afford your insurance

What are the advantages of employer-sponsored health insurance?

There are advantages to getting insurances through your employer. Typically your employer will choose a coverage option for you and you can decide to accept the benefits if you are an eligible employee.

A few advantages of purchasing employer-sponsored health insurance are:

  • Your employer does the shopping and decides on your plan options for you
  • Your employer will typically split the cost of your premiums with you
  • The premium contributions your employer makes are not taxed and your contributions can be made on a pre-tax basis. This will lower your taxable income.

What option is cheaper: individual health insurance or group health insurance?

Cost is a deciding factor for many when it comes to health insurance. The cost for both an employer-sponsored health insurance plan and an individual health insurance plan can vary greatly depending on several factors.

Factors that may influence the monthly cost of your health insurance are income, location, size of family, and the percentage of your premium is willing to pay. According to the Kaiser Family Foundation (KFF), employers in the US paid 78% of their employee’s health insurance premiums in 2017.

Average Annual Single Premium per Enrolled Employee for Employer-Based Health Insurance: Employer Contribution, 2017

Depending on the percentage of the Federal Poverty Line (FPL) you make, you may be eligible for Affordable Care Act (ACA) – also known as Obamacare – subsidies to help pay your monthly premium for an individual health insurance plan. Generally if you make above 400% of the FPL you will not qualify for a subsidy.

According to the KFF, the average premium tax credit received by marketplace enrollees in 2018 was $519.

Average Premium Tax Credits

Where do I shop for individual health insurance?

If you decide not to buy health insurance through your employer, you can shop through the state or federal marketplace, directly from an insurance company, or through a broker like eHealth.

While eHealth is not a government marketplace, you can compare a large range of coverage options and you can still qualify for premium tax credits if you buy an ACA-compliant plan.

When can I apply?

You can apply for health insurance during the open enrollment period at the end of the year, which is from November 1st through December 15th for 2019.

If you have experienced a qualifying life event, you may be eligible for a special enrollment period. Some qualifying life events may include a loss in coverage due to job loss or change, getting married or divorced, or becoming ineligible for coverage because of a change in income.

Special enrollment periods generally last for 60 days.

To help find the right individual health insurance plan for you, enter your zip code where requested on this page to get a quote.

Small Business Health Insurance in New York

With one of the largest state economies in the nation, New York is home to many small and medium-sized businesses. According to a 2018 Empire State Development report, 98 percent of New York State businesses have fewer than 100 employees, making small employers a significant part of the state economy.

As a New York business owner, you may have questions about how small business health insurance works in your state. Continue reading to learn about New York health insurance group plans.

How to qualify for small business health insurance in New York

To be eligible for group plans in New York, you must meet the following requirements as a small business owner, as per New York’s Department of Financial Services:

  • Your business must be located within New York State.
  • Your business must have had between 1 and 50 full-time or full-time equivalent (FTE) employees over the past calendar year.
  • At least 30 percent of your employees must earn $43,000 or less in annual wages. The wage level is adjusted every year to account for inflation.
  • Your business must not have previously provided group health insurance coverage to your employees within the past 12 months.

If you are the owner of a sole proprietorship in New York, you should know that you usually would not qualify for small business health insurance unless you had eligible full-time or full-time equivalent employees. As a sole proprietor with no employees, you would instead qualify for individual health insurance in New York.

Your obligations as a small business after enrolling in a New York group plan

According to New York’s Department of Financial Services, in order to participate in HealthyNY, a small business must meet all of the following criteria:

  • As the employer, you contribute at least 50 percent to paying for monthly employee premiums.
  • 50 percent of your eligible employees participate in the group health insurance program. Employees who have health insurance through another source (including a spouse or government program) can count toward the 50 percent participation requirement.
  • The plan is offered to all employees who work 20 or more hours per week and are paid $43,000 or less (adjusted annually).
  • At least one employee who earns wages of $43,000 or less enrolls in the plan.

Once you offer group health insurance coverage and meet New York State requirements, your business may have access to significant tax advantages. For example, the monthly employee premiums that your business pays are usually 100 percent tax deductible. Offering small business health insurance can also mean reduced payroll taxes.

Qualifying for the small business health insurance tax credit in New York

As a New York small business owner, you may be eligible for a health tax credit to help you afford the cost of offering group health insurance to your employees. Typically, the requirements to qualify for a small business health insurance tax credit in New York are:

  • Your business has 25 or less full-time or full-time equivalent employees.
  • Your business pays an average annual salary or wage of less than $53,000 a year per worker (this amount is indexed annually for inflation).
  • Your business contributes at least 50 percent toward paying for the cost of employee premiums (specifically, your employees’ lowest cost single tier coverage).
  • Your business offers Small Business Health Options Program (SHOP) plan coverage to all full-time employees.

If your New York small business does qualify for the small business health insurance tax credit, then the maximum available federal reimbursement for your company is up to 50 percent of the premiums you pay for the medical, dental, and vision insurance of your employees. It is important for you to know that the tax credit is only available to your New York small business for a total of two consecutive years.

The small business health insurance tax credit is offered on a sliding scale, so the smaller your group, the more likely your New York business will benefit from the tax credit. For example, if your New York business has less than 10 full-time equivalent employees who are paid wages less than $25,000 annually, then your company may be eligible for the maximum tax credit amount.

How to find small business health insurance in New York

It’s fast, free, and easy to use eHealth to get affordable New York health insurance for your business. With eHealth’s online marketplace, you can compare plans from multiple insurance companies, find personalized quotes, and get unbiased support and advice from licensed health care agents. Visit eHealth today to learn more about New York small business health insurance plans that work for you and your company.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice. Group and employee definitions vary by insurance company and state, so be sure to check with a licensed insurance agent to find out the details for your specific situation.

Small Business Health Insurance in Virginia (Everything You Need to Know)

Small business health insurance in Virginia continues to be an important consideration for business owners, especially with the instability of the individual health insurance market and concerns about rising prices. When businesses offer group health coverage, they can gain distinct advantages. Keep reading to learn how providing small business health insurance in Virginia can benefit your company.

Top 3 reasons why you might offer small business health insurance in Virginia

Here are 3 great reasons to offer group plans to your employees:

  • Lower prices – Due to the benefits of having a larger risk pool, small business health insurance is often cheaper per person than individual health insurance. When more people pay premiums into a group pool, insurance companies take on less risk, making it possible to lower prices.
  • Cost sharing – The costs of monthly premiums are shared between the employer and employees in group plans in Virginia. This makes it easier for workers to have affordable health coverage.
  • Pre-tax benefits – Employees’ share of group health insurance is typically taken from their paychecks, meaning that their portion is from pre-tax dollars. If your employees had an individual health insurance plan, they would have to pay for premiums with post-tax money.

From an employer’s perspective, there are also valuable reasons to offer group plans in Virginia.

What are the advantages of offering Virginia small business health insurance?

By offering group coverage in Virginia, your company could benefit from lower costs and tax advantages.

  • Small business health insurance tax credit – If you have less than 25 full-time equivalent employees who are paid $50,000 or less per year, then your Virginia small business could be eligible for a tax credit to help your company afford group insurance coverage.
  • Tax advantages – After you implement group insurance for your employees, you can usually deduct premium expenses from your federal business taxes. Also, by providing health insurance, your Virginia small business may potentially be able to have reduced payroll taxes.
  • Recruit and keep employees – Providing a valuable benefit like health insurance to your Virginia employees can help you retain and attract high-quality talent for your workforce.
  • Stand out as a Virginia small business – According to the Kaiser Family Foundation, only 34 percent of Virginia firms with less than 50 employees offer health insurance. Offering health insurance coverage can help set your company apart from the competition.

Many employees highly value health insurance, which may lead to higher employee job satisfaction. Offering group insurance means that your employees can benefit from preventative care and discounted prescriptions and doctor visits. Due to all of the health care resources your employees have access to, your Virginia small business may have a healthier, more productive workforce that takes less sick days.

How to qualify for small business health insurance in Virginia

To provide group plans to employees, your Virginia small business must generally meet all of the following requirements:

  • Your business must have an office or work site within the state of Virginia.
  • Your business must have less than 50 full-time or full-time equivalent employees.
  • You must offer group coverage to all of your full-time employees (usually those who work 30 or more hours per week). Note that it is optional to offer health insurance to part-time employees.
  • In Virginia, at least 70 percent of the employees your business offers health insurance to must enroll in the group health plan or have coverage through another source.

If your Virginia small business does not meet the minimum 70 percent participation requirement, you should know that you can enroll in a group plan through the Small Business Health Option Program (SHOP) Marketplace between November 15 and December 15. During this time, your business can enroll without meeting a minimum participation requirement.

If you are the owner of a sole proprietorship in Virginia, you should know that you will only qualify for small business health insurance if you have eligible full-time or full-time equivalent employees. As a sole proprietor with no employees, you would instead qualify for individual health insurance in Virginia.

How to find small business health insurance in Virginia

You can find affordable Virginia small business health insurance plans that work for you and your company through eHealth. With eHealth’s online marketplace, you can quickly compare plans from multiple insurance companies, find free personalized quotes, and get unbiased support and advice from licensed health care agents. If you’ve decided that group health insurance is the right choice for your company, you can visit our Virginia small business page to start getting quotes today.

This article is for general information only, and should not be relied on for legal, tax, or accounting advice. Please consult your legal, tax, or accounting advisor to better understand your specific situation. Group and employee definitions vary by insurance company and state, so be sure to check with a licensed insurance agent to find out the details for your specific situation.

Small Business Health Insurance for Startups

As a new business owner, you may have questions about whether you should offer small business health insurance group coverage to your employees. You may also want to know what your options are when it comes to group health plans, as well as the costs of small business health insurance.

Continue reading to learn more about health insurance for startups.

Why offer health insurance as a startup?

If you own a startup with less than 50 full-time equivalent employees, then your company probably qualifies for small business health insurance. Although offering group health insurance is optional if your startup has less than 50 employees, there are several compelling reasons that looking into health insurance for startups can provide value to your new business.

  • Offering group health plan coverage in a total compensation package can help you recruit and retain the best employees in a competitive market.
  • Owners of startups and small businesses frequently look at health insurance group coverage as a way to hedge against price instability.
  • Usually, group health plans offer guaranteed acceptance for the business owner, other employees, and their families.
  • Startup and small business owners who enroll in group health plan coverage can benefit their company and employees while also protecting themselves and their own families.

How much does health insurance for startups cost?

The costs of health insurance for your startup will depend on the plan that you and your employees choose, in addition to your business location, employee ages, and coverage and benefit preferences.

When your startup considers different small business health insurance options, it can be helpful to start with looking at the metal levels of each group health plan. Metal levels, such as bronze, silver, gold, and platinum, represent each health plan’s actuarial value (AV), which means the percentage of total average costs paid by the health insurance company for covered benefits.

For example, if one of your startup’s employees had a health plan with a 60 percent actuarial value, then the health insurance company would pay an average of 60 percent of all covered medical expenses, while the startup employee would be responsible for paying 40 percent of medical costs until he or she reached the health plan’s out-of-pocket maximum limit.

From a startup perspective, a bronze health plan may be a good choice due to its low cost. Bronze health plans tend to have low monthly premiums and high annual deductibles, meaning that your employees pay less per month to be enrolled in a group health plan.

  • A bronze plan could work well if your startup employees tend to be young and relatively healthy. Due to infrequent doctor visits and minimal medical expenses, these employees would probably have no need to meet their high annual deductible.
  • On the other hand, you should also make sure that your plan remains affordable for employees who may have chronic health conditions, require more frequent doctor visits and prescriptions, or otherwise prefer a plan with a lower annual deductible.
  • You should talk with your startup employees to find out their health insurance preferences, especially in terms of premiums, deductibles, out-of-pocket maximums, and emergencies.

What kind of health insurance to choose for a startup

After getting a sense of your startup’s cost preferences for group coverage, you should consider the different types of health insurance plans. You and your startup employees can select from several popular plan types for small business health insurance based on your budget and health care needs.

  • Your startup employees might favor a Preferred Partner Organization (PPO) plan over a Health Maintenance Organization (HMO) plan if they don’t want to see a primary care physician before visiting a specialist.
  • Alternatively, your startup employees might prefer an HMO plan over a PPO plan due to the lower cost of an HMO, which comes from staying in a medical network for services.

In addition to HMO and PPO plans, there are other possible health plan choices for a startup with a young and relatively health workforce that prioritizes affordability and flexibility.

  • With Exclusive Provider Organization (EPO) plans, your employees can use all specialists and providers with no referrals, although there is usually no out-of-network coverage. EPO plans tend to cost less than HMO and PPO plans, and could be a good choice for startup employees who do not expect much medical care and want to save money.
  • A Point of Service Plan (POS) plan is basically a combination of HMO and PPO plans, in that employees need to work with a primary care physician while usually having access to a wider range of health care providers. Startup employees might go with a POS plan if they want to benefit from access to a wider network.
  • Another choice of health insurance for startups is the Health Savings Account (HSA). These are specially designated, tax-advantaged savings accounts that employees can use to pay for expenses from high-deductible health plans. Money left over in an employee-owned HSA is saved over time and can earn interest. HSAs can work well for employees who prefer lower premiums.
  • Health Reimbursement Arrangements (HRAs) work in a similar way to HSAs, with one of the main differences being that employees do not own their HRA accounts.

Overall, cost, convenience, and the need for medical services should all be taken into account when selecting the type of small business health insurance plan for your startup.

Cost sharing in health insurance for startups

Since group plans are considered to be employer-sponsored health coverage, you should also decide how much your startup will share the costs of health insurance with your employees. Most states require employers to pay for at least 50 percent of monthly employee premiums, thereby splitting the cost with their workforce. As a startup founder and employer, you should also know that you can usually deduct employee premiums from your federal business taxes.

It is usually up to you as a small business owner whether your group plan will cover employee dependents. Regardless of whether your business chooses to partially pay for the cost of dependents, employees can typically still choose to add dependents to their health plan.

Depending on your number of full-time equivalent employees and how much they are paid, your startup may be able to qualify for a small business health care tax credit. If you are eligible, this tax credit may be able to help your startup reduce the cost of offering group health coverage to your employees.

How to get health insurance for your startup company

Although looking at health insurance for startups might seem overwhelming as a new business owner, it can serve as a valuable investment for your company and employees.

For more information about implementing group health coverage for your startup, you can look through eHealth’s small business preparation checklist. To find small business health insurance quotes, visit eHealth.com today or speak with one of our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Small Business Health Insurance Rules in 2019

What to know about your employer obligations for group health insurance requirements in 2019

As a business owner, it can be challenging to keep up with changing rules and regulations, especially those related to health care.

What are the essential insurance requirements you need to know for this year? And what are the advantages of offering small business health insurance? Keep reading to learn what your employer obligations are for group health insurance requirements in 2019.

Are employers required to offer small business health insurance in 2019?

Even with the now-repealed Individual Mandate from the Affordable Care Act (ACA), employers were never required to provide small business health insurance. According to the insurance requirements of the ACA, employers with less than 50 full-time employees are considered to be small businesses, and are still not required to provide group health insurance coverage to their employees in 2019. However, businesses with 50 or more full-time employees (applicable large employers, or ALEs) are still required to provide health insurance to their workers or face penalties in 2019.

How can employers qualify for the small business health insurance tax credit?

Although it is optional for small businesses to offer group health insurance, employers may be able to benefit from the health care tax credit. A small business can usually qualify for the tax credit if it meets the following insurance requirements:

  • The small business has 25 or less full-time equivalent (FTE) employees.
  • Employees are paid an average salary of no greater than $54,200 (in 2019).
  • The small business pays at least 50 percent of employee premiums.
  • The small business buys a SHOP Marketplace Plan on the Marketplace, or from a partner such as eHealth.

Smaller businesses can generally be eligible for a higher health care tax credit. For instance, a business with less than 10 employees and an average salary of less than $25,000 would qualify for the highest tax credit. Overall, the health care tax credit may help make the purchase of group health insurance more affordable for small businesses while ensuring that their coverage meets ACA insurance requirements.

How can employers save money on small business health insurance premiums?

Small businesses can still purchase group health insurance even if they do not qualify for a health care tax credit. For instance, small employers may still be able to deduct the cost of contributing to monthly employee premiums from their federal taxes as a business expense.

Since group health insurance is employer-sponsored coverage, small businesses can also ask employees to pay for a portion of monthly premiums (typically 50 percent or less) from out of their paychecks while still fulfilling employer cost-sharing requirements and ACA health insurance requirements.

What are small business health insurance requirements related to tax reporting in 2019?

There are certain tax reporting requirements for small businesses to keep in mind for 2019.

  • If your company decides to offer group health coverage after meeting insurance requirements, you must report the value of the insurance provided to each employee. This information goes on the employee’s Form W-2 using the code DD, as per IRS requirements.
  • According to the IRS, your business is required to withhold and report an additional 0.9 percent on employee compensation that is greater than $200,000, as per the ACA.
  • Your small business also must pay a fee toward funding the Patient-Centered Outcomes Research Trust Fund. You are required to report this fee through Form 720.

Why should employers offer small business health insurance?

Although in some cases, offering health insurance is beyond typical employer requirements, there are several advantages to offering a group health insurance plan to your employees.

  • Retaining and attracting employees – Providing group health insurance coverage may help your small business recruit better employees while also helping keep your best current employees. In a competitive talent market, offering health insurance as part of a compensation package may be an appealing incentive for people to join your company.
  • Helping your business stand out – According to the Bureau of Labor Statistics, only about 55 percent of companies with less than 100 workers offered medical benefits through small business health insurance. Employees frequently sign up for group plans, even when they have to pay for part of the premiums.
  • Building a healthier workforce – When employees have health insurance, they may take less sick days and could help your small business be more productive. By having access to many health care resources, your employees can proactively attend to their medical needs with fewer disruptions to their work schedule.

Overall, offering group health coverage may be a worthwhile investment for your small business, regardless of your employer requirements.

Where can employers find small business health insurance?

As a small business employer, you quickly can find group health insurance coverage through eHealth. With eHealth’s online marketplace, you can easily compare group medical plans from multiple health insurance companies, including plans which may not be offered on the exchange. By quickly entering in your number of employees and company’s ZIP code, you can instantly get quotes for small business health insurance.

To learn more about affordable group health plans and insurance requirements, visit eHealth today or speak with one of our licensed health insurance agents by dialing the toll-free number. Even though your small business is not required to offer health insurance, you may find that group plan coverage is an effective choice for your company in 2019.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Small Business Health Insurance for Employees in Multiple States

As a small business owner with employees in multiple states, you may have questions about providing health insurance to your multistate workforce. Continue reading to learn about the group health insurance options available to your small business and employees in multiple states.

Can a small business health insurance plan cover employees in multiple states?

A small business owner with employees in multiple states has multiple options for offering health insurance:

  • health insurance through one national group health plan
  • multiple separate state plans
  • a health reimbursement arrangement (HRA) account.

Providing one national group health plan to employees in multiple states

One health insurance option you may consider is offering a single national group health plan to all of your employees in multiple states. Selecting one national group health plan provides your small business with the convenience of not having to manage or keep up with the different rules, laws, and regulations that multiple states have regarding health insurance.

  • With one national group health plan, each of your employees across multiple states gets the same health insurance coverage no matter where they live.
  • Only a small number of health insurance companies have national group health plans, meaning that there is a more limited selection of plans available which may have higher prices.

Providing state plans to employees in multiple states

Another health insurance option that might work for your small business is offering multiple state plans to your employees who work in different states. Having a separate state plan for each state your workers are located in may allow them to have group health plans that better fit their coverage preferences and medical needs.

One factor to keep in mind is that your selection of health insurance options may vary depending on which health insurance companies offer coverage in each state. For example, consider the Small Business Health Option Program (SHOP) Marketplace, which helps small business owners provide health insurance to their employees. While SHOP plans are widely available in most states, they are not available as an insurance option in every state; some states have their own health care exchanges.

Also, when comparing the small business health insurance plans that are available for your state, you should be sure to look into which medical providers are available within a particular carrier’s network.

Offering a small business HRA to employees in multiple states

A small business health reimbursement arrangement (HRA) is a form of health insurance that employers can offer to their employees in multiple states. HRAs allow small businesses to create reimbursement accounts with fixed allowances on behalf of their workers. Employees then purchase their own individual or family health insurance plans and use the employer-provided allowance funds in their HRA accounts to pay for premiums and certain out-of-pocket costs.

An HRA might work for an employer with employees in multiple states since the monthly HRA allowance your business sets is fixed and the same for all your employees, regardless of which state they work in. The other multistate advantages of choosing an HRA for your business health insurance include allowing your employees to choose the level of health care coverage that works for them and a more straightforward way to manage the administrative side of health insurance.

Health insurance for employees in multiple states: the next steps

Ultimately, the health insurance options you choose for your multi-state employees will depend on the cost and coverage preferences of you and your workforce. Flexibility in choosing policies and the local availability of health insurance companies in each state are also important factors for your small business to consider. Overall, you should know that you have several effective options to choose from when offering health insurance to your employees in different states.

For more information about Health Reimbursement Arrangements for small businesses, speak with an accountant or a legal or tax advisor. To learn more about your small business health insurance options today, visit eHealth.com or speak to one of our licensed health insurance agents.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Small Business Health Insurance in California

With the largest state economy in America, California is home to many small and medium-sized businesses. If you are a California business owner, then you may be wondering how group plans for health coverage work in your state.

Continue reading to learn about small business health insurance in California.

How to qualify for small business health insurance in California

According to the Covered California website, to be eligible for small business health insurance in California, your company needs to meet certain requirements for contributions and participation, including:

  • Your business has between 1 and 100 eligible full-time or full-time equivalent employees.
  • The majority of your business’s eligible employees live in California.
  • At minimum, at least one of your employees receives a W-2 form.

According to the employer mandate in the Affordable Care Act (ACA), business owners with 50 or more full-time or full-time equivalent employees are required to offer health coverage to their employees.

Also, as per the ACA, small business owners with less than 50 full-time employees are not required to offer group health insurance to their employees. If you do decide to offer group health insurance as a small business in California with less than 50 full-time employees, then that health coverage must meet the ACA’s minimum standards and requirements, which include:

  • Coverage of the 10 essential health benefits.
  • No annual or lifetime benefit maximums.
  • Adherence to the ACA’s built-in consumer protections.

If you are the owner of a sole proprietorship in California, you should know that you usually would not qualify for small business health insurance unless you had eligible full-time or full-time equivalent employees. Instead, as a sole proprietor with no employees, you would qualify for individual health insurance in California.

Qualifying for the small business health insurance tax credit in California

As a small business owner in California, you may be eligible for a health tax credit. The ACA created this tax credit to help small businesses afford the cost of group health insurance for their employees.

Generally, the three primary requirements to qualify for a small business health insurance tax credit in California are:

  • Your business has 25 or less full-time or full-time equivalent employees.
  • Your business pays an average annual salary or wage of less than or equal to $54,000 a year per worker (this amount is indexed annually for inflation).
  • Your business contributes at least 50 percent toward paying for the cost of employee premiums.

If your California small business does qualify, then the maximum available federal tax credit could reimburse your company for up to 50 percent of the premiums you pay for the medical, dental, and vision health insurance of your employees. Once your California business qualifies, it is important for you to know that the tax credit is only available for a total of two consecutive years.

If your California business has less than 10 full-time equivalent employees who are paid wages less than $25,000 annually, then your company may be eligible for the maximum tax credit amount.

How to find small business health insurance in California

You can use eHealth to find affordable group plans for your small business in California. As an authorized federal government partner, eHealth can help you choose small business health insurance from among California’s most popular and leading brand-name health insurance companies including, but not limited to:

  • Anthem BlueCross
  • Blue Shield of California
  • Kaiser Permanente
  • Oscar
  • UnitedHealthcare

It’s fast, free, and easy to use eHealth to get group plans for your California small business. With eHealth’s online marketplace, you can compare plans from multiple insurance companies, find personalized quotes, and get unbiased advice from licensed health care agents. Visit eHealth today to learn more about California health insurance plans that work for you and your company.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Where’s the Worst Place for Seasonal Allergies

As spring and summer approach so does allergy season.

Allergies are your immune system overreacting to an otherwise harmless substance like pollen or dander. Exposure to these allergens can cause anywhere from annoying to debilitating symptoms for allergy sufferers.

For those suffering from seasonal allergies, it may be helpful to know where your city stands in terms of the worst places in the U.S. for Allergies.

The worst places for allergies in the U.S.

According to the Asthma and Allergy Foundation of America (AAFA), the allergy capital of the U.S. in 2019 is McAllen, Texas.

This year’s report the listed McAllen, Texas as most challenging place to live with spring allergies in the country for a few reasons:

  • Above average pollen count
  • Above average allergy medication usage
  • Lower availability of board-certified allergists

Based on these 3 factors they named three other allergy capitals for the other regions of the U.S.

  • The Northeastern allergy capital is Providence, Rhode Island
  • The Midwestern allergy capital is Toledo, Ohio
  • The Western allergy capital is Fresno, California

The biggest culprits of seasonal allergies are tree and grass pollen, which become more common in the air spring and summer. As it becomes warmer more people are drawn to be outside, which may be difficult for allergy sufferers.

However, there are some things you can do to keep your allergy symptoms in check.

Here’s what to do to keep allergy symptoms at bay

If you suffer from season allergies, it is recommended by the AAFA that you limit your outdoor activities to prevent exposure to allergens in the air. Additionally, you should try to keep your windows open. This includes keeping your windows shut at night.

You also should make sure you wash your hair, change your clothes, and wipe off any outdoor pets after coming in from outside to limit your exposure to outdoor allergens while inside your home.

Make sure you wash your sheets at least once a week to rid them of pollen and allergens. You can also use a certified air cleaner – such as a blank – to keep your home pollen free.

Additionally, you can use over-the-counter antihistamines (such as Claritin or Benadryl) or corticosteroids (such as Flonase) to treat your symptoms.

If your allergies still bother you after taking these precautions and medications, you may want to see your doctor or an allergist.

How can I treat my seasonal allergy symptoms?

While avoiding allergen and over-the-counter medications are two options for treating your allergy symptoms, there are prescription strength allergy medications that an allergist can prescribe that may help with your symptoms.

According to the AAFA, there is a third option for treatment called Immunotherapy.

There are two types of immunotherapy that are available right now:

  • Allergy shots – These shots involve getting injected with increasing doses of allergens over time. The patient should slowly become less sensitive to the allergen. This treatment generally works well for those with allergies to pollen as well as pets and dust.
  • SLIT – is another way to treat allergies that do not involve injections. Patients receive small doses of allergies under the tongue. The patient should become less sensitive to the allergen and reduce their symptoms. This treatment is generally is effective for those who are allergic to grass and ragweed.

These treatments must be given under the supervision of an allergist.

If you have seasonal allergies it is important to have health insurance as the costs of visits to your allergists and prescription medications can add up otherwise.

The proper health insurance coverage may help you offset the costs of seeing an allergist. Some important things to consider while shopping for health insurance as an allergy sufferer are if your doctor or allergist is in-network, if your plan will cover drug costs, and if it covers the costs of the treatment of asthma and allergies.

eHealth can help you find a health insurance plan to help cover these medical expenses.

How Much Does a Family Health Insurance Plan Cost?

Protecting your family’s health is important, but so is protecting your wallet from unexpected healthcare costs. It’s a smart idea to get family health insurance to not only keep your family healthy, but also your finances.

If a member of your family has a medical emergency, and they are uncovered, you could end up paying the hospital bills and various related costs all out of pocket, which could have the potential to break anyone’s bank.

Average cost of family health insurance premiums

An insurance premium is the monthly payment you make to stay enrolled with your insurance carrier. In 2018, the average cost per month for family health insurance was $1,168, according to our data from plans sold on our site.

Keep in mind that this number is an average and your premium can vary greatly depending on the size of your family, location, and level of coverage.

Average cost of family health insurance deductibles

Another cost that you can expect when enrolling in family coverage are deductibles. A deductible is the amount of money that you have to pay out-of-pocket for healthcare before your health insurance takes over payment. After you’ve reached this amount, your insurance will generally pay for the rest of any covered care that you receive for the rest of the year.

Unlike individual plans, you may have two deductibles with family health insurance: an individual deductible and a family deducible. This is not true for all plans though, so make sure to check your plan details before buying, and educate yourself about how deductibles work for your chosen plan.

You must reach either the individual or family deductible before your health insurance kicks in and starts paying toward care.

According to eHealth, family health insurance plans had an average deductible of about $8,232 in 2018.

Other costs you can expect with family health insurance

In addition to your premium and deductible, you can expect other costs with family health insurance such as copayments and coinsurance.

A copayment is a fixed amount that you pay for a covered service. A copayment may come into effect before or after you have reached your deductible.

Coinsurance is a percentage you pay for covered service after reaching your deductible. You can expect to pay coinsurance until you’ve reached your out-of-pocket maximum.

Out-of-pocket maximums are limits on how much money you can pay for coverage. Once you have reached your out-of-pocket limit your insurance will pay for 100% of the cost of your covered benefits for the rest of the coverage year.

Out-of-pocket maximums are crucial to help keep healthcare costs low, especially for large families.

Government Assistance

Depending on what your household income is per year, you may qualify for government assistance to afford coverage for yourself and your family.

  • ACA subsidies: The Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare, offers tax credits for those who make a certain percentage of the federal poverty line (FPL) and would otherwise have difficulties affording healthcare.
    In general, you’ll get larger subsidies the lower your income and the larger your family.
  • CHIP: The Children’s Health Insurance Program (CHIP) is a federal-state effort to provide inexpensive or – in some cases – free health insurance for families with children.
    In general, if you have children and make too much money to qualify for Medicaide but have an income below 200% you will qualify for CHIP.
  • Other options: If you have at least a family of for and an income of less than $99,000 per year, you should qualify for some state or federal assistance as there are other state programs specifically for families who have a difficult time affording health insurance.
    Short term health insurance plans are also a good option if you need to fill gaps in coverage quickly. Short term health insurance will not provide you with the same coverage as most major medical plans, but they are good if you find you and your family without coverage.

What to keep in mind while shopping for family health insurance

Costs of family health insurance will vary significantly depending on your circumstances and preferences. While there is no tax penalty for not having health insurance in 2019, it’s still important to get your family covered to protect yourself from unexpected healthcare costs which can cost your family large sums of money.

To find family coverage that’s right for your family and your budget, take a look at eHealth’s family plan options now.

How to Get Family Health Insurance

Where should I shop for family health insurance?

Almost 50% of Americans get their health insurance from an employer (also called employer-sponsored health insurance) according to the Kaiser Family Foundation. If your employer offers health insurance, it’s likely you were briefed on your options, prompted to pick a plan from what is offered, and coverage began soon after (with premiums shared by your employer).

If you’re the 7% of the population that does not receive government-sponsored health insurance, employer-sponsored health insurance, or are uninsured, then you’ll be looking for family health insurance on your own.

If you don’t have employer sponsored health insurance, you’ll have to look to other marketplaces to shop for your family health insurance. Depending on which state you live in, you will have to shop in either a state or federal market place.

Check the chart below to see which type of marketplace you have in your state.

State and federal insurance marketplaces

Nerdwallet

If you don’t want to shop on government or state marketplaces, you still have plenty of options:

  • Shopping directly through a health insurance company
  • Shopping with a local broker
  • Shopping with an online broker like eHealth (where you’ll still be able to apply for government subsidies)

What type of plan is right for my family?

As you shop for family health insurance coverage, you’ll notice that there are a four main types of plans:

  • HMO (Health Maintenance Plan): With this plan type, you generally must stay in network to get coverage apart from emergencies. You will also need to get a referral for certain procedures and specialists.
  • PPO (Preferred Provider Organization): With this plan you won’t have to stay in-network to get coverage, however in-network providers are generally less expensive. Additionally you don’t have to get a referral to get certain procedures or see specialists.
  • EPO (Exclusive Provider Organization): With this plan, you usually have to stay in network to get coverage except for emergency situations. However, you do not need a referral to get certain procedures or specialists.
  • POS (Point of Service Plan): With this plan you don’t have to stay in network to receive coverage, however you need a referral to go out of network and to get procedures and specialists.

When choosing which plan type is right for your family, consider you and your family’s medical needs and history. Consider the amount and type of care you’ve received in the past, allow that to inform your decision on what type of plan to choose.

What about networks?

One extremely important factor to consider while shopping for family health insurance, is if your preferred providers are in-network. You can directly ask your doctor or the insurance provider if they are covered under the plan you’re considering.

Additionally, you should make sure the plan you’re considering has plenty of in-network providers in your area. This way you won’t have to travel for in-network care or get charged large amounts of money if you need to go out-of-network.

What does family health insurance cost?

According to eHealth, the average premium for family health insurance was $1,168, in 2018; however your premium will vary depending on where you live, the size of your family, and other factors.

In addition to your monthly premium you will have a deductible. A deductible is the amount you must pay out-of-pocket before your insurance kicks in.

You may also have other various costs such as copays and coinsurances. These costs vary from plan to plan and may kick in before or after you reach your deductible.

Generally a plan with a higher premium and a lower deductible is a good choice for family health insurance since you have more than yourself to cover.

Lower premium plans are great if you have difficulty affording higher premium plans or infrequently require medical care.

How do I shop on eHealth for family health insurance?

Getting a quote for family health insurance on eHealth is as simple as entering your zip code and a few other pieces of information about you and your family.

Enter your zip code in the form on the right side of the page to get a quote and explore health insurance plans that are available to you. Or you can sign up for our newsletter on the right side of this page, as well.

From there eHealth will show you family health insurance options that you can filter out and compare. You can narrow your options down by company, monthly cost, and deductible.

How Many Hospitals Are There in the U.S.?

In total, there are a little over 6,000 hospitals in the U.S. Knowing how many hospitals – and which hospitals – are near you can be a deciding factor in which health insurance plan you choose.

A main concern for those shopping for health insurance is whether or not there plan will cover the providers in their area or their preferred providers.

Finding a plan that not only covers the hospitals, doctors, and specialists in your area but your preferred providers is important. Before you shop, it may be helpful to know which hospitals and doctors are in your area before you choose a plan.

How many hospitals are in the U.S.?

Not including hospitals that are not accessible by the general public – like hospital units in prisons or universities – there are 5,262 community hospitals in the U.S. Community hospitals include facilities like short-term general hospitals, special hospitals, and teaching hospitals.

Within the community hospitals in the U.S. there are a total of 798, 921 staffed beds.

This information is based from 2017 data collected by the American Hospital Association (AHA) and published in the 2019 edition of AHA Hospital Statistics.

What states have the most hospitals?

The states with the most community hospitals in the U.S. tend to be some of the larger, more populated states. For instance, Texas is the state with the most hospitals in the nation. (528 hospitals). This state alone has about 10% of the total hospitals in the country.

On the other hand, smaller states have hospitals. For instance, Rhode Island and Washington D.C. have 11 community hospitals each. This puts them at having about 0.2% of the total hospitals in the U.S.

What are medical networks?

A provider network is a list of hospitals, doctors, and other healthcare providers that a specific plan is contracted with to provide care at a discounted price. These doctors, hospitals, and other providers are considered in-network. Providers who are not contracted with a specific plan are considered out-of-network.

What do different plans cover?

Some types of plans will allow you to see a wide range of doctors and hospitals in the U.S., while some plans will limit your choices and potentially charge you more for going out of network.

There are four main different types of plan networks that you will encounter while you shop:

  • HMOs cover in-network providers and require you to get a referral to see specialists
  • PPOs will likely offer partial coverage if you go to an out-of-network provider and do not require a referral to see specialists. However, their monthly premiums tend to be more expensive.
  • EPOs only cover in-network providers, but don’t require a referral to see a specialist.
  • POSs will likely offer partial out-of-network coverage, but you must get a referral to see a specialist.

What if I go out-of-network?

If you are charged for an out-of-network visit you may be able to appeal for reasons such as not being able to find medically necessary care in-network.

If your doctor leaves your network you should be notified a may have to look for another provider. However, some plans will let you continue to see the doctor under special circumstances like being in the 2nd or 3rd trimester of pregnancy.

What should I look for in a health insurance plan?

When you are shopping for an insurance plan, it’s important to know what hospital, specialists, and networks are in their area. Knowing what providers are in your area, allows you to make a more informed decision when shopping for coverage.

You should always double check that your preferred doctors or providers are covered under a particular plan. Depending on your coverage, it may cost you a substantially more to go to a doctor that is outside of your provider network.

Instead of calling the doctor’s office and asking if they take your insurance, make sure to confirm that your doctor is within your network with a licensed agent or the insurance carrier.

It‘s always good idea to shop online with a licensed health insurance marketplace like eHealth.com to make sure that you are getting a plan that covers the providers that are not only near you, but the doctors that you prefer.

Small Business Health Insurance in Texas

As one of the largest states in America, Texas is home to both one of the largest state economies and many small- to medium-sized businesses. More than 4.4 million Texans, or 45 percent of all employees in the state, work for small firms, according to the Small Business Administration.

As a Texas business owner, you may have questions about how group health plan coverage works in your state. Continue reading to learn about Texas small business health insurance.

How to qualify for small business health insurance in Texas

Texas small businesses and Texas small employers have the choice of whether to offer group health plans to their employees.

If your Texas small business has less than 50 full-time equivalent employees, you are not required to offer health insurance, and you won’t have to pay a penalty. If your company does decide to offer Texas small business health insurance, then you should know the following differences between full-time and full-time equivalent employees.

  • Full-time employees – According to federal law, a full-time employee works a minimum of 30 hours during a typical week.
  • Full-time equivalent employees – As per the law, each 120 hours worked per month by part-time employees count as one full-time equivalent employee.

In Texas, deciding to provide small business health insurance means that you are required to offer coverage to all of your employees who work at least 30 hours or more each week, as well as their dependents. Newly hired employees must have at least 31 days from their start date to enroll in your small business health insurance plan.

As a Texas business owner, you can enroll in your company’s small business health insurance plan if at least one of your employees also enrolls in the plan. In this case, it is important for you to know that the employee cannot be a business owner, partner, or family member. If you meet the requirements to have a group plan, but none of your employees opt to be covered by the plan, then you will likely not be able to get a group health insurance plan. Not only do you have to have at least one employee, but at least one employee has to be opting into your plan too.

Qualifying for the small business health insurance tax credit in Texas

As a Texas small business owner, you may be eligible for a health tax credit to help you afford the cost of offering group health insurance to your employees.

Typically, the requirements to qualify for a small business health insurance tax credit in Texas are:

  • Your business has 25 or less full-time or full-time equivalent employees.
  • Your business contributes at least 50 percent toward paying for the cost of employee premiums.
  • Your business pays an average annual salary or wage of less than $50,000 a year per worker (this amount is indexed annually for inflation).
  • Your company buys a Small Business Health Options Program (SHOP) plan.

If your Texas small business does qualify, then the maximum available federal tax credit will reimburse your company for up to 50 percent of the premiums you pay for the medical, dental, and vision health insurance of your employees. It is important for you to know that the tax credit is only available to your Texas small business for a total of two consecutive years.

If your Texas business has less than 10 full-time equivalent employees who are paid wages less than $25,000 annually, then your company may be eligible for the maximum tax credit amount.

How to find small business health insurance in Texas

eHealth can help you find affordable group health plans for your Texas small business. As an authorized federal government partner, eHealth offers a broad selection of small business health insurance from among the most popular and leading brand-name health insurance companies in Texas, including:

  • Blue Cross and Blue Shield of Texas
  • Humana
  • National General Benefits Solutions
  • UnitedHealthcare

It’s fast, free, and easy to use eHealth to get Texas health insurance for your business. With eHealth’s online marketplace, you can compare plans from multiple insurance companies, find personalized quotes, and get unbiased support and advice from licensed health care agents. Visit eHealth today to learn more about Texas small business health insurance plans that work for you and your company.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

ACA Health Insurance Subsidies and the Middle Class

When it comes to purchasing Affordable Care Act (ACA) compliant health insurance, it’s important that you know where your income stands in terms of the Federal Poverty Line (FPL).

Depending on how much your income is above or below the FPL, you may qualify for ACA subsidies which help lower and middle-class households afford health insurance.

Knowing where your income is in comparison to the FPL could mean the difference between paying full price for health insurance premiums and getting an ACA subsidy – which could mean paying nothing for coverage.

What are ACA Subsidies?

ACA subsidies are available to some of those who make between 100% and 400% of the FPL. These ACA subsidies go toward paying health insurance premiums for those who would otherwise struggle to afford health insurance.

In general, subsidized enrollees are also shielded from rising premiums as ACA subsidies usually increase along with the price of premiums. This helps keep health insurance affordable for the lower and middle classes.

These ACA subsidies can be taken in advance. However, if you use more advance payments than what you are allotted per month you must repay the difference. If you use less, you will get the difference as a refundable credit when you file your taxes.

It’s important to know that there are two kinds of ACA subsidies (also called Obamacare subsidies by some). The more common kind are called “Advanced Premium Credits”, which individuals and families can qualify for at the beginning of the year, and help pay for health insurance premiums through the year. The second kind of ACA subsidy is called a “Cost-Sharing Reduction (CSR) Subsidy”.

How do I know if I qualify for ACA Subsidies?

Every year the government benchmarks the FPL at a particular income. Your eligibility for certain programs and forms of assistance – including ACA subsidies – is based on how much your income is above or below this number. For instance, for 2018 this number was $12,140 for an individual and $25,100 for a family of 4.

Those who earn between 100% and 400% of the FPL may qualify for ACA subsidies.

2018 Poverty Guideline for the 48 Contiguous States and the District of Columbia

Persons in Family/Household 100% of  Federal Poverty Line 200% of FPL 300% of FPL 400% of FPL
1 $12,140 $24,280 $36,420 $48,560
2 $16,460 $32,920 $49,380 $65,840
3 $20,780 $41,560 $62,340 $83,120
4 $25,100 $50,200 $75,300 $100,400
5 $29,420 $58,840 $88,260 $117,680
6 $33,740 $67,480 $101,220 $133,880
7 $38,060 $76,120 $114,180 $152,280
8 $42,380 $84,760 $127,140 $169,520

Households with more than 8 members, add $4,320 for each additional person.

The above numbers are the 2018 HHS poverty guidelines, which the Federal Register published on January 18, 2018. Eligibility for ACA subsidies for the 2019 coverage year is based on these guidelines for 2018.

Additionally, other factors such as your age, household size, and location can seriously effect if you are eligible for ACA subsidies.

What does this mean for the middle class?

Middle class households who have an income on the lower end of the middle-income spectrum may qualify for ACA subsidies.

However, middle-income individuals and households who make just above 400% of the poverty line will receive no subsidies and may struggle to pay full price for ACA compliant coverage.

This phenomena is referred to as “the subsidy cliff” as there is no phase out for those who make just over the income cut off for ACA subsidies.

What is a subsidy cliff, and how is the middle class affected?

According to an eHealth analysis, the subsidy cliff was $6,771 for a typical family of three. This means that earning an extra $204 per year – which would increase their income from 400% to 401% of the FPL and possibly make them ineligible for ACA subsidies – could cost them $6,771 in federal subsidies.

While the cost of ACA premiums are holding steady or falling in most parts of the country in 2019, the cheapest plans are still proving to be difficult to afford for many middle class households who do not receive any kind of subsidies.

According to the same eHealth analysis, in 2018 a household of three making between $81,884 and $128,795 in annual income would not be able to afford the lowest-priced health insurance plan. On average, the cheapest bronze plan would cost them $10,368 per year which is classified as unaffordable according to ACA rules.

Report income changes as soon as possible

If you experience any changes in your income during your coverage year it’s important that you report them as soon as possible. You may become eligible for subsidies if you experience a drop in income, or become ineligible if you experience a rise in your yearly earnings.

Note: When it comes to Advanced Premium credits, you report your expected income at the beginning of the year, and if you end up making a lot more than you originally reported, you could end up owing back money on your taxes. Make sure to avoid money at the end of the year by correctly reporting your income.

Make sure to report any changes in income as soon as possible so that you don’t miss out on receiving assistance if you become eligible. If you become ineligible and don’t report the change in income, you may have to pay money back during tax season.

Small Business Health Insurance: Blue Cross Blue Shield

eHealth offers small business health insurance plans from many of the top health insurance companies, including Blue Cross Blue Shield (BCBS). Keep reading to learn about how Blue Cross Blue Shield plans and other group health insurance options are available through eHealth’s online marketplace.

About Blue Cross Blue Shield

The Blue Cross Blue Shield Association is a nationwide network made up of 36 independent and locally operated health insurance companies that provide health coverage to millions of people in every ZIP code and in all 50 U.S. states, the District of Columbia, and Puerto Rico. BCBS plans are a popular choice of health insurance, as demonstrated by the following facts and figures:

  • There are 106 million health plan members insured under Blue Cross Blue Shield.
  • Through their companies, Blue Cross Blue Shield insures one in three Americans.
  • BCBS companies partner and contract with more than 90 percent of the nation’s doctors, hospitals, and specialists, which is more than any other health insurer.

Founded in 1929, the BCBS companies evolved from the country’s oldest health insurance provider by starting with a grassroots approach to prepaid hospital plans that ultimately would have a significant influence on the nation’s health care practices.

Overall, BCBS has distinguished itself through its focus on continuously improving its health care system, meeting the needs of local communities, and creating customized products and services.

Blue Cross Blue Shield plans are widely adopted

BCBS is notable for its scale, structure, and history. Here are some other relevant facts about BCBS’s role as a major health insurance company with national coverage and widely adopted health plans.

  • In the National Association of Insurance Commissioners (NAIC)’s most recent annual report, Blue Cross Blue Shield’s insurance market share in California, which has most significant market share compared to BCBS in all other U.S. states, was 1.69 percent.
  • When added together, the sum of BCBS and all of its local subsidiaries actually form a much larger part of the national health insurance company market share.
  • BCBS was rated “among the best” for J.D. Power Member Satisfaction Index Rankings in Massachusetts.
  • The BCBS Federal Employee Program insures over 5 million federal employees, retirees, and their families.

With the availability of health care plans across the country and a wide range of health coverage choices, BCBS is among the most trusted and reliable health insurance companies on the market.

Using eHealth to find BCBS small business health insurance

Many small businesses use Blue Cross Blue Shield for group health insurance plans. In fact, BCBS companies insure 7.3 million people who work for small businesses.

eHealth makes it easy to shop for small business plans available from some of the best health insurance companies, including UnitedHealthcare, Aetna, Kaiser Permanente, Anthem, Humana, Cigna, Wellcare, Highmark, and Health Care Service Corporation (HCSC). eHealth allows you to compare group plans from these companies and more, all in one place.

Shopping for group health insurance plans through eHealth’s marketplace gives you the advantages of:

  • Customized Group Health Quotes – With eHealth, you can find the best selection of personalized quotes for your company based on your budget and coverage preferences.
  • Useful Group Plan Comparisons – You can compare a variety of options for group plan rates and benefits by choosing from multiple leading, brand-name health insurance companies.
  • World-Class Customer Service – eHealth’s licensed agents can help answer your questions, give unbiased advice, and provide ongoing support after you purchase your group health plan.

eHealth’s website and representatives can help you find small business health insurance from Blue Cross Blue Shield and other top health insurance companies. Visit eHealth today to see if BCBS group health insurance coverage is available in your area.

Small Business Health Insurance: Costs Per Employee

Updated June 20, 2019

As an employer considering the cost of small business health insurance, you may have questions about the cost per employee through group plan coverage. While the cost of employees depends on what small business health insurance plan you choose, the good news is that group health insurance plans are generally cheaper than individual health plans.

The cost of small business health insurance depends on the plan you choose

As per the Affordable Care Act (ACA), if you have less than 50 full-time or full-time equivalent employees, you have the option of whether or not you decide to offer group insurance coverage. If you do choose to offer a group plan to your employees, you should know that the cost and related cost per employee partially depends on the type of group plan you choose. Different small business health insurance plan types have different metal levels, meaning that each plan has corresponding different monthly premiums and annual deductibles.

For example:

  • A group plan with a low monthly premium and high annual deductible may allow you to save more up front, and could mean a lower cost per employee.
  • A group plan with a high monthly premium and low annual deductible may result in a higher cost per employee, but may make sense depending on the needs of your workers.

The preferences and anticipated healthcare needs of your employees may also influence your choice of group plan and your cost of small business health insurance. Relatively healthy employees might choose plans with lower premiums, while employees who tend to visit the doctor more often for prescriptions or treatments might choose higher premium plans. Either way, your cost per employee may vary.

Group plans may be less expensive than individual plans

According to a recent eHealth report, small business health insurance plans have lower average per person costs compared to coverage in the individual market.

The report found that, in 2018, the average premium per person was 7 percent lower with a small business plan than the average premium for an individual plan, and that group plan deductibles were 31 percent lower per person than for individual coverage.

Source: eHealth 2018 Small Business Health Insurance Report

The eHealth report also found that:

  • Average group insurance premiums decreased – Average per-person premiums for small business health insurance plans decreased by 2 percent between 2017 ($416) and 2018 ($409).
  • Group size can affect premiums – In 2018, groups with 5 or less employees had an average monthly premium of $419 per covered person, while groups with 6 to 29 employees had an average monthly premium of $364 per covered person, or 13 percent less.
  • Group plans have remained stable – While average premiums for individual coverage increased 54 percent between 2015 and 2018 (from $286 in 2015 to $440 in 2018), average per person premiums for small business coverage increased only 5 percent during the same period.

Overall, small business health insurance plans have shown substantially more premium stability than individual coverage while also maintaining lower costs per person.

Why are group plans usually less expensive than individual plans?

Generally, small business health insurance plans are cheaper than individual plans, partially because of the advantage of having a larger risk pool. This means that when a larger amount of people are enrolled in a group health plan, the risks are more evenly spread out across all members of the group. Since group plan members pay monthly premiums to maintain their coverage, there is more money available for the health insurance company to draw from when someone enrolled in the plan needs medical care. Because of these reasons, choosing small business health insurance may result in better pricing and a lower cost per employee.

Dependents and the cost of small business health insurance

Another factor that influences the cost of small business health insurance and the cost per employee is whether dependents are part of the group plan. It is important to know that most small business health insurance plans usually allow the addition of qualified dependents. However, it is your choice as an employer whether or not you decide to pay for the employee dependents’ health insurance.

Whether or not you contribute to dependents’ premiums, your employees can still add their dependents to the group plan. Providing a group health plan that includes dependents can benefit your company and employees while protecting yourself and your family.

Cost sharing can mean lower cost per employee

You should know that premiums will not represent your company’s actual cost of small business health insurance. Since group plans are employer-sponsored coverage, both the employer and employees split the cost of monthly employee premiums between them. This is called cost sharing for small business health insurance. Cost sharing lowers the price for individuals in a group health plan because both the business owner and employees contribute to the cost of small business health insurance.

Tax credits and tax deductions can also reduce the financial impact of cost sharing and premiums for your company. Overall, you can likely offer better health benefits to employees for less money through a group plan.

Finding affordable small business health insurance

For help with figuring out your cost of health insurance and cost per employee, you can quickly find competitive premium quotes through eHealth’s online quote form. You can also speak with one of eHealth’s licensed health insurance agents. Our specialists can assist you with determining your cost per employee through a group health plan, and we can help you find the right plan for your budget and preferences.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

Everything You Need to Qualify for Small Business Health Insurance

Wondering what you need to qualify for small business health insurance? If you have full-time or full-time equivalent employees, it’s generally easy to qualify for small business health insurance, and you may even potentially qualify for a small business healthcare tax credit.

Continue reading to learn everything you need to qualify for small business health insurance.

How to qualify for small business health insurance

Essentially, you need to satisfy two main requirements to qualify for small business health insurance. They are:

  • Having at least one qualified full time or full-time equivalent employee besides yourself
  • Legally being considered a business according to your state’s regulations

The Affordable Care Act (ACA) considers a “small employer” to be a business with 1 to 50 employees, so your small business would meet that requirement by having at least qualified one employee, besides yourself or a spouse.

You can use certain forms of documentation to prove to health insurance companies that you are a business with an office or work site in your state. Examples of records that could help with your approval for small business health insurance include:

  • Your articles of incorporation
  • Your current business license
  • Your recent full business tax return

Who is considered an employee?

As the small business owner, you need at least one employee besides yourself to qualify for small business health insurance. Specifically, your workers must be full-time or full-time equivalent employees.

Generally, as per IRS standards:

  • Full-time employees are employees who work for you at least 30 hours per week.
  • Full-time equivalent employees are non-full-time employees, who, in combination, are the equivalent of a full-time employee.

For small business health insurance purposes, your employees must also pass the common-law test. As per the IRS, a person who works for you would pass the common-law test if you as the small business owner have control over both:

  • The work that person does
  • The way they go about doing the work.

So, a worker is considered to be your small business employee if you control both their production process and the finished product of their work.

Who is not considered an employee for small business health insurance?

Who doesn’t count as a small business employee based IRS standards and the common-law test?

  • Most contractors are not considered common-law employees since you usually don’t have any oversight over how they do a job.
  • A spouse is not considered a small business employee for health insurance purposes.
  • A sole proprietor with no employees would not qualify for small business health insurance.

Although you can choose to offer group health insurance to part-time or seasonal employees, it is important to know that they will not count toward the number of employees you need to have in order to qualify for small business health insurance.

How to qualify for a healthcare tax credit

The ACA created the healthcare tax credit to help small businesses cover the cost of group health insurance for their employees. As a small business owner, you can qualify for a healthcare tax credit if:

  • You have 25 or less full-time or full-time equivalent employees.
  • You pay an average annual salary less than or equal to $50,000 a year, adjusted for inflation.
  • You purchase your insurance coverage via the Small Business Health Options Program (SHOP) Marketplace or through a licensed agent, like eHealth, who can enroll you in a SHOP plan.

If you are a qualified small business owner, then you may receive a healthcare tax credit of up to 50 percent of the amount that you pay (at least 50 percent) toward the monthly health insurance premiums of your employees.

Small business health insurance may offer significant tax advantages

Even if you don’t qualify for the healthcare tax credit, offering group insurance coverage can still mean potential tax advantages as well as cost savings.

As a small business owner, you are usually able to deduct 100 percent of the health insurance premiums you pay on qualifying group health plans from your business taxes, which can help you offset the costs of contributing to employee premiums. Offering group health insurance as part of a total compensation package may also result in reduced payroll taxes.

Another advantage of small business health insurance is that enrolling in a group plan often has lower costs per individual and better pricing than each employee purchasing his or her own individual or family plan. Also, through group health plans, employees may be able to pay for their share of premiums with pre-tax dollars, meaning that your employees can benefit from tax savings as well.

eHealth’s licensed health insurance agents can answer your questions about qualifying for small business health insurance and can guide you through the application process. With no broker fees and no obligation to enroll, eHealth makes it easy shop for customized group health insurance plans. Overall, eHealth can help you find affordable small business health insurance for you and your employees.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

What Is a Family Health Insurance Plan?

How are family health insurance plans different from other plans?

Shopping for a family health insurance coverage may be daunting, however family plans are very similar to individual health insurance plans. Think of a family health insurance plan as an individual plan only with dependents added to the policy.

What you should know about the typical costs for family coverage

As with all insurance policies, there are a few different kinds of costs to consider while shopping:

  • Premiums: Premiums are the monthly payments you make in order to stay enrolled in your family plan. In 2018, the average cost per month for family coverage was $1,168.
  • Deductibles: Your deductible is the amount of money you have to pay out-of-pocket before your health insurance takes over payment. After you’ve reached this amount of money, your family health insurance will pay for any other health care you receive that year.
    With family health insurance you generally have two types of deductibles: family and individual. You must reach either the individual or family deductible before your family health insurance kicks in.
    On average, family health insurance plans had a deductible of about $8,232 in 2018, according to eHealth.
  • Other various costs: There are a few other costs – like copayments, coinsurance, and out-of-pocket maximums – associated with family coverage that you need to consider when looking for a policy.
    A copayment is a fixed amount of money you pay for a covered service which either come into effect before or after you’ve reached your deductible. Coinsurance is a percentage you pay for covered services after you’ve reached your deductible until you’ve reached your out-of-pocket maximum.
    After you hit your out-of-pocket limit, your family health insurance will pay for 100% of the cost of your covered benefits for the rest of the year.

What to keep in mind while shopping for coverage for your family

When you shop for coverage, you have more to consider than if you were shopping for individual coverage.

While a plan with a low premium and a high deductible might seem appealing at first, you must consider that you’re shopping for health insurance for your children or other dependents. When it comes to buying health insurance for kids, you may want to consider looking for a family plan with a higher monthly premium and a lower deductible since you have several people’s healthcare needs being covered under one plan.

If you have a larger family than a four-person household, you can expect your insurance to be more expensive overall, however you may end up paying less per person. You’re also likely to pay less per person if the members of your family are in good health. In this case, it’s smart to get an insurance policy that covers preventative care to keep your family healthy and costs lower in the long run. Additionally, you’re likely to pay less if you’re getting your insurance through an employer.

While family coverage may seem expensive, your finances can be impacted by unexpected medical expenses if you do not have health insurance for you and your family. If you have trouble affording health insurance there are programs and incentives that help you keep your family covered.

  • ACA Subsidies: The Patient Protection and Affordable Care Act, also known as Obamacare, provides tax credits for those who have difficulty affording health insurance. In general, the lower your income and the larger your family the greater tax credit you’ll qualify for.
  • CHIP Plans: The Children’s Health Insurance Program, also known as CHIP, is a federal-state collaborative effort to provide free or inexpensive health insurance for families with children. Requirements are different in every state, however you will usually qualify for CHIP if you make too much money to qualify for Medicaid but have an income 200% below the poverty line.
  • Other coverage options: There are other state programs that are specifically for families that have a difficult time affording health insurance. If you are at least a family of four, with an income of less than $99,000 a year you should qualify for some state or federal assistance.
    If you need coverage for a short amount of time or quickly, there are short-term health insurance plans available. While you will not be receiving the same level of coverage as major medical plans, you will have some coverage at a low cost and fairly quickly with some applicants getting approved next-day.

eHealth offers wide access to many health insurance plans for families. Take a look at family health insurance plans today to find what coverage is right for you.

Tips for New Small Business Owners

Being a new small business owner means that you get many exciting opportunities to build foundations for future success. The experience and adventure of entrepreneurship can be rewarding as well as challenging, especially when you are first starting out as a new small business. Learning to prioritize certain goals can help you create a successful small business while staying focused on the big picture.

Continue reading to learn the top 5 tips for your new small business, including advice about impactful marketing, effective employees, and the value of offering small business health insurance.

1. Promote your new small business through marketing

Marketing not only plays a crucial role in increasing awareness about your business; it can also serve as a powerful call to action for your target audience.

  • Online reviews – Customer reviews from apps and websites like Yelp and Google reviews can help to position your new small business as the go-to source for your product or service.
  • Referrals – People tend to value advice from trusted friends and peers, so getting referrals can be an amazing tool for generating new business at practically no cost to you.
  • Digital communications – You can share announcements and updates about offers, discounts, and events with your audience through your website, email newsletters, and social media.
  • Networking – Building relationships with other entrepreneurs is another excellent form of business development that allows you to stay on the pulse on current trends in your industry.

Memorable and effective marketing can turn out to be a worthwhile ROI (return on investment) by adding credibility to your new small business while also creating a growing community of satisfied customers and clients.

2. Create a budget for your new small business

New small business owners can face a variety of expenses, and getting organized early on by creating a comprehensive budget can help you stay on track to achieve your goals as a successful business.

Here are key expenses to prioritize and keep in mind:

  • Location expenses include the cost of rent, permits, licenses, related taxes, and maintenance.
  • Resource expenses include supplies, materials, equipment, and technology.
  • Administrative expenses include inventory, accounting services, and legal counsel.

You should also leave a significant amount of room in the budget for unanticipated costs which may be part of any new small business undertaking. This can help save you from financial headaches later on.

3. Focus on your niche by outlining clear goals

Starting a new small business can seem overwhelming at times, which is why you shouldn’t try to do everything at once. By taking the time to outline realistic quarterly, short-term, and long-term goals, you can better steer the course of your new small business by concentrating on what matters most.

Blocking out clear objectives can also help you focus on your specialization as a new small business, especially in terms of clarifying the value of the primary solution, product, or service you provide:

  • Value – By understanding the one key area that your new small business does really well in, you can better organize your resources to deliver the best quality experience for your customers.
  • Simplicity – By keeping your idea for a small business simple and straightforward, you can avoid unnecessary costs and complications that might hinder the growth of your new small business.

4. Give your employees the opportunity to succeed

Thinking you can do it all alone is one of the common mistakes small business owners should avoid. Although you might feel the need to manage all aspects of your new small business, you may not have the time or energy to meet all of the competing demands or unexpected challenges you may face.

This is where your employees come in. Transferring responsibilities to your employees can give your new small business the structure and autonomy it needs to flourish. Be sure to consider:

  • Training – Investing the time in training your employees well at the beginning will better position both your workers and your new business for future success.
  • Delegation – Delegating responsibilities as much as possible to employees will allow you as the new small business owner to stay focused on the big picture while minimizing distractions.
  • Motivation – Understanding what motivates your employees can help enhance their productivity and improve their performance as they help your business grow over time.

5. Offering health insurance can help you get quality employees

Health insurance is one of the top benefits most valued by employees, and the availability of health plan benefits could even make or break a prospective hire’s decision to join your new small business.

Providing employer-sponsored group health insurance coverage in a total compensation package often serves as a compelling incentive to potential employees. Many small business owners decide to offer small business health insurance coverage because it helps them to recruit and retain the best workers, as well as promote healthy practices, such as going to annual checkups.

Overall, offering small business health insurance can be an effective hiring strategy, allowing you to find the top talent available to help your business thrive, grow, and succeed.

The next steps for new small business owners

Starting a new small business isn’t easy, but the effort involved is often worthwhile. eHealth is here to support your journey as a new small business owner, and we can help you find an affordable small business health insurance plan that works best for you and your employees.

Small Business Health Insurance Costs: Out-of-Pocket Maximums

Understanding all the costs associated with your small business health insurance plan is a great way to ensure you’re using your plan to its best abilities.

In addition to monthly premiums and annual health insurance deductibles, out-of-pocket maximums are a significant part of selecting a small business health insurance plan that works for you and your employees.

What are out-of-pocket maximums?

An out-of-pocket maximum is the annual limit on how much you are responsible for sharing medical costs with your insurance company under your health insurance plan. The out-of-pocket maximum limit does not apply to your monthly premiums, balance-billed charges from health providers outside of your network, or services that your plan does not cover.

As part of the cost-sharing required by a group health insurance plan, the health insurance deductible and copayments or coinsurance that your employees pay all go toward meeting their out-of-pocket maximums. After your employees have spent their group health plan’s out-of-pocket maximums, the insurance company will usually pay for the rest of the plan year’s cost of covered medical services.

It is important to remember that your employees will continue to pay their portion of monthly premiums, even after they have met their out-of-pocket maximums, in order to stay enrolled in your group health insurance plan. Also, in most small business health insurance plans, there is usually no copayment for covered medical services after employees have met their out-of-pocket maximums. However, all group plans are different, so be sure to review the full details of each plan.

Determining out-of-pocket maximums for small business health insurance plans

Your out-of-pocket maximums may vary depending on the type of small business health insurance plan you choose, and they can usually be understood based on how much you pay toward employee premiums and how often your employees visit the doctor.

Generally, small business health insurance plans with lower out-of-pocket maximums tend to have higher monthly premiums, and small business health insurance plans with higher out-of-pocket maximums will likely have lower monthly premiums.

The health care needs of your employees also play an important role in determining what their out-of-pocket maximums might be.

  • If your employees are relatively healthy and do not visit the doctor very often, they might choose plans with lower monthly premiums and a higher annual deductible. This is because they might not meet the out-of-pocket maximums to benefit from the resulting full coverage of covered medical costs from the insurance company for the rest of the plan year.
  • Conversely, employees who require doctor’s visits, treatments, and prescription medications might choose plans with higher monthly premiums and a lower annual deductible, allowing them to more easily meet out-of-pocket maximums and benefit from the resulting full coverage of covered medical expenses from the insurance company for the rest of the plan year.

As a small business owner, offering several group plans with different out-of-pocket maximums can give your employees the flexibility to choose the plan that best fits their individual health care needs.

Additionally, being enrolled in a small business health insurance plan can mean lower premiums per employee and lower annual deductibles than through an individual health insurance plan.

Out-of-pocket maximums in perspective

Out-of-pocket maximums are important considerations for your small business health insurance plan. It is useful to understand how out-of-pocket maximums relate to premiums and deductibles, especially when employees evaluate their anticipated annual medical expenses and coverage preferences.

To learn more about how you and your employees can potentially save money by enrolling in an affordable small business health insurance plan, visit eHealth today.

This article is for general information only and not intended to provide any tax or legal advice. Always consult your tax and legal advisors to understand your specific tax and compliance situation.

Small Business Health Insurance Deductible

Updated June 10, 2019

Whether you’re looking for a new small business health insurance plan or trying to understand your current one better, it’s important to know the various costs associated with the plan.

In addition to premiums and out-of-pocket maximums, health insurance deductibles serve as an important area to consider when choosing a small business health insurance plan.

What is a health insurance deductible?

A health insurance deductible is the annual dollar amount you may be required to pay out of pocket before your insurance company begins to make payments for your medical claims. Most people know about the health insurance premium, because this is the price that you pay every month, regardless of whether or not you used health care services; it’s important to know that this cost does not count toward your deductible.

Not all plans require a health insurance deductible. For instance, although there are many exceptions, HMO plans usually do not require a deductible, while the majority of PPO and indemnity plans do.

If possible, it is recommended that you choose a health insurance deductible that is no greater than 5 percent of your gross annual income.

Determining your annual health insurance deductible

The cost of your health insurance deductible will depend on your small business health insurance plan. A convenient way to think about annual health insurance deductibles for your small business is to look at them in relation to your monthly premiums.

  • If you want spend less on health insurance upfront, then choosing a plan with a higher annual health insurance deductible can allow you to keep your monthly premiums lower.
  • If you don’t mind paying more upfront and less when using medical services, then selecting a plan with a lower annual deductible may be a good choice for you and your employees.
  • Keep in mind that you should look for an affordable health insurance deductible in case of medical emergencies.

Another similar yet useful way to look at health insurance deductibles is to review the metal levels of each plan.

  • Small business health insurance plans with higher metal levels, like gold plans, usually have a lower annual health insurance deductible but higher monthly premiums.
  • Small business health insurance plans with lower metal levels, such as bronze plans, usually have lower monthly premiums but higher annual health insurance deductibles.

Health insurance deductibles in a small business context

Choosing a health insurance deductible for your small business health insurance plan will often depend on the anticipated health care needs of your employees. For example, an employee with frequent medical costs from prescription drugs and office visits might select a plan with a low health insurance deductible, since they would be able to meet the deductible fairly quickly. He or she would then be able to split covered medical costs with the health insurance company through co-insurance for the rest of the year.

Conversely, a relatively healthy employee with minimal medical costs might choose a plan with a high health insurance deductible and low monthly premiums. For instance, the employee might not meet a $1000 health insurance deductible if he or she only spends a few hundred dollars annually on medical expenses, so this high-deductible plan would allow them to save money though lower premiums.

Health insurance deductibles may be more affordable through a group plan

Group coverage for small businesses can often be less expensive per person than an individual insurance plan. This is usually due to the larger risk pool advantage found in group coverage, since risks are spread across all members of a medical plan.

According to an eHealth report on small business health insurance, the national average small business plan deductible was 31 percent lower than the national average deductible for plans in the individual market in 2018. Average plan prices in 2018 were as follows:

  • Deductible for small business coverage: $3,140
  • Deductible for individual coverage: $4,578

Enrolling in a group plan for your small business health insurance can cover everyone together under one policy and can also help you and your employees save money with lower annual costs for health insurance deductibles.

Health insurance deductibles in perspective

Understanding health insurance deductibles can help you choose the right small business health insurance plan for you and your employees. In addition to health insurance deductibles, you should also review monthly premiums and out-of-pocket maximums when deciding on a group plan. Overall, selecting a group plan with lower annual deductibles may be able to save money for your small business.

Visiting eHealth’s website today or speaking with eHealth’s licensed health insurance agents can help you find the best small business health insurance plan based on your budget and coverage preferences.

Always consult your tax and legal advisors to understand your specific tax and compliance situation. This article is for general information and not intended to provide any tax or legal advice.