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

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.

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.

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.

Small Business Health Insurance Premium

Some people may not know that there are several costs to understand when it comes to health insurance plans.  The premium is the first major element of selecting a small business health insurance plan, and the cost of premiums serves as an important consideration for both the employer and employees.

Continue reading to learn about how monthly premiums form an important part of your small business health insurance plan.

What is a health insurance premium?

A health insurance premium is the total monthly cost for having coverage through a health insurance plan. Your premium is paid directly to the health insurance company that provides your coverage. For group health insurance, the employer fully or partially pays the premium on behalf of employees and their dependents.

Health insurance plan prices are fixed by law, and premiums are set by insurers based on some of the following factors:

  • location
  • ages of the employee group
  • coverage levels
  • features specific to each plan

The cost of monthly premiums depend on the type of small business health insurance plan you choose, although they can generally be considered relatively high or low based on the plan’s annual deductible.

  • If you and your employees want to save more upfront, then you may want to select a plan with a lower monthly premium and higher yet still affordable deductible in case of an emergency.
  • If you and your employees prefer to pay more upfront and less when you use medical services, then you may want to consider a plan with a higher monthly premium and correspondingly lower annual deductible.

High premiums vs low premiums for group health insurance

Choosing a plan with lower monthly premiums might make sense for your small business if your employees are relatively healthy and do not need to visit the doctor frequently.

Conversely, a small business health insurance plan with higher monthly premiums could be a better investment if your employees anticipate the need to see the doctor pretty often. Overall, you should try to find an affordable balance between a monthly premium and an annual deductible that works for as many of your employees as possible.

Premiums are split between employer and employee in group plans

Since group health insurance coverage is sponsored by the employer, small business health insurance premiums are generally split between employer and employee. This means that both the employer and employees typically share the cost of premiums, with employers in most states usually being required to pay at least 50 percent of monthly employee premiums.

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

  • If you have less than 50 full-time or full-time equivalent employees, it is optional to offer group health insurance coverage; however, if you do decide to offer group coverage, you may qualify for a tax credit toward cost sharing related to paying for premiums.
  • If you have 50 or more full-time or full-time equivalent employees, you are required to pay at least 60 percent of their monthly premiums. The cost sharing arrangement cannot make employees contribute more than 9.86 percent of their household income toward premiums.
  • Pre-existing medical conditions will usually not affect the cost of premiums.

Premiums per individual may be more affordable though a group plan

One of the major benefits of small business health insurance is that premiums per individual might be more affordable since there is a larger risk pool. This means that when more people pay into the plan through monthly premiums, there is a larger amount of money available for the insurance company to draw from when one of the enrolled members needs medical care.

Since risks are spread out across all members of a group health insurance plan, this tends to lower the overall cost of monthly premiums per individual member. Thus, premium costs for employees might be more affordable through a group health insurance plan, rather than through buying an individual plan for themselves.

Small business health insurance premiums in perspective

It is important to understand the role of premiums in small business health insurance. Although reviewing premiums should be your starting point, you should also consider annual deductibles and out-of-pocket costs as well. While the cost you pay for premiums will depend your coverage and benefit preferences, enrolling in a group health insurance plan may be able to save money for you and your employees through cost-sharing and lower premiums per individual.

To learn more about affordable small business health insurance plans, visit eHealth today.

Small Business Health Insurance Brokers

Wondering if you should use a broker to shop for small business health insurance plans? Brokers can clarify your questions about group health coverage while educating you about the most optimal options available.

Keep reading to learn about how an experienced health insurance broker like eHealth can help you find the right group plan for your business.

Will using a broker cost more money?

Using eHealth does not come at any extra cost to you. You’ll benefit from using our tools, resources, helpful agents, and easy shopping and enrollment processes for free.

Additionally, the law sets prices on health insurance plans, and brokers have to abide by government and state regulations, which means that brokers cannot raise the price of group plans.

Why use a broker when shopping for health insurance?

A health insurance broker serves as an intermediary between you as a small business owner and health insurers, helping to match you with a health insurance plan or company best suited to your needs.

  • The major difference between a health insurance broker and a health insurance company is that brokers have the freedom to offer plans from across the entire small business health insurance marketplace, instead of being limited to options from just one health insurance company.
  • The licensed agents who work for health insurance brokers can answer your questions and connect you to small business health insurance plans that meet your preferences regarding monthly premium and annual deductible costs, network coverage, and additional benefits.

Although all health plan prices are fixed by law and government regulations, meaning that a health care broker cannot reduce prices, the value of working with a broker’s agent is that he or she completes all the groundwork for you. Licensed health insurance agents can help you look at a variety of plan options offered by multiple companies that fit your budget and price range.

If you buy a plan through a health insurance broker, the services of the agent do not cost you anything, so you can generally be confident that there is no incentive for the agent to favor one company or plan over the other.

Overall, using a health insurance broker allows you to shop around and explore more options for group coverage to see if you could save money for your small business.

Using eHealth as a broker for small business health insurance

If you choose to use the services of an agent who works for a health insurance broker like eHealth, then that broker will help you find affordable group plans from multiple insurance companies.

Using eHealth as an insurance broker makes it easy to set up your small business health insurance:

  • No Broker Fees – Whether using our online marketplace or speaking directly with our licensed health insurance agents, it is free to shop for small business health insurance quotes through eHealth with no additional cost to you, since we do not charge any broker fees.
  • Unbiased Advice – Since eHealth is a health insurance broker and not an insurance company, we can provide unbiased insights related to group coverage. By offering plans from more than a single insurance company, our agents concentrate on finding you the right plan for your small business, rather than promoting any particular type of plan or company.
  • Convenience – View all of your insurance options in one place through the eHealth website, comparing plans from different companies to find the best solution for you and your employees. eHealth’s agents are available year-round to resolve your small business insurance questions.
  • Advocacy – If you decide to buy a small business health insurance plan, eHealth’s free support will still be available during the entire duration of your coverage. For instance, our agents can help you interact with your health insurance company in dealing with coverage or billing issues.

As a health insurance broker, eHealth provides you with the assistance, information, and resources you need to make the best decision regarding group health insurance, and our licensed insurance agents are committed to helping you find the right plan for your small business. Visit us today at eHealth.com.

Where to Find Health Insurance Quotes

You can find health insurance quotes online through both private and government-run health insurance marketplaces. In accordance with the Affordable Care Act (ACA), health insurance marketplaces such as eHealth make it easy for individuals and families to compare insurance quotes, review insurance companies, and enroll in a plan that meets their personal medical needs and budget.

What is a health insurance marketplace?

A health insurance marketplace is a website where individuals, families, and small businesses can shop for health insurance plans by comparing price quotes and choosing the best option for their needs.

By visiting a health insurance marketplace, individuals and families can more easily:

  • Discover individual health insurance plans based on affordability and coverage.
  • View and compare health insurance quotes without making phone calls.
  • Ask questions and find answers about the specifics of both individual and family health insurance plans.
  • Review health insurance companies to learn more about their reputation, services, and network of local doctors.
  • Learn more about tax credits for both health programs and private insurance.
  • Enroll in a health insurance plan that is tailored to your specific preferences.

What is the difference between finding quotes on private and government-run marketplaces?

Both private and government-run health insurance marketplaces can help you find quotes for an affordable health insurance plan. Private marketplaces, such as eHealth, make finding and comparing health insurance quotes as easy as visiting their website, answering a few questions, and receiving a quote in minutes. Private marketplaces may have plans not available on government-run marketplaces.

You can buy Obamacare plans and other health insurance products through eHealth’s online marketplace. You can also receive expert support and advice from eHealth’s licensed and unbiased agents by contacting them by phone, email, or through the eHealth website’s chat feature.

How to find affordable health insurance quotes using a private health insurance marketplace

Private health insurance marketplaces have made finding affordable health insurance quotes more convenient and accessible than ever before. Designed to help you find individual health insurance plans and family health insurance plans in just minutes, private marketplaces allow you to compare health insurance quotes and offer a variety of benefits, including:

  • Flexibility – You can find the plan that best fits the current and future medical needs of you and your family.
  • One Stop Shopping – You can easily weigh all of your quotes and options on one website before selecting the best plan.
  • Custom Search – You can choose plan quotes based on affordability, coverage, flexibility, and tax credits (if applicable).
  • Cost Savings – You can avoid spending extra money by working with a private health insurance marketplace that does not charge any broker fees.
  • Peace of Mind – You can ensure that you and your family have the right health insurance plan for when you need it most.

Purchasing personal health insurance is easier when you compare health insurance quotes

Whether you have recently started working at a new company or are transitioning between jobs, you do not want to be left unprotected. By using a private health insurance marketplace, you can easily compare health insurance plans so that you and your family remain safe in the event of an unexpected injury or illness.

If you are looking for where to find health insurance quotes, private health insurance marketplaces, such as eHealth, can help you find the plan that best fits your unique medical needs. From choosing the most affordable plan to selecting a plan with the top health insurance companies, eHealth makes it easy for you to get free online quotes, compare plans, shop, enroll, pay, and discover if you qualify for subsidies. Find the health plan that is right for you and your family by visiting eHealth today.

Is a Sole Proprietor a Small Business?

Although a sole proprietorship is the simplest way to structure a small business, you may be unsure how being a sole proprietor affects your health insurance options. If your sole proprietorship has employees, then you may be able to qualify for group health insurance. Keep reading to learn more about your options for health insurance as a sole proprietor.

What is a sole proprietorship?

The Small Business Administration defines a sole proprietorship as an unincorporated business owned and run by one individual, with no distinction between the business and the owner. The sole proprietor is entitled to all profits and is personally responsible for all of the business’s debts, losses, and liabilities.

  • For tax purposes, the income of the sole proprietorship is the income of the owner, because the owner and his or her business are considered one and the same.
  • You should know that a sole proprietorship, even if operated under a fictitious name or trade name, is not considered a separate legal entity. Instead, it means the person who completely owns the business.
  • The IRS explains that if you are the sole member of a domestic limited liability company (LLC), you are not a sole proprietor if you elect to treat the LLC as a corporation.

Can a sole proprietorship be defined as a small business?

Since the sole proprietorship and its owner are considered identical, a sole proprietor can generally be defined as a small business when it comes to qualifying for a small business health insurance plan; however, if you have no employees but yourself, then your sole proprietorship will likely not qualify you for a group plan.

Like other small business owners, sole proprietors do have the ability to hire employees. As per the IRS, any time a sole proprietor hires an employee other than an independent contractor, the sole proprietorship will need to obtain an Employer Identification Number (EIN). When working without employees, the sole proprietor’s Social Security number identifies the company for tax purposes.

Can sole proprietorships get small business health insurance?

No, sole proprietors usually do not qualify for group insurance, unless the sole proprietorship includes at least one full-time equivalent employee.

To qualify for a group insurance plan, your sole proprietorship would need to have one common-law, or full-time equivalent employee beyond yourself, your spouse, or any independent contractors. Otherwise, without one qualified employee, the sole proprietor can only get individual health insurance from the health insurance marketplace or a licensed insurance agent.

What is a common-law employee?

According to the IRS, under common-law rules, anyone who performs services for your business is considered to be your employee (instead of a contract worker) if you control both what must be done and how something must be done.

Based on the business’s degree of control and oversight, the IRS mentions three general considerations to find out if the person providing a service is an employee or an independent contractor.

  • Behavioral: Does the business have the right to control what the person does and how the person performs his or her job?
  • Financial: Are the business aspects of the person’s job (including pay, reimbursements, and tools and supplies provided) controlled by the business?
  • Type of Relationship: Are there written contracts or employee type benefits, such as a pension plan, insurance, or vacation pay? Will the working relationship continue, and is the work performed a significant part of the business?

What are the qualifications for small business health insurance?

In addition to being registered as a business based on your state’s regulations, you do need to have at least one employee in order to qualify for small business health insurance. You must also contribute to paying for employees’ monthly premiums as a business owner.

As per the employer mandate in the Affordable Care Act (ACA):

  • It is optional for businesses with less than 50 full-time or full-time equivalent employees to offer group insurance plans, although they can decide to offer a group plan and may qualify for a tax credit to assist with cost sharing.
  • Businesses with over 50 full-time employees are required to provide group plans to their employees and pay at least 60 percent of premiums in their cost sharing solution.

Whether or not you have employees as a sole proprietor, you can find both individual and group health insurance plans that fit your budget and preferences 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.

How to Start a Small Business

Starting a small business can be a time of both excitement and uncertainty. As a new or prospective small business owner, you may have questions about planning, finances, and costs like small business health insurance.

Here are 5 steps on how start a small business the right way.

1. Start with research

Once you have an idea for your business, you should gain insight into how your product or service will fit into the current market. Key questions to consider during the research and data-gathering stage include:

  • What does the local and regional market landscape look like for your industry?
  • Who will your customers or clients be? How would you target and appeal to their needs?
  • What is the competition? And how would you differentiate your business?
  • How would technology, weather, and seasons impact or influence your small business?

By taking the time to carefully and realistically evaluate the advantages and disadvantages of your business idea, as well as thinking about external opportunities and challenges, you can set yourself on the right path toward starting your small business.

2. Move forward with a business plan

After conducting your initial research, you need to create a business plan that will structure your work as you establish your small business.

  • What is your unique value proposition? What do you bring to the table that others don’t?
  • What is your mission and purpose? What are your guiding principles?
  • How will you become profitable? What are your quarterly business goals?
  • How will you market and promote your business? How will you demonstrate credibility?
  • What are your short-term objectives? What is your long-term strategy?

3. Determine finances and organization

Next, you should review the financial, administrative, and logistical considerations of managing your business.

  • Will your business need additional capital or financing from a loan or outside investment?
  • Will your business be a corporation, limited liability company (LLC), sole proprietorship, or partnership? What are the related tax implications? What permits and licenses are needed?
  • What accounting systems and processes will you use? Will you need to manage inventory?
  • Where will your business be located? What is the property lease? Will you need to invest in materials or equipment?

4. Hire employees and build a team

Depending on your business, you may or may not need to hire employees. If you do, here are some relevant questions to consider.

  • How many employees will your small business have?
  • What roles and positions need to be filled?
  • How many will be full-time or part-time employees?
  • Will they be compensated hourly or with salaries?
  • Will you use independent contractors?
  • Do you need outside legal or accounting advisors?

5. Deciding on a small business health insurance plan

Thinking about health insurance benefits is an important part of starting a small business. First, you should determine whether or not you are required to offer group health plan coverage.

As per the Affordable Care Act (ACA) employer mandate:

  • Businesses with less than 50 full-time or full-time equivalent employees are not required to provide group health insurance, although they can choose to offer coverage and may qualify for a tax credit to help with cost sharing.
  • Businesses with over 50 full-time employees are required to provide group health insurance and pay at least 60 percent of premiums in their cost sharing solution. Note that the employee contribution toward premiums may not be over 9.86 percent of their household income.

How to save money by qualifying for a small business health insurance plan

You may qualify for small business/group health insurance if:

  • You are a small business owner with at least one full-time employee other than yourself
  • You qualify as a business within your state as per your state regulations

Enrolling your business in a group health insurance plan could help save some money for everyone involved. Monthly premiums are typically less per person through a group plan than through an individual or family plan, because risks are spread out across group insurance members.

Small business owner contributions and cost sharing

As a small business owner, it is vital to understand health insurance contributions. Although small business health insurance coverage is sponsored by the employer, both the employer and employees pay for monthly premiums. Also, in most states, there is usually a requirement for employers to cover at least 50 percent of the monthly premium for employees.

Learn more about affordable small business health insurance cost sharing solutions here.

Choosing a small business health insurance plan

If you and your employees decide to go with a group health insurance plan, you have many different choices depending on your needs, budget, and preferences.

  • For instance, do you want to pay more for your insurance up front and less when sick, or vice versa? What medical benefits do you and your employees find most important?
  • Once you decide on what direction you want to go with your group insurance coverage, you can search for plans online through a health insurance marketplace website, and compare plans based on premium and deductible costs.
  • You can find out about the most popular different plan types for small business health insurance, such as HMOs, PPOs, POS plans, EPOs, and HSAs, before you shop for health insurance.

You can also read our small business preparation checklist to help guide you through the process of getting small business health insurance.

Whether you are a new or experienced entrepreneur, there are many factors to consider during the process of starting a small business. If you choose to offer group coverage to your employees, eHealth can help you find the ideal health insurance plan for your business.

Top 5 Reasons to Offer Small Business Health Insurance

Offering small business health insurance provides significant advantages and cost savings for both small business owners and their employees.

Although offering group health insurance is optional for employers with less than 50 full-time or full-time equivalent employees, there are many practical reasons to provide health insurance plans.

Learn about the top 5 reasons to offer small business health insurance.

1. Employee satisfaction and retention

A 2016 Glassdoor survey observed that “The factor with the single biggest impact on employee satisfaction was the quality of employer-provided health insurance plans.” Being enrolled in group health insurance is a core benefit highly valued by today’s employees.

The 2017 eHealth report on small business health insurance trends found that 64 percent of respondents said they offered small business coverage because it helps them recruit and retain top quality employees.

Providing a competitive compensation package that includes group health insurance can help small business owners attract new talent and promote loyalty and satisfaction among current employees.

2. Lower premiums per person

Group plans tend to have better pricing and be less expensive than individual plans, and small business health insurance policies often have lower premiums per person.

According to the 2017 eHealth report on small business health insurance:

  • The national average monthly premium for a small business health insurance plan per person was $397 in 2017.
  • This was 10 percent less than the national average premium of $440 for individual health insurance coverage for consumers not receiving government subsidies.
  • The national average small business plan deductible was 40 percent lower than the national average deductible for plans in the individual market.

Employers typically share premium costs with employees, meaning that employees may find small business group plans to be more affordable than purchasing their own individual or family plans.

3. Healthier employees

Healthy employees are a valuable asset for any business, and offering group insurance plans can help drive employees to perform at their professional best. Healthier employees tend to:

  • Be less absent – Healthy employees will take fewer sick days and be more likely to see the doctor for regular checkups and preventative care visits.
  • Be more productive – With their medical needs met, healthy employees are more likely to remain motivated and focused on their jobs.
  • Be more open – When employees have group health insurance, they will generally be more up front with their employer about any health problems.

By investing in the long-term health of their employees through offering health insurance, employers can gain from the benefits of building a more effective workforce.

4. You and your family can join the plan

Another reason to offer small business health insurance is that your own family can join the group plan. Depending on your situation, your family could join the plan as either dependents or employees (in the case of a family business).

Generally, small group plans allow qualified dependents to be added to any plan. In terms of group plans, it is worth noting that the employer has the choice of whether or not to pay for the dependents’ health insurance. Learn more about who qualifies as a dependent for small business health insurance here.

If you run a family business, you should know that your spouse cannot usually count as your one and only employee. If you have other employees, who may also be your family members, your spouse can generally enroll in the group plan.

5. Tax incentives

The Affordable Care Act (ACA) created the small business health care tax credit to provide incentives for small business owners to offer health insurance to their employees.

For eligible small business owners, the government may give you a tax credit to help you pay for your portion of employee premiums. A licensed health insurance agent can help determine if you qualify for a small business health care tax credit.

You will also likely be able to deduct health insurance costs from your taxes as a small business owner. This deduction could help you lower or offset the cost of contributing to your employees’ premiums.

The potential to save money through tax incentives serves as a major advantage for an employer considering getting coverage for his or her small business employees.

What to know if you decide to offer small business health insurance     

There are many reasons to offer small business health insurance, including the cost savings of lower premiums and tax incentives, as well as the long-term benefits of greater employee job satisfaction and the ability to add family members to a plan.

If you decide that a group plan is the right choice for your company, visit eHealth.com to find the best group health insurance plan for your employees, 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.

Where to Find Group Health Insurance Quotes

Getting started with group health insurance quotes

A group health insurance plan is a health insurance policy that small businesses can provide to their employees. You can find free quotes for group health insurance online at licensed health care marketplace websites like eHealth.

What is a health insurance quote?

A quote is a price for health insurance offered by a licensed broker. No matter where you buy a group health insurance plan, you will pay the same premiums and plan costs for the same plan. This is because prices for health insurance are filed with state authorities annually, meaning that a health insurance plan cannot be sold for a price other than the officially filed price.

As a result, you will not receive a discount if you decide to buy directly from an insurance company. Instead, by going to eHealth’s online marketplace, you can ensure that you find quotes from the full range of health plan pricing options offered by multiple companies.

What is a group health insurance quote?

Group health insurance quotes are for small businesses with less than 50 full-time or full-time equivalent employees. Typically, group health insurance is a single policy that provides coverage for the entirety of the company’s employees and potentially their dependents.

On average, group health insurance often costs less than individual health insurance, since risks are spread across the entire group of employees. A 2017 eHealth study found that the average premium for small group health insurance was $397 per month in 2017, compared to $440 for an individual plan (a difference of about $500 per person per year). The study also found that small group health plans had an average deductible of $2754 per year, versus $4578 for individual plans.

It’s free to get quotes for small business health insurance plans

The value of getting free quotes is that you can easily compare different plans against each other, weighing the pros and cons of each one.

  • Affordable – By adjusting deductible and copayment options for group health insurance plan quotes, you can more easily find affordable monthly premiums for your employees.
  • No Obligation – You are under no obligation to purchase small business health insurance when you get free group health insurance quotes. Also, you are not locked into paying for an insurance plan during this process.
  • Cost Savings – Evaluating multiple insurance companies through quotes empowers you to save money and find the best solution for your budget, needs, and preferences.

The benefits of using eHealth to find group health insurance plan quotes

Visiting eHealth lets you quickly enter information like your zip code and the number of employees with your small business before providing you with group health insurance quotes in just seconds.

  • Easy Comparison – Using eHealth allows you to search for group plans from many different health insurance companies, which you would not be able to do if you were shopping on a specific company’s site. eHealthgives you all the information you need to compare and contrast group health insurance quotes from a variety of reputable companies.
  • No Brokerage Fees – eHealth does not charge any brokerage fees, so you can be confident that you are getting the best group health insurance quotes for your small business. The plans you see at eHealthcost the same as plans elsewhere, as required by law.
  • One Stop Shopping – With eHealth, all your options are conveniently located in one place. You can browse through group health insurance quotes, consider the advantages of plans offered by each company, and even find out if you qualify for the small business health care tax credit, all without leaving the eHealth

Licensed agents can help clarify group quotes

eHealth’s licensed brokers can help you find group quotes from different insurance companies in your area. And if you decide to buy a group health insurance plan through eHealth, you will have access to personalized support and unbiased advice from a licensed agent during the entire time you have your group plan coverage, with no additional cost to you.

It is important to note that the final premium you will pay for group health insurance may change based on your finalized employee count, as well as other considerations unique to your situation. So, looking for group quotes online should be your starting point, followed by working with a licensed agent to provide more refined quotes that give you a better sense of what your final costs may be.

eHealth makes it easy to find group health insurance quotes that fit your budget and preferences. Contact us 24/7 by email, phone, or by using our convenient online chat function, and receive the information you need to choose the best group health insurance for your business.

Plan Types for Small Business Health Insurance

Learn about the top plan types for small business health insurance

When looking at small business health insurance, you can choose from a variety of plan types, including PPOs, HMOs, EPOs, and HSAs. Choosing the right plan for your business and employees will depend on your cost and coverage preferences, and it is important to know what your options are. Learn more about the different plan types for small business health insurance.

What is an HMO plan?

HMO stands for “Health Maintenance Organization.” For small business health insurance, an HMO plan is based on each employee choosing a primary care physician to provide the majority of their health care needs. The primary care doctor coordinates health services within the specific contracted network of the HMO. Your employees might choose an HMO due to the plan’s lower monthly premiums and out-of-pocket costs, as well as the plan’s typically straightforward procedures, since HMO members usually do not have to file claims.

As a highly centralized plan type, HMOs are not as flexible as other plans, and employees will require referrals from their primary care physician if they need to see a specialist. As a type of small business health insurance, an HMO plan is a practical and convenient option for your company to consider if you want your employees to save on health care costs.

What is a PPO plan?

PPO stands for “Preferred Provider Organization.” A PPO plan allows employees to have greater flexibility when choosing their health care services, since PPO members can see doctors outside of their network and do not have to select a primary care physician to coordinate their care. With PPOs, employees can visit any doctor within the network at any time, and do not require referrals in order to see specialists, whom they can visit directly. However, the trade-off for being able to choose from a wider variety of health care options is the cost of having to pay more for using health care services outside of the network.

Employees have to pay higher premiums and out-of-pocket costs with PPOs, and will generally have more paperwork. As a plan type, PPOs may be the right small business health insurance for your company if offering employees more freedom to choose their own doctors is a greater priority than cost.

What is an EPO plan?

EPO stands for “Exclusive Provider Organization.” As a small business health insurance plan type, an EPO allows employees to use all health care providers and specialists without referrals, but typically does not provide out-of-network coverage. Also, EPOs do not require members to choose a primary care physician to coordinate their health care, and EPO plans generally cost less than HMO and PPO plans. For small businesses with employees who want to save money and do not expect needing much medical care, an EPO could be an optimal choice of health insurance plan.

What is an HSA plan?

HSA stands for “Health Savings Account,” which is a specially designated account meant to be used with high-deductible health insurance plans. Members save pre-tax money in an HSA in order to spend the funds on future health care expenses. Every year, money left in the tax-advantaged HSA rolls over and can earn interest. Ultimately, when a qualifying high-deductible health plan is used with an HSA, members can save on medical costs and receive a tax write-off.

HSAs may be appealing to employees if they visit the doctor infrequently and prioritize cheaper monthly premiums, despite having a higher annual deductible if they become ill or injured. Employees own their HSA account, and can carry their funds with them if they change jobs. HSAs may be an effective small business health insurance plan type for your company if your business has relatively young and healthy employees who prefer low costs.

What is a POS plan?

POS stands for “Point of Service.” POS plans are a popular choice of small business health insurance and are essentially a combination of the features in HMO and PPO plans. Like an HMO, employees enrolled in a POS plan need to choose a primary care physician who will provide them with all specialist referrals within their insurance company-approved network.

Like a PPO, a POS plan usually provides access to a wider range of health care providers than HMO coverage. Receiving care outside of the network could lead to more out-of-pocket expenses, or might not be covered at all.

Choosing a small business health insurance plan type

Overall, the right type of health insurance plan for your small business will depend on your cost and coverage preferences. You can also offer multiple plan types to your employees. eHealth’s licensed insurance agents can help you choose the most affordable and effective small business health insurance plan for you and your company.

ACA and Small Businesses: How Are You Affected?

Despite many legal and political challenges, much of the Affordable Care Act remains intact. Specifically, the employer mandate is still present and enforceable. Here’s how the ACA employer mandate affects your small business.

Calculate How Many FTEs Your Business Has

Precisely how your small business is impacted by the employer mandate depends on how many full-time employees (FTEs) or their equivalent you have. These are referred to as “FTEs” in the ACA and related IRS literature.

To determine how many FTEs your business has, go through the following steps:

  1. Count each permanent employee who works full-time as 1 FTE
  2. Count each permanent employee who works part-time as a fraction of an FTE, with the fraction being determined by the average number of hours they work in a week. For instance, an employee who works 30 hours a week would be considered 0.75 FTEs.
  3. Include full- and part-time seasonal employees, who are defined as employees who work a maximum of six months.
  4. Don’t include any seasonal workers, who are defined as people who work fewer than four months or 120 hours on a temporary basis.

Add up your total, and you should have the number of FTEs your business employs.

50 or More FTEs: Need Group Health Coverage

If your small business has 50 FTEs or more, the ACA doesn’t consider your business to be a small business. Instead, the act classifies your business as a “large employer” and its employer mandate applies. Under the ACA employer mandate, any businesses with 50 or more FTEs must make group health coverage available.

Additionally, the ACA states that your business must pay at least 60 percent of employees’ plan premiums and the share paid by employees isn’t to exceed 9.86 percent of their household income. Should your business fail to offer a plan and pay at least 60 percent of premiums, it will be assessed a significant penalty under the ACA.

(Many businesses exceed the ACA’s minimum 60-percent minimum threshold, with employers paying 82 percent of premiums for single coverage and 67 percent of family coverage premiums on average according to a 2018 Employer Health Benefits Survey completed by the Kaiser Family Foundation.)

25 to 49 FTEs: No Employer Mandate in Place

If you determine that your small business has between 25 and 49 FTEs, the business isn’t impacted by the ACA. Businesses with fewer than 50 employees are excluded from the employer mandate.

(Your small business may, of course, still want to offer an affordable group health plan in order to attract high-quality employees.)

Under 25 FTEs: Small Business Tax Credit Available

If you count fewer than 25 FTEs, your small business still isn’t subject to the ACA employer mandate and doesn’t need to offer group health coverage. If you choose to offer coverage and select a qualified plan, however, the business has the chance to qualify for the Small Business Health Care Tax Credit.

The amount of the tax credit is determined by many factors, but it’s usually quite significant. Businesses with fewer than 10 FTEs that pay an average annual salary of $25,000 or less can qualify for especially generous amounts.

To qualify for this credit, your business must:

  • Employ fewer than 25 FTEs
  • Pay an average annual employee salary around $50,000 or less
  • Cover at least 50 percent of employees’ group health plan premiums
  • Make coverage available to all employees
  • Select a qualifying SHOP plan (for most businesses)

Coverage doesn’t have to be made available to employees’ family members, and businesses located in areas where SHOP plans aren’t available can still qualify if they meet certain conditions and purchase an alternative ACA plan.

Qualifying SHOP plans can be purchased through eHealth, an approved SHOP plan broker that offers many ACA-compliant group health plans.

Find an ACA-Compliant Group Health Insurance Plan

Whether your small business is legally required to provide group health coverage under the ACA or you want to offer coverage for other reasons, our representatives can help. Talk with one of them about finding a policy that meets ACA standards and SHOP standards (if applicable).

What Is Major Medical Insurance?

Major medical health insurance covers all the minimum essential benefits and meets the standards of the Affordable Care Act (ACA) for individual and family coverage.

Understanding major medical health insurance plans

Major medical health insurance plans are the type of insurance people are referring to when they talk about typical health insurance coverage. These plans comply with the ACA’s regulations for qualifying health plans. They offer the ten essential benefits:

  • hospitalization
  • outpatient procedures (also called ambulatory care)
  • preventive care like check ups and immunizations
  • prescription medicine
  • mental health and addiction counseling
  • laboratory services
  • emergency services
  • pediatric services
  • maternity and newborn care

These plans aren’t only sold through the official state and federal marketplaces. They can be sold off-exchange through licensed private brokers. For example, eHealth is a private marketplace that sells major medical plans alongside other insurance options like individual and family plans, and alternative coverage options like short term health insurance.

Benefits and drawbacks of major medical health insurance

Major medical health insurance covers the most necessary care associated with serious illness and hospitalization, along with plenty of additional benefits.

However, these plans may cost more than other options in monthly premiums due to those hefty benefits. A major medical health insurance plan that is sold during open enrollment or a special enrollment period can qualify for subsidies that significantly reduce the cost of premiums.

Buying major medical health insurance on and off the exchange

Major medical health insurance can be purchased through official health insurance exchanges and through licensed brokers like eHealth who are allowed to sell qualifying health plans. However, you are limited to buying on an exchange during certain times of year. This includes each year’s open enrollment period. You can also qualify for what is known as a special enrollment period if you have a qualifying event. These include:

  • changing jobs
  • getting married or divorced
  • having a child

If you wish to buy major medical health insurance at other times of year, or if you wish to purchase a plan that is not offered on the exchange, you also have the option of buying a policy off the exchange. Buying an off exchange policy, however, may have certain drawbacks. If you buy major medical health insurance off the exchange, for instance, you are probably not eligible for subsidies. Since these subsidies can have a major impact on the monthly premium cost, the monetary difference between on and off exchange plans can be significant even if the coverage is similar.

Alternatives to major medical health insurance

The elimination of the health insurance penalty means that more people are consider alternatives to conventional major medical health insurance. One alternative that some people choose is catastrophic health insurance. Catastrophic plans differ from major medical health insurance in that they only offer a very limited range of benefits. These plans will typically cover expenses associated with a hospitalization, surgery or major illness or injury. However, they will not cover preventive care or more minor health issues. The premiums for these plans is far lower than the premium for major medical health insurance to reflect the lower coverage levels.

Short term health insurance allows people to buy coverage that lasts only a couple of months instead of a full year of coverage at a time. Short term health insurance can be a good option if you are moving or suffer job loss.

When choosing between major medical health insurance and other options, it is best to consider your most likely health scenarios, as well as your personal financial situation. Thinking about the amount of money you have saved, whether you are likely to need medical care and other options can help you choose the right coverage option for you. At eHealth, we offer major medical along with other options so that you have the freedom to pick the plan that fits your needs and your life.

What Is an Off Exchange Plan?

What is an off exchange plan?

The term off exchange plan describes a health insurance policy that you buy directly from an insurance carrier or through a licensed broker like eHealth outside of an official state or federal ACA Marketplace.

Some off exchange plans offer the same sorts of coverage that are available with ACA plans. These plans will adhere to the rules for qualified health plans, which include:

  • clear communication of information that includes premium, deductibles and other out of pocket costs.
  • meeting the network adequacy standards established by the respective state exchange.
  • providing a summary of benefits and uniform coverage summaries before the beginning of open enrollment.

While the criteria for qualified health plans are the same nationwide for plans on the exchange, they can vary state by state if you look at an off exchange plan.

However, instead of being offered through the government Marketplace, or state-run marketplaces, these are available directly purchase directly from insurance companies or through independent brokers. In many cases, an insurance carrier will offer both an on exchange and off exchange plan with the same coverage. This is a choice made to increase consumer choice.

Off exchange plans that are not ACA-compliant

In addition to these major-medical qualifying plans, you can look at other coverage that may not be as robust. For instance, catastrophic insurance can be found among off exchange plan options. This insurance will not cover many basics such as check-ups or immunizations, but offers coverage for catastrophic events like major injuries and illnesses. In exchange, those who buy these plans will pay significantly lower premiums. Examples of eff-exchange plans that are not qualifies health plans (QHPs)—or in other words, all you can find on government exchanges:

  • short term health insurance
  • medical insurance packages (MIPs)
  • GAP insurance
  • Critical illness
  • Medical indemnity

These plans should only be considered by people who are in good health and who do not frequently use medical services. When medical services are mostly paid out of pocket, it can result in significantly higher costs overall. When picking a plan with a low premium (monthly costs) make sure you always check plan details and walk into it with the understanding that benefits might be cut compared to plans that are more expensive.

Visit eHealth to see more details on these plans and get free quotes.

Perks of choosing on exchange plans

When you buy a plan on the government Marketplace, you have a guarantee that what you are buying is a qualified health plan that meets the consumer protection requirements of the ACA. You can also quickly and easily compare the bronze, silver, gold and platinum insurance options in your state. On exchange plans often require less out of pocket, as these plans are eligible for subsidies that substantially cut insurance costs.

Keep in mind that you can also find these “on exchange” plans even outside of the government Marketplace—eHealth has a proxy agreement with the government where we can sell the same Qualified Health Plans (QHPs) they offer, but customers get to use our shopping experience.

Reasons to look at off exchange plan options

When individuals are shopping for insurance, it is a good idea to carefully look at many insurance options. Run some scenarios to estimate which will result in the best price for coverage for you. If you are someone who does not qualify for subsidies or who finds coverage with an off exchange plan that they cannot find on the exchange, an off exchange plan can be advantageous. Compare the off exchange plan and its cost throughout the year against an on exchange plan. Both on exchange and off exchange plans are offered at eHealth for easy comparison.

By thoroughly investigating your options, you can get a better idea of what a reasonable cost for insurance is for someone in your specific circumstances. This information, in turn, can help you find the best deal for your money and the coverage that best fits your lifestyle and your needs.

How Does Health Insurance Affect Your Taxes?

Same as every year, tax season has arrived—which means that you will need to spend some time gathering together all of your financial and health insurance documents. Whether you qualified for a premium tax credit, or might owe additional funds, your insurance does impact your tax return.  Some of the main tax forms to look out for are 1095-A, 1095-B, and 1095-C , and we’ll explain how to know which one you should receive.

Learn how to report your health insurance for 2018 taxes. 

The Affordable Care Act (ACA) requires that all United States citizens, legal residents, and dependents have health insurance throughout the entire year. Fortunately, your health plan can be supplied via employers or purchased through a government sponsored or private health care marketplace. With this in mind, if you weren’t enrolled in a health plan for any portion of 2018, then you might have to pay a tax fee. As a general rule of thumb, if you didn’t have insurance for any or all of 2018, then you might have to pay $695 or 2.5 percent of your income as a tax penalty. The good news is that if you are a single with an income that ranges between $11,880 to $47,520 for the entire year, then you might receive a tax credit that can be applied to your insurance premium. No matter your income level, one thing is certain, you will have to report your health insurance on your 2018 taxes.

What forms should you use on your 2018 taxes?

There are different forms that you will use to report your health insurance on your 2018 taxes. It is important to note that these forms will vary on a) the type of health plan that you purchased, b) how you received your health insurance (i.e. from a marketplace or an employer), and c) if you had a marketplace plan and used premium tax credits to lower your insurance costs throughout the year.

  • Form 1095-A, Health Insurance Marketplace Statement. — This form is used if you have purchased health insurance from a government-sponsored or private marketplace. The form will include the information that you need to complete Form 8962, which is used to receive a premium tax credit. Additionally, you will need to complete Form 1095-A for each insurance policy that you had for 2018.
  • Form 1095-B, Health Coverage. — Your insurance provider will typically send you this form to show that you and your family had health coverage throughout all or part of 2018. With this in mind, this form is not typically included in your tax return; however, it does contain vital information that will help you to properly fill out your taxes.
  • Form 1095-C, Employer-Provided Health Insurance. — If you received health insurance for all or part of the year from an employer, then they will send you Form 1095-C. Like Form 1095-B, this form has vital information that you will need to properly file taxes, however it will not be included in your actual tax return.

If you have additional questions about which health insurance forms to look out for during tax season, visit the official IRS website.

What does it mean to “reconcile” your premium tax credit? 

If you purchased a health plan from either a private or government-sponsored marketplace, and used premium tax credits, then you will need to “reconcile” your premium tax credit. To do this you will need to complete the following steps.

  1. Write down the amount you used to lower your monthly premium costs throughout the year.
  2. Based on your final income for the year, calculate the actual amount of financial aid that you qualified for in 2018.
  3. Compare the figure from Step 1 with the figure from Step 2. If there is a difference in the figures from Step 1 and Step 2, then you will need to either pay additional funds, or receive a tax refund.

The good news is that Form 1095-A will help you to easily complete Steps 1-3, so that you can accurately determine if you owe additional funds, or if you will receive a tax refund. Keep in mind, that if you didn’t take any of your premium tax credit throughout 2018, then you will need to fill out to complete Form 8962, so that you can receive your tax refund.

Make filing taxes easier by keeping good records. 

Filing taxes is made easier when you keep good records. Remember that your health care provider will send you the information needed to successfully complete your Form 1095-A. Additionally, you will need to reconcile your premium tax credit and properly fill out Form 8962 so that you can receive your tax refund (if applicable). In conclusion, by keeping good records, you can more easily understand how your specific health plan will impact your taxes at the end of the year.

Cost Sharing: Small Business Employer’s Contributions

Cost sharing on small business health insurance plans

Although the Affordable Care Act’s individual mandate was repealed for 2019, the employer mandate to offer group health coverage is still fully intact. Here’s a look at what the mandate requires of employers and how small businesses are handling the cost sharing.

The ACA employer mandate

The ACA employer mandate classifies employers according to how many full-time or full-time equivalent (FTE) employees they have.

When tabulating FTEs, the proportion of a 40-hour work week that a part-time employee works determines how they count toward an FTE employee. For example, an employee who works 10 hours per week would count as 0.25 FTEs. Seasonal employees are included, but seasonal workers who are employed for less than four months and 120 hours aren’t.

Per the ACA employer mandate:

  • Businesses with over 50 FTEs are required to provide group health coverage and pay at least 60 percent of the premiums in their cost sharing solution. Additionally, the cost sharing may not make employees contribute over 9.86 percent of their household income toward premiums.
  • Businesses with fewer than 50 FTEs aren’t required to provide group health coverage, but they can choose to do so and may qualify for a tax credit to help with cost sharing (see below).

There is no legal requirement to provide employees with access to group health coverage if your business is defined as a small business. Many businesses that are often classified as small, however, may fall into the ACA’s classification of 50-plus FTEs and need to offer coverage. In both cases, businesses are welcome to provide more coverage or pay a higher portion of employees’ premiums than the law requires.

Small businesses offer lower cost sharing assistance than large ones

The Henry J. Kaiser Family Foundation published a 2018 Employer Health Benefits Survey that showed many employers offer more cost sharing assistance than they’re required to. Small businesses, however, paid a significantly smaller portion of their employees’ premiums than large companies did for family plans.

Among cost sharing payments for single coverage, the survey found no difference between what small and large employers paid. On average, both paid 82 percent of their employees’ single coverage premiums at a per-employee cost of $5,655 annually.

When insuring employees and their families, large employers paid an average of 71 percent of family coverage premiums at a per-employee cost of $13,917 per year. Small employers only covered 62 percent of family coverage premiums on average, trimming their per-employee cost for this coverage to $11,618 annually. That’s a cost sharing reduction of $2,309, which would have a significant impact on both employers’ and employees’ bottom lines.

*For the purposes of the survey, small employers were defined as businesses which have 3 to 199 employees. This differs from the ACA’s cutoff, but it still shows that smaller employers are trying to mitigate their health insurance costs through cost sharing more than their larger counterparts.

Small employers have several group health coverage options

Small employers looking for affordable cost sharing solutions that comply with any ACA requirements they’re under and that are appreciated by employees have a few options available to them.

First, the most obvious option is to provide a traditional group health insurance plan that meets or exceeds ACA requirements. Employers who have fewer than 25 FTEs and purchase a qualifying plan through a SHOP-registered broker like eHealth may qualify for the Small Business Health Care Tax Credit. The tax credit can help greatly with cost sharing. Keep in mind that there are many restrictions to this tax credit, and you can only get it a few years in a row, so don’t limit yourself to qualified SHOP plans just because of the tax credit.

Second, you can combine a small business health insurance plan and a group coverage HRA as an effective cost sharing solution. These are usually paired with high-deductible group plans, which typically cost both employers and employees less in premiums, and they offer employees reimbursement for qualifying medical expenses.

Third, the qualified small employer health reimbursement arrangement (QSEHRA) became available in 2016. Under this arrangement, employees purchase their own health insurance plans and receive reimbursement (subject to a maximum) in the form of pre-tax income from their small employer.

Finally, the Department of Labor expanded association health plan (AHP) availability for small businesses in 2018. These plans let small businesses that share a commonality (e.g. industry, profession, region, etc.) to form an association and purchase group health insurance together (or they might be able to self-insure). Be sure you understand concerns about AHPs before joining one instead of purchasing a small business health insurance plan for yourself and your employees.

Find a small business health insurance cost sharing solution

For help finding a health insurance solution that suits your small business, talk with one of our specialists. We’re a registered broker offering SHOP plans, and our representatives are well-versed in the cost sharing options available for small business health insurance plans.

The Complete Guide to Selecting the Best Small Business Health Insurance Plan

As a business owner, you probably understand the benefits that a small business health insurance plan can provide your company, employees, and even your own family. You may also have concerns that you lack the resources of larger organizations, so you might wonder how the costs of buying and administering health insurance will impact your business.  This guide to selecting the best small business health insurance will give you the information and resources you need to make good decisions for yourself and your company.

Most important, you should not make choices about small business health insurance costs in time or money before taking a few minutes to explore all of your options. These will vary by your location, business situation, and even personal preferences. At any time, you can start comparing a variety small business health insurance plans online at eHealth. You can also call to speak with a licensed, small business health insurance broker during business hours.

Small business health insurance facts

Before you explore small business health insurance options for your own company, you may benefit from some facts about the group health insurance market in the United States.

For instance:

  • According to the Bureau of Labor Statistics, eighty to ninety percent of medium-sized and large companies and government employers provide health plans for employees and their families.
  • In contrast, only about half of companies with less than 50 employees offered small business health insurance.
  • Since small businesses provide employment for such a large portion of Americans, only about 60 percent of all adults and 49 percent of children rely upon group coverage in the United States, according to the Kaiser Family Foundation.

Small businesses might struggle with the idea of offering group plans for a variety of reasons. Business owners commonly cite concerns over small business insurance costs for their company and for their employees. Since small businesses often lack a dedicated human resources department, owners also wonder if administering the plan will take too much time away from other activities.

You should know that none of these problems are inherent to small business health insurance. The licensed health insurance brokers at eHealth can answer questions, alleviate worries, and best of all, help you develop the right strategy to compare, buy, and implement group health insurance for your unique organization.

If you lack a good strategy to compare, buy, and administer group health insurance:

  • You may not know that you can find a variety of health plans at various price points.
  • You may adjust premiums by changing such factors as deductibles, copays, type of health insurance, and employee contributions.
  • You may not have considered the ways that the benefits of small business health insurance can positively impact your bottom line through tax advantages, employee access to good medical providers, and even a better company image.
  • Also, insurers and licensed brokers can offer support and online tools that make choosing,  implementing, and servicing an employee health plan efficient and fast.

Why offer small business health insurance?

As noted above, large organizations usually do offer group health plans. At the same time, only about half of all small businesses provide employees with these benefits. Rather than focusing upon companies that don’t offer group medical benefits, you might find it helpful to learn why other small employers have chosen to provide their employees with these plans.

In a recent survey, eHealth asked their own small business customers why they decided to provide their employees with health insurance:

  • Over 60 percent said that group coverage helped them compete for and keep good workers.
  • About 40 percent of small employers felt a sense of responsibility towards their people. Almost 30 percent worried that employees and their families could not afford health insurance without help.
  • Over half of the surveyed companies also offered such additional benefits as dental and vision plans or contributions to health savings accounts. They found that adding extra benefits made their company more and not less competitive.
  • Even though small businesses won’t get penalized for failing to offer small business health insurance, over 90 percent of employers said that change to the law would not impact their own coverage. They may have gotten group health insurance to avoid the Obamacare penalty but decided to keep it even without it.

Small companies may have to operate with fewer resources than larger businesses or government organizations. Still, the small business owners who did choose to provide their employees with group coverage believed that these benefits gave them a competitive advantage over other similar companies. In other words, small business health insurance helped their company enjoy the competitive advantages of much larger businesses.

The surveyed small business owners also said:

In any case, you might consider employee loyalty and increased competitiveness for good employees as strong advantages over other businesses that lack group health plans. These don’t even account for the main benefits that group health insurance provides, including affordable access to good medical providers. Business owners can help keep their employees healthy and in return, reap the rewards of having their workers appreciate them for it.

Instead of deciding that your business doesn’t need group coverage because similar companies lack it, you might begin to look at the ways that offering small business health insurance can give your company a competitive advantage over rivals.

Small business health insurance costs

As a small business owner, your primary alternative to having your own group health insurance may be an individual or family health insurance plan for yourself and your household. You also might expect your employees to do the same. When eHealth compared average small business health insurance costs to individual and family plans, they found that premiums for individual and family plans increased at twice the rate as group coverage.

Very often, owners of very small businesses and startups looked at group coverage as a way to hedge against price instability.  Typically, group plans also offer guaranteed acceptance for the owner, other employees, and families. While business owners may implement medical plans to benefit their company and employees, they also do it to protect themselves and their own families. With that in mind, these are some average premiums for group plans for smaller companies from eHealth’s own data:

  • Average per-person premium: $397
  • Average per-individual deductible: $2,754
  • Average total premiums each month for small business with an average group size of three: $1,769

In contrast, average per-person premiums for individual health insurance were about $440 a month, and that was for an average deductible of over $4,500. It’s very likely that a business can offer better health benefits for less money with a group plan. While eHealth serves all sorts of small businesses, average customers tend to run companies with three to four employees, including the owner. Business owners of these micro companies can also benefit by obtaining group coverage for themselves and their own families.

Premiums for your own business will depend upon such factors as the kind of plan chosen, the insurance company, the location, and the average age of employees. It only takes a few minutes to obtain competitive premium quotes for your own business with eHealth’s online quote form, and you’re also welcome to call to discuss your needs with a licensed broker.

Actual costs vs. small business health insurance premiums

You should remember that the premiums won’t represent the actual small business health insurance cost for your company. These factors should reduce the actual cost your company will pay for employee health plans:

  • Cost sharing: With eHealth, about 40 percent of surveyed companies shared premiums equally with employees, and not quite half paid at least 75 percent.
  • Tax credits: Companies with 24 or fewer employees may qualify for small business health insurance tax credits through the ACA Marketplace.
  • Tax deductions: Small businesses can also take advantage of tax deductions for their small business health insurance costs, including premiums and administrative costs.

To estimate small business health insurance costs, you should consider how you want to share premiums with your employees. After that, factor in any tax credits and deductions that might further reduce the actual impact of premiums on your company’s bottom line.

Even if an average small business might have premiums of about $1,700 a month, the actual impact on the bottom line should be much less. Besides cost sharing and tax benefits, you may find that you can offset costs in reduced employee turnover, more competitive recruiting, and of course, better health. Some insurers may also offer discounts for companies with wellness and safety programs that help reduce the amount of claims.

An eHealth small business insurance broker can offer some guidance, but you may also run your numbers past your accountant.

Guide to Shopping for group coverage for a small business

To make sure that you can buy the best small business health insurance for your company, you can develop a strategy for comparing, purchasing, and implementing your group plan.

Your strategy should include:

  • Making certain that your business qualifies for group coverage
  • Determining which employees to offer benefits to
  • Figuring out how to maximize employee participation
  • Gathering the information about your business that insurers will need to supply quotes
  • Learning about various insurance companies, plan, and plan options

Make sure your small business qualifies for a small group policy

At this point, you should ensure that your company qualifies as a group for health insurance. The definition of a small group can vary by state. This is a quick guide to small business health insurance requirements:

  • Most states follow federal rules and consider a company with at least two employees who live in different households as a group. For instance, even if a small company employs both spouses and has no other employees, it might not qualify as a group.
  • Some states allow self-employed individuals to form a group with only one employee, so you and your dependents can enjoy the benefits of small group health insurance even if you’re a sole proprietor or contract employee. Otherwise, you may need to buy an individual or family plan if you are your company’s only employee.
  • Small business groups have a maximum of 50 employees. Insurers and the government typically consider companies with more than 50 employees to constitute a large group.

Typically, you need to offer coverage to all full-time employees if you offer it to any of them. You might not need to offer your plan to part-time employees or contract workers. On the other hand, some companies may offer group coverage to part-time or 1099 employees to help them qualify for group coverage and in some cases, for better rates.

These are some reasons to consider including part-time or contract workers in your group health insurance plan:

  • If your population of 1099 or part-time employees is younger than your permanent employees, your entire business may benefit by allowing these contract workers to join your plan.
  • If you’re the only permanent, full-time employee, you might be able to qualify as a small group if you open your plan to part-time or 1099 employees.

While you may need to offer to pay at least half of the premium for full-time employees to qualify for tax credits, you may not need to help fund the group plan for other employees. The rules can vary considerably, depending upon your state and tax benefits you may qualify for. A licensed health insurance broker at eHealth can give you the information that you need to make the best financial decision for your business.

Consider ways to maximize employee participation

Most states will require at least 70 percent of full-time employees to participate in the group or to have a valid exemption. Examples of exemptions could include having medical insurance through a spouse or through Medicare. Depending upon the state, the small business health insurance requirements for the participation rate could vary from 50 to 75 percent.

Obviously, you hope to encourage participation by offering a benefit that employees will find affordable and valuable. Previously, you might have only thought about the cost of health insurance for your company. At this point, you also should consider the amount employees would have to pay for their share of the premium. Of course, to actually use their coverage, employees will probably also need to pay for deductibles and copays. To satisfy your people, you will need to provide coverage that they find affordable to buy and to use.

To encourage participation, employers will need to shop for benefits that their employees will find both valuable and affordable. Before making a final decision about the health plan, you might consider surveying your employees to learn more about their expectations. You can use that information to shop for plans that offer the most value for a premium that both you and your employees find affordable.

Gather business and employee information

To obtain accurate small business health insurance quotes, you should prepare by gathering the following information about your company:

  • Business name, start date, and physical address
  • SIC industry code, tax ID, and payroll records
  • Employee census with names, ages, ZIP codes, and the number of dependents

Compare types of group health insurance plans

You should also familiarize yourself with common kinds of small business health insurance. The most common kinds of group health plans use a provider network to help reduce costs for both insurance companies and plan members. Doctors, hospitals, and other medical providers will agree to charge the amount the insurance company allows in order to contract with them and join the plan network.

These are common types of small business group health insurance plans:

  • HMO: Health maintenance organizations, usually called HMOs, do a good job of controlling costs; however, they typically only pay for care outside of the plan network when it’s an emergency or another unusual situation. With an HMO, you need to choose a primary care doctor and get referrals from that doctor to visit specialists. Most of the time, an HMO will be the cheapest kind of plan to purchase and to use.
  • PPO: Preferred provider organizations, or PPO, also use a network to help control costs. At the same time, they will cover services outside of the network at lower amounts. While PPOs offer more flexibility than HMOs, they typically cost more to buy and use. You don’t need a primary care doctor or referrals for specialists.
  • POS: These hybrids between PPO and HMO plans are called point-of-sale plans. A POS will still offer some coverage outside of the provider network, but it will require referrals for specialists.  Expect to find POS prices between those of PPOs and HMOs.
  • EPO: An exclusive provider organization is another kind of PPO-HMO hybrid. You still need to seek covered services inside of the network, save for rare exceptions, but you can visit a specialist without a referral from your primary care doctor. Like POS plans, premiums for an EPO should fall between those of an HMO and a PPO.

HSAs and high-deductible health insurance for small businesses

In addition, you may choose a high-deductible health plan that works with a health savings account, or HSA. You and/or your employees can contribute to this plan to help defray the cost of such out-of-pocket expenses as deductibles and copays. You must buy an HSA-qualified plan to use an HSA, but the savings account can also help pay for certain medical expenses, such as dental visits, that medical insurance does not cover.

These are some benefits of HSA plans for small businesses:

  • Within limits, whoever makes the contributions can deduct them from their taxes, so they offer a way to pay for out-of-pocket expenses with pre-tax dollars.
  • One good thing about HSA plans is that any unused money will roll over from year to year.
  • Disciplined savers tend to be satisfied with high-deductible health insurance and HSAs.

Alternatives to typical small business health insurance

Very often, to obtain health insurance for a small business with one employee, the business owner may need to consider an individual or family health plan. As noted above, a few states allow business groups with only one employee, but they usually require at least two. In addition, some small companies may employ more than one person but expect them to either rely upon a spouse’s coverage or to buy their own plan on the individual market.

Depending upon your company’s situation, you could also consider some of these alternatives to group health insurance.

QSEHRA

A qualified small employer health reimbursement account, called a QSEHRA, allows you to give employees a tax-free allowance each month. Employees can choose how to spend the money, and they can get reimbursed for their expenses.

Since employees may each have their own requirements or preferences, this option has grown increasingly popular because you won’t have to choose a one-plan-suits-all health insurance plan for everybody. For instance:

  • An older employee with a family may want to spend more on their health plan than a younger employee who does not have children.
  • Some employees may have insurance through a spouse and might want to use the reimbursement for out-of-pocket expenses.

Your business can simply set a budget for employees and let them choose their own options. You can learn more about setting up a QSEHRA on the IRS website.

Integrated HRA

An integrated health reimbursement account, usually just called an HRA, works somewhat similarly to an HSA but has some important differences.

This list contrasts an integrated HRA to an HSA:

  • Like an HSA, an HRA account helps employees pay for certain out-of-pocket medical expenses that they may incur. An HRA isn’t meant to pay premiums. Also like an HSA, an HRA isn’t really an alternative to group coverage. Instead, it serves as a way to supplement health insurance.
  • To earn tax advantages, the company doesn’t need a qualified, high-deductible health plan; however, an HRA does need to work with health insurance that offers minimum essential coverage, as defined by the ACA.
  • Employees or employers might contribute to an HSA; however, only the employer contributes to an HRA account. While money in an HSA typically belongs to the employee, the money in an HRA belongs to the business.

Private health insurance exchange for small business

The rules for private exchanges can vary by state. Sometimes called health insurance coops, these private exchanges may allow groups of small businesses to band together to increase their purchasing power. While a private exchange may open up better alternatives, it also means that the business owner cannot customize the plan for his or her own business.

Taxable stipends for employee health insurance

Even though offering wage increases, bonuses, or other compensation for employees to use for health insurance isn’t a formal alternative, it’s surprisingly common. Small companies may simply offer extra money with the intention that employees use this money to buy health insurance or defray healthcare costs.

Since this doesn’t count as any sort of qualified plan, employees will have to report this extra income on their taxes, but in some cases, they may be able to deduct such qualified expenses as premium. Of course, the employer doesn’t have any way to force their employees to use the extra money on health insurance.

Examples of small business health insurance companies

Before you get started with your personalized quotes, you might have an interest in learning about a few popular companies that offer health insurance to small groups in most parts of the country. Depending upon your location, you may have a selection of nationwide and local insurance companies to choose from. Just as small business health insurance requirements can vary between states, so can the choice of insurers, plans, and premiums.

This list profiles some of the largest insurers that operate across the United States:

  • Aetna: Founded in the 1800s, Aetna now boosts of a health insurance network with millions of providers and thousands of hospitals.
  • Blue Cross and Blue Shield: The nationwide network of Blue Cross companies evolved from the oldest health insurance provider in the country and has members in every ZIP code and a contract with 90 percent of the nation’s healthcare providers.
  • United Healthcare: The largest health insurance company in the country serves all 50 states and is heavily invested in innovation and technology.

Why call upon the licensed brokers at eHealth for help?

At eHealth, both the online quote system and licensed brokers can help you compare a great variety of small business health insurance companies in your own local area. This gives you an advantage over an agent who only represents one insurance company with a limited selection of plans. Even though you can purchase Obamacare small business coverage through eHealth, you can also gain access to plans that aren’t listed on the ACA Marketplace.

You won’t pay higher premiums if a broker assists you. Your request for quotes an information also doesn’t obligate you to purchase health insurance for your small business.

In return, these professionals can help you save time and money by:

  • Helping you compare a variety of plans, premiums, and insurance companies
  • Making sure that both you and your employees understand how various health insurance plans work
  • Demonstrating the impact on your company’s bottom line of various choices
  • Working with you and the insurer you select to implement your plan
  • Uncovering solutions that you might use to reduce premiums and improve employee health
  • Providing ongoing service to help resolve any billing or claims issues
  • Assisting in renewals or new coverage selection

You can begin comparing customized group health insurance quotes for your business at any time online. All you need to do is to enter your ZIP code and the number of employees you intend to cover to begin. You are also welcome to call the toll-free number to speak with a licensed business health insurance broker. Besides group health insurance, eHealth can also help you find individual health insurance, dental insurance, and much more.

What Is Private Health Insurance?

When it comes to insurance coverage, the options can be a little overwhelming. Understanding all of the terms and how they apply to you is an essential starting point for making an informed decision. One of the terms that you’re likely to run into when shopping for coverage is “private health insurance.”

According to the U.S. Census Bureau, the vast majority of Americans are enrolled in private health insurance, compared with those who get coverage through a government program (or “public” health insurance). Employer-based health coverage continues to be the most common source, followed by Medicaid (19%) and Medicare (17%).

Here’s an overview of private health insurance, including what it is, the options available to you, and how it may affect your bottom line.

What is private health insurance?

The term “private health insurance” simply refers to any health insurance coverage that is not offered by a state or federal government. Instead, private health insurance is offered by a private entity, such as an insurance company or broker.

There are a number of private health insurance options available. This can include:

  • Federal or state marketplace plans
  • Health insurance offered through an employer (such as a group health plan)
  • Private health insurance plans offered by licensed brokers or agents

Some private health insurance plans have benefits that meet the minimum essential coverage requirements of the Affordable Care Act (also known as Obamacare). Other types of private health insurance options, such as short-term plans and catastrophic coverage, may offer different benefits, but may not count as a qualified health plan under the Affordable Care Act.

Please note that not all plans available outside of the government marketplace count as qualifying health coverage, and, up until 2018, you would have faced a tax penalty for not meeting the requirements of the ACA if this was the only coverage you had. However, beginning with the 2019 plan year, if you’re enrolled in a plan that doesn’t meet minimum essential coverage standards, you will no longer face a penalty.

What is public health insurance?

Now that we’ve defined private health insurance, you may be wondering how public health insurance works. Currently, there are only a few limited options for public health insurance in the US. These include:

  • Medicare, a federal program for adults over the age of 65 and certain disabled individuals.
  • Medicaid, a state-run public health insurance program for low-income individuals.
  • The Children’s Health Insurance Program (CHIP), a subset of Medicaid, which offers subsidized low- or no-cost health insurance for children.

For people who aren’t eligible for these government programs based on income or other criteria, there are currently no other public health insurance options. Instead, people can get the coverage they need through private health insurance providers.

Where can I get private health insurance?

For those looking for private health insurance, there are a few options. If you don’t have coverage through your employer or you’re self-employed, you might get private health insurance through the federal marketplace or your state’s marketplace. Employer-sponsored plans and all marketplace plans are required to include certain essential health benefits, such as maternity care, mental health services, preventive care, and more.

ACA-compliant coverage is also available through licensed health insurance brokers like eHealth. eHealth also offers other options that may offer more flexibility for those looking for coverage over a short period or in specific situations.

Types of private insurance outside the marketplace

If you already have ACA-compliant health coverage, such as through an employer, you might be interested in exploring other insurance options outside the marketplace.

For instance, someone who is young and healthy may want a more “bare bones” insurance policy, such as catastrophic insurance. A catastrophic policy offers very limited coverage for those under 30 who qualify for a “hardship exemption” and can’t afford qualified health coverage. Catastrophic coverage covers the same essential health benefits offered through other ACA-compliant plans, as well as some preventive services for no cost. However, you’ll need to meet a very high deductible before the plan begins to cover costs. In 2019, all catastrophic plans have a deductible of $7,900.

A catastrophic plan might help with high expenses from a severe illness or accidental injury. However, it might be less helpful with routine health care, such as check ups, where you’re less unlikely to meet the yearly deductible and could wind up with high out-of-pocket expenses. This type of coverage could be a good fit if you know that your annual health-care costs will meet the deductible, or if you’re generally in good health but want coverage for a worst-case scenario.

Another type of private health insurance to consider is short-term coverage. Coverage terms depend on the state you live in. Federal laws allow short term plans to have initial terms of 364 days, with the chance to renew for up to 36 months. States are allowed to have their own laws limiting short term plans further, so make sure to check short term laws in your state if you’re considering this kind of coverage. These affordable private health insurance policies can be a good fit if you only need coverage for a short period – for example, if you’re between jobs and need insurance to bridge a coverage gap, but don’t want to pay the high premiums of a COBRA policy.

Please note that 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.

What type of private insurance coverage is right for me?

While every person’s situation is different, here are some things to consider as you explore coverage options.

One benefit of private health insurance is that certain types of coverage may be available any time of the year, instead of only during open enrollment periods. Marketplace plans are typically only available during Open Enrollment unless you qualify for a Special Enrollment Period. If you do not have coverage and don’t qualify for a Special Enrollment Period, some types of private health insurance (such as short-term plans) may help bridge the gap in the meantime.

If you opt to get insurance through a broker, such as eHealth, costs for coverage may be different — and possibly lower — than plans offered through the marketplace. Plan types and availability may vary by location as well.

When looking for coverage, it’s important to consider all of your private health insurance options. A licensed insurance agent can help you find a policy that offers what you need at a price that makes sense for your specific circumstances. If you have questions, feel free to contact eHealth today to explore coverage choices that might fit your situation.

Should You Join a Health Care Sharing Ministry?

Rising health care costs and changing insurance programs have inspired many people to seek alternative health care options. Among the more unusual options is the health care sharing ministry. With this type of program, you contribute an annual fee for membership. After you meet a specified out-of-pocket limit, the cost-sharing program will typically begin paying for eligible health care costs. The costs of these programs can be significantly less than qualifying health care coverage from the health care marketplace or an independent insurance broker. However, these programs differ from traditional insurance in a number of ways.

Benefits of joining a healthcare sharing ministry

While health care sharing ministries have existed for decades, they became especially popular when the Affordable Care Act went into effect. These organizations were seen as an option for people who want inexpensive health care provisions.

A health care sharing ministry might be an affordable option if you fit the criteria for membership. You can usually sign up for a health care sharing ministry any time of year. If you missed open enrollment, but are still looking for health care provisions, a health care sharing ministry may be an option for you.

A health care sharing ministry can be good for those whose lifestyles fit the criteria. While criteria vary from plan to plan, you might need to agree to certain behavioral standards and beliefs. The plans may require that you be a Christian. They might also specify a Biblical lifestyle that restricts activities such as drinking, smoking, or sex outside of marriage. If these fall in line with your specific lifestyle, membership in Christian health care plans can be affordable and affirming of your faith.

A health sharing ministry might save you money if you don’t expect many doctor or hospital visits. If you are healthy and are comfortable paying for certain preventative care out of pocket, savings can amount to thousands a year in some cases.

Some people like the community aspect of religious cost-sharing. Since eligible health care costs are generally paid for by the  fees paid by its members, the ministry can offer a feeling of stewardship toward one another.

Drawbacks of a health care sharing ministry

In the past, membership in a health care sharing ministry exempted members from penalties for lack of coverage under the Affordable Care Act. However, since the federal government will not assess fines for lack of insurance in 2019, this is no longer a factor as of the publishing date of this article.

The exclusivity mentioned among the provisions of a health care sharing ministry, of course, cuts both ways. In general, a health care sharing ministry will not accept someone who is not Christian. Since a health care sharing ministry is exempt from the rules that govern insurance companies, it may also deny membership on the basis of weight, sexual orientation or other factors.

An application for a health care sharing ministry may ask you to affirm statements like “abortion is wrong” or “marriage is only between a man and a woman.” If these are terms that do not align with your personal ethics and morality, signing such an affidavit may be a deal-breaker for you.

There are many health care services that may be ineligible for sharing (not paid for) under the terms of a health care sharing ministry. For instance, many say in their terms that they will not share in costs associated with a pregnancy that is the result of adultery. Many plans also do not share in preventative care such as checkups, immunizations or birth control.

How to sign up for a health care sharing ministry

Because they don’t have to conform with the Affordable Care Act, health care sharing ministries can add members at any time, instead of just during open enrollment. Someone who is interested in a health care sharing ministry can research options online to find one that best aligns with their specific religious beliefs. eHealth, for instance, offers Medi-Share through our website. (The specific beliefs of Christian cost-sharing ministries are not necessarily those of eHealth.)

Alternatives to a health-sharing ministry

If you can’t afford a major medical health plan, but you’re not comfortable with a health-sharing ministry, you might have other options. For instance, a catastrophic health insurance plan may have a lower premium than a major medical insurance plan. Major medical plans may be more expensive, but can cost less out of pocket if you incur a lot of health-related costs.

By researching all of your options, you can compare the pros and cons of each and choose the one that best fits your lifestyle, your health care needs and your budget. Compare health care options on eHealth today. Just click the button on this page to get started.

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 Does the ACA Affect Small Business Health Insurance?

How does the ACA affect small business health insurance?

The Affordable Care Act (also called Obamacare) has dramatically reshaped health insurance requirements in the United States. Initially passed into law in 2010 and challenged multiple times since then, some businesses aren’t aware of what obligations and incentives the act includes for them. The following is a look at how the ACA affects small business health insurance.

Defining small business as under 50 employees

Before your business can determine how it’s affected by the ACA, you must first identify how your business is classified under the act. Classification is based on the number of full-time employees (FTEs) or equivalent employees.

To calculate how many FTEs your business has:

  • Start with the number of full-time employees you have.
  • Now you’ll need to take a look at your part-time employees. In a way, you add them together to equal a certain number of full-time employees (FTEs).
  • Part-time employees should be counted at whatever percentage of 40 full-time hours they work, so a person who works 20 hours a week would count as 50% FTE. So, two part-time employees who each work 20 hours a week count as one full-time employee for the purposes of this definition.
  • In most cases, you don’t count independent contractors or seasonal workers in this FTE calculation. If seasonal workers work fewer than 120 hours during the tax year, you generally don’t count them.

Once you’ve calculated how many FTEs your business has, the important categories are as follows:

  • Businesses with fewer than 25 FTEs
  • Businesses with fewer than 50 FTEs
  • Businesses with 50 or more FTEs

Requiring large businesses to provide health insurance coverage

The ACA’s requirement for businesses to make group health insurance coverage available to their employees applies only to businesses with 50 or more FTEs. Every large business must offer an affordable employer-sponsored coverage option, usually a large group plan. Large businesses are required to pay at least 60 percent of the cost for single coverage. Employers who meet the FTE criteria and fail to provide sufficient coverage may have to pay a penalty.

If your business has fewer than 50 FTEs, you don’t have to provide or pay for a health coverage plan. The ACA has no absolute small business health insurance coverage requirement for businesses with fewer than 50 FTEs. But you can still offer your employees health insurance and eHealth may be able to help you find a surprisingly affordable plan.

Offering coverage as a small business with fewer than 50 FTEs

Although not a formal legal requirement, many businesses with fewer than 50 FTEs want to offer group health insurance coverage to their employees. They do this for a variety of reasons, as health insurance plans help attract quality employees, reduce employee turnover, and improve overall morale.

If your business has fewer than 50 FTEs, but you’d like to make group health coverage available to employees, think about offering a small group health insurance plan. These plans are similar to large group plans, but they’re adjusted to better meet the financial needs of small businesses and their employees.

The ACA-sanctioned Small Business Health Options Program, which is otherwise known as SHOP, offers affordable small business health insurance plans. You can find SHOP plans through a SHOP-registered broker, such as eHealth. Just click the button on this page to get started.

Qualifying for a small business tax credit with fewer than 25 FTEs

SHOP small business health insurance plans may be especially attractive to businesses that have fewer than 25 FTEs. If your business has fewer than 25 employees, it might qualify for the ACA Small Business Health Care Tax Credit.

To qualify for the Small Business Health Care Tax Credit, your business must:

  • Have fewer than 25 FTEs
  • Pay an average annual salary around $50,000 or less
  • Cover at least half of employees’ health insurance premium costs
  • Offer SHOP health insurance coverage to all full-time employees

You don’t have to offer coverage to part-time employees or dependents to qualify for the tax credit.

The credit is based on many factors, but in most cases it’s a substantial amount that greatly offsets the cost of offering a SHOP small business health insurance plan to employees.

Find a SHOP small business health insurance plan

For help finding an ACA SHOP small business health insurance plan that fits your business’s budget and provides solid coverage for employees, click Find Plans on this page. eHealth is a SHOP-registered health insurance broker. Our representatives are well-versed in the plan options and able to assist in comparing multiple ACA health insurance plans so you can select the best available one for your business. eHealth can help you find affordable coverage, with a plan that qualifies for the tax credit if that’s applicable in your situation.

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.

eHealth Medicare Customers Speak Up

How confident are you in the future of the Medicare program? What do you think of the “Medicare-for-all” ideas that some politicians are proposing these days?

Those are among the questions eHealth asked in a recent survey of customers who bought Medicare Advantage, Medicare Supplement or Medicare Part D prescription drug plans through eHealth. With more than 2,000 responses, the results were really fascinating.

Enrollees are worried about the future of Medicare

Most enrollees are happy with their Medicare. Only 6 percent said they were dissatisfied with their coverage. But a lot of Medicare enrollees are worried about the future of the program. In eHealth’s survey, fewer than two out of ten enrollees believe Medicare will survive for generations to come.

  • 23 percent were not confident that Medicare would last even their own lifetime.
  • 41 percent were not confident that Medicare would be there for their children, though they thought it would last their own lifetime. believed Medicare would be there for themselves, but might not be there for their children.
  • 17 percent were not confident Medicare would be there for their grandchildren, though they believe the program would last long enough for themselves and their children.

Reducing drug costs are seen as key to saving Medicare

When asked what they think should be done to help ensure the future of Medicare, there was a surprising amount of consensus when it came to prescription drugs:

  • 73 percent said that caps should be placed on the amount that pharmaceutical companies can charge for drugs.
  • Twenty-five percent said that doctors and hospitals should be paid less for medical care.
  • Twenty-three percent said that Medicare taxes should be raised on people who are not yet eligible for coverage.

What about “Medicare for All?”

With the 2020 presidential election in sight, some politicians are talking about expanding Medicare to cover more people than it does today. When eHealth asked enrollees how they feel about some of these proposals, responses were mixed:

  • 41 percent of survey respondents said that all Americans should have some form of Medicare-like coverage.
  • 42 percent believed that Medicare should stay the way it is – limited primarily to people age 65 and older.
  • 11 percent said that the Medicare eligibility age should be lowered from 65 to 55.

To read more about eHealth’s recent survey, click here. eHealth will be tracking these and other trends among Medicare enrollees in the months to come.

Why Some Older Consumers Choose Short-Term Coverage

In a recent survey of people who bought short-term health insurance, eHealth learned some surprising things about the way in which older consumers approach short-term coverage.

For example, they’re more cost conscious than younger enrollees and more likely to treat short-term plans like a less-costly mid-term alternative to health plans compliant with the Affordable Care Act (ACA):

  • Affordability is key for many older enrollees: 70 percent of respondents ages 55 to 64 cited affordability as their primary reason for choosing short-term coverage, compared to 53 percent of young adults ages 18 to 24.
  • Older enrollees want short-term coverage for the long haul: 64 percent of people ages 55 to 64 said they would like to retain short-term coverage for 7 months or longer; by comparison 56 percent of those between the ages of 18 and 24 said they intend to keep their short-term coverage for no more than 6 months.

eHealth believes that comprehensive coverage – the kind provided by ACA plans – is your best choice if you can afford it. Unfortunately, many middle-class Americans don’t qualify for ACA subsidies and cannot afford comprehensive ACA plans.

Since the cost of coverage increases significantly as you age, older Americans who don’t get ACA subsidies may be forced to choose between short-term coverage or going uninsured.

A big change of perspective on short-term coverage

While older consumers showed special interest in short-term coverage, eHealth found a change in consumer attitudes across all age bands since the maximum term of short-term policies was extended beyond 90 days:

  • Overall, 61 percent of eHealth’s survey respondents say they chose short-term coverage primarily because it was more affordable than their other coverage options; 28 percent say they chose short-term because they only need temporary coverage.
  • A year ago, when short-term plans carried a maximum policy term of 90 days, 27 percent cited affordability while 61 percent said they only needed temporary coverage.

Most short-term customers are satisfied with their plans

eHealth’s survey also found that the vast majority of short-term buyers are happy with their coverage. More than 9 in 10 enrollees said they were very satisfied (41 percent) or somewhat satisfied (51 percent) with their short-term plan.

Eighty-six percent of those who have received medical care while covered by their short-term plan said they were very or somewhat satisfied with their coverage, despite the fact that short-term plans do not provide the comprehensive coverage available under ACA-compliant plans.

Read eHealth’s full survey report for more survey results and analysis.

Know what you’re getting when it comes to short-term coverage

eHealth strongly believes that consumers interested in purchasing short-term health insurance should understand what they’re buying and how short-term coverage differs from coverage provided through ACA-compliant health insurance plans.

Short-term plans do not typically coverage things like preventive medical care, pre-existing medical conditions, maternity care, or retail prescription drugs, and it’s possible to be turned down for coverage based on your medical history.

Educational materials are found on the eHealth website and a brief guide to short-term coverage may be found here.

5 Tips for Saving on Your Small Business Taxes

Running your own business can make filing your taxes complicated, so the sooner you start organizing your finances, the better. The 2018 tax year is coming to a close, which means it’s the perfect time for small business owners to start planning for next year’s taxes.

Here are some tips to help you stay ahead of the game and save some money:

1. Tax software is helpful—use it!
There are many good reasons for small business owners to use tax software. For one, it keeps track of deductions that may otherwise be missed. In addition, your filings are automatically backed up. Most importantly, your filings are accurate – according to the IRS, less than 1% of online tax returns have errors, compared to 21% of paper returns.

2. Stay on top of tracking deductible expenses.
It’s easy for expense receipts to get lost and expense tracking to get neglected. Download expense tracking software, or better yet, a mobile app that lets you take photos of your receipts. Some apps even let you roll in expenses from your credit card and online banking accounts so that your expenses are all in one place. At year end, you’ll be able to easily produce a report rather than have your CPA waste their precious time sifting through a shoe box of receipts.

 3. Pay your retirement accounts now.
As a self-employed worker, your taxable income can be reduced by putting income into a retirement plan. This income won’t be taxed until you retire, so you’ll double your benefits by having a tax break now and creating a secure retirement for later. As a small business owner, you can contribute up to $5500 to a traditional or Roth IRA if you’re under 50; $6500 if you’re over 50.

4. Make sure to deduct your home office and business equipment.
If you work from home, you may be able to deduct insurance, mortgage interest payments, repairs and utilities. Both renters and homeowners are eligible. After determining what portion of your home is dedicated to running your business, your tax software calculates which percentage of these you can deduct.

 5. Keep an eye out for carryovers.
Some deductions may not be fully used in one year and can be carried over into future years. These can include capital losses, net operating losses, home office deductions and charitable deductions. Don’t forget to track these from one year to the next.

 

This article is intended to provide generalized tax information. It does not give personalized tax advice.

How to Create the Perfect Springtime Salad

The basics of salad

Salads can be made any time of the year, but spring is arguably the best time to enjoy them because more fresh produce is available.

The key to building a great salad is creating a balance of tastes and textures. Follow this simple formula to make a spring salad that is substantial enough to stand on its own as a meal:

1. Salad greens

A typical salad base begins with approximately three cups of salad greens per person. Romaine, red leaf, butter or Little Gem are good varieties of lettuce to try. Spinach and arugula are also in season in spring, as is baby kale (massage first with olive oil first). Save some prep time with pre-packaged salad mixes.

2. Vegetables and (technically) fruits

Use as many of these as you want! Some ideas: avocados, carrots, cucumbers, asparagus, radishes, peas, spring onions and sprouts.

3. Grains or starch

Salads can be made into a complete meal by adding a little starch, but don’t go too crazy–around half a cup per person is good. Healthy grains such as rice, couscous, quinoa, wheat berries or farro work well.  New potatoes are also a nice springtime addition.

4. Protein

Feel free to add a little lean protein to your salad. Aim for about 3oz of chicken, tuna, hard-boiled eggs, or tofu. Half an ounce of crumbly cheese like blue cheese, feta or goat cheese can add more flavor and help fill you up!

5. Garnishes

Garnishes can be used to make your salad stand out. Crunchy or salty work well here. Sprinkle nuts and seeds like almonds, walnuts, pumpkin seeds, or pine nuts.

6. Dressing

Some say that the best salad dressing is a simple combination of three parts olive oil to 1 part vinegar—the higher quality the ingredients, the better the dressing. Add salt and pepper to taste. You can also substitute lemon juice for vinegar and add honey, mustard, herbs, minced garlic or shallots. Tahini and white miso also make good bases.

Create your own healthy masterpiece

Now that you have the proportions down, create your own salad masterpiece or try one of the following combinations:

Salade Niçoise

Butter lettuce, green beans, red peppers, new potatoes, tuna, hard boiled eggs, pitted Kalamata olives. For the dressing, whisk together olive oil, red-wine vinegar, Dijon mustard, garlic, and salt to taste.

Kale Salad

Massage kale with olive oil, lemon juice and a pinch of salt. Add in chopped avocado, brown rice and crumbled wasabi-flavored nori (seaweed). Top with sliced green onions. This salad doesn’t really need a dressing but a splash of soy sauce is a good addition!

Farro or Wheat Berry Salad

Arugula, cooked farro (or wheat berries), cherry tomatoes, cucumber, radishes, pine nuts and shaved parmesan cheese. Top with a dressing made from olive oil and apple cider vinegar with your choice of fresh herbs.

5 Mistakes Small Business Owners Should Avoid

Being a business owner isn’t easy! There’s a lot of work to do and countless decisions to make every day. The last thing you want to do is make a mistake that can hurt your potential for success, or set you back from your goals.

Here are 5 commons mistakes that you should avoid as you continue to build your business.

1. Failing to plan

As the saying goes, “when you fail to plan, you’re planning to fail” and this couldn’t be more true when it comes to owning your own business. A solid business plan will help you make the right decisions for your company.

A business plan should include measurable goals, a realistic budget, and a marketing plan.

If you need help getting started, there are plenty of online tools that make creating a business plan painless.

2. Complacency

Don’t assume that your customers are satisfied and your employees are happy. If you’re not constantly trying to do improve, then you’ll quickly fall into a state of complacency.

Be proactive – get feedback from your customers and always challenge yourself to do better. Make sure you’re listening to your employees and strive to make the office an enjoyable space.

3. Underspending

Sure, you don’t want to blow out your budget and put yourself in a tight spot. However, you may need to spend money to make money. Don’t limit your potential for success by refusing to put money into areas that matter.

Critical items to spend money on are marketing efforts, equipment necessary for the job, and proper technology.

If you’re not sure where to get the most bang for your buck, work with a financial planner to make sure you’re spending in an area where you’ll see the return.

4. Not knowing who your customer is

One very vital part of creating a successful business is understanding who your ideal customer is. Make sure you do your market research so that you can put together the right marketing approach and create an ideal customer experience.

Once you’ve got a pool of customers, start reaching out for feedback. Make calls, send surveys – get to know your customers and continue to improve the services and experience you provide to them.

5. Thinking you can do it all alone

Stop trying to do everything yourself! Start delegating works and asking others for help. You’re in this for the long haul and do not want to get burned out because you take on too much.

You’ll be run a more productive business if you hire the right staff and assign work to others. One person can only handle so much before they start making mistakes.

3 Easy Exercises for Beginners

Whether you’re brand new to exercise or just took an extended break, make sure you ease into your new routine. Start with easy, beginner-level exercises and work your way up to harder workouts.

Here are 3 basic exercises that you can do from the comfort of your home. No gym membership is required!

Perform each exercise below for 2 sets of 10 repetitions each. Do this quick workout three times a week for great results and a fun challenge. For extra support and stability, use an exercise mat.

1. Low –impact jumping jacks

Increases blood flow to the heart and gets your muscles warmed up!

  • Stand with your feet together, knees slightly bent, and arms at your side.
  • Extend your right leg to the right side while raising your arms above your head.
  • Bring your right leg back to original standing position with your feet together.
  • Extend your left leg to the left side while raising your arms above your head.
  • Bring your left leg back to original standing position with your feet together.

Once you’re comfortable with these steps, boost your workout with standard jumping jacks.

2. Push-ups

Builds upper body strength in the triceps, chest and shoulders.

Start slowly with beginner push-ups:

  • Get on your hands and knees with palms flat on the ground, shoulder width apart.
  • Keep your back straight and slightly bend your elbows.
  • Slowly lower your chest halfway to the ground and then push back up.
  • To avoid neck strain, makes sure to keep your gaze focused on the ground.

When you feel ready, challenge yourself with standard push-ups.

3. Plank

Strengthens your core, which includes your abdominal, pelvic, and back muscles.

Begin with this easy version of the plank:

  • Move into a beginner push-up position (mentioned above) so your knees are on the ground.
  • Keep your back straight and slightly bend your elbows.
  • Hold this position for 10-15 seconds (or as long as you can).

If you master the easier plank position, push yourself to try a full plank position by lifting your knees off the ground.

Remember, if anything hurts or causes pain, stop immediately. And, as always, check with your doctor before beginning this exercise program.

3 Ways to Have a Healthier Work Day

1. Block out “you time” on your calendar

We may say to ourselves that we are going to get more steps in or incorporate a gym session during the day, but with a day full of meetings and a growing to do list, it’s easy to let a workout commitment slip away. Set a meeting with yourself for 15 minutes, 30 or even an hour a day and commit that time to be active. Whether it be a walk around your workplace or a quick session at the gym, you’ll be happy you set up those reoccurring “meetings” for self-care.

2. Store healthy snacks in your drawer

Whether you’re in the middle of a big project or you’re chained to your desk with a looming deadline, there are days when lunch hour gets missed. Stock up your drawer with healthy snacks that have a longer self-life. Dried apples, nuts, plain oatmeal packets, applesauce, and granola are great options to have on-hand to stay fueled and focused. By keeping healthy options close by, you’ll be less likely to grab fast food or visit the vending machine.

3. Hydrate!

We all know drinking lots of H20 is good for the body and mind, but it is so easy to forget! To make sure you stay hydrated, first look up how much water you should be drinking a day based on your height and weight. Second, set a task on your calendar at the end of your workday that has you check with yourself if you met your daily ozs. Try this for a month and once it becomes habit, you probably won’t need that water reminder!

Medical Expenses and Taxes: What You Need to Know

Medical expenses can add up, especially if you experience unforeseen emergencies that aren’t covered by your health insurance. The good news is that the Internal Revenue Service (IRS) has made some of these expenses partly tax-deductible.

How much can I deduct?

For the 2018 tax year, you can deduct qualified medical expenses that exceed 7.5% of your adjusted gross income.  Beginning Jan. 1, 2019, all taxpayers may deduct only the amount of the total unreimbursed allowable medical care expenses for the year that exceeds 10% of their adjusted gross income.

Your adjusted gross income is your taxable income minus any adjustments, such as deductions, contributions to your IRA and student loan interest.

Which medical expenses are deductible?

Qualified medical expenses that you can deduct include preventative care, treatment, surgeries and dental and vision care. You can also deduct visits to psychologists and psychiatrists. Prescription medications and appliances such as glasses, contacts, and hearing aids are also deductible.

The IRS also lets you deduct the expenses that you pay to travel for medical care, such as care mileage and parking fees.

You cannot deduct any medical expenses for which you are reimbursed. You also cannot deduct expenses for cosmetic procedures, non-prescription drugs (except insulin), or general health purchases, like band aids, vitamins, or toothpaste.

How do I claim my medical expenses?

In order to claim your medical expenses as a deduction on your taxes, you need to itemize your deductions. Itemizing your deductions means that you do not take the standard deduction. You should only claim the medical expenses deduction if your itemized deductions are great than your standard deduction.

To learn more about how to itemize your deductions, including your medical expenses, we recommend consulting a tax professional.

This information is current for the 2018 tax year. For more information, including a complete listing of deductible medical expenses, visit the IRS website at https://www.irs.gov/taxtopics/tc502

This article is intended to provide generalized tax information. It does not give personalized tax advice.

3 Things You Should Know About Your Short-Term Plan

1. Your Short-term plan likely covers your existing doctor

Many short-term plans do not have networks, which means you can generally go to whatever facility or provider you want. If your plan does have a network, you’ll need to check the plan specifics in order to see where you can go in order to receive covered care. Short-term plans typically restrict what type of doctor visits are covered, so check your plan details.

2. You may be able to have your short-term coverage for up to 3 years in most states.

Some short-term plans can provide coverage for up to 3 years in some states! However, unlike a major medical plan, your short-term health insurance does not automatically renew. You can submit a new application if you want to add another period of coverage. Some states and some plans do not allow coverage up to 3 years.  In addition, pay attention to deductible resets, pre-existing condition exclusions, and other issues that may come up when you re-apply for a short-term plan. Check your policy to find out how long you’re covered and your options for applying for longer coverage.

3. You should know the national Open Enrollment dates if you decide to switch coverage

If you want a major medical plan (sometimes called long term health insurance or ACA plans), you’ll have to wait for the annual Open Enrollment Period or until you have a qualifying life event that triggers a Special Enrollment Period. The end of a short-term plan is not a qualifying life event, whether or not you are able to apply for additional short-term coverage.  With that in mind, make sure to stay on top of the annual Open Enrollment Period (generally in November to December) so that you can switch to long term coverage.

Get even more of your questions about short-term health insurance answered here.

What Are Health Insurance Marketplaces?

Many people acquire health insurance through their jobs, school, or spouses. However, other individuals, such as those who are unemployed or are self-employed, need to use various health insurance marketplaces to enroll in a plan that meets their unique medical needs. In fact, in accordance with the Affordable Care Act (ACA), both private and government-run health insurance marketplaces make it easier for individuals to review plans, ask questions, and compare health insurance quotes.

What is a health insurance marketplace?

A health insurance marketplace is an incredibly valuable resource that is available for individuals, families, and small businesses as they research the best healthcare options for their unique medical needs. By visiting a health insurance marketplace, individuals can more readily complete the following tasks.

  • View and compare health insurance quotes without phone calls.
  • Discover the best individual health insurance plans based on affordability and coverage.
  • Ask questions and receive answers about the specifics on both individual and family health insurance plans.
  • Review health insurance companies to learn more about their reputation, the services they provide, and their network of local doctors.
  • Learn more about tax credits for both health programs and private insurance.
  • Enroll in a health insurance plant that is uniquely designed to meet the specific needs of you (and your family).

Instead of speaking with someone on the phone, or in person, you can receive a quote in minutes by providing some basic information about yourself on an online marketplace. The latter marketplaces are often considered the “one stop shop” for finding and purchasing health insurance throughout the entire year.

Private exchanges vs public marketplaces

Essentially, a private health insurance exchange is a health insurance exchange run by a private company, and a public health insurance exchange is run by the government. The state exchanges are also considered public health insurance exchanges.

eHealth is an example of a private online marketplace, and an example of a public exchange is the government-run Marketplace. Public marketplaces such as the government Marketplace, or your state’s official exchange (if it has one) are only going to offer ACA-compliant health insurance plans, also called Obamacare, or Qualifying Health Plans (QHPs). Private marketplaces like eHealth have a wider range of options, including plans that have less benefits, but are more affordable. Luckily, on eHealth you can look at Obamacare plans (QHPs) along with off-exchange plans and major medical alternatives like short-term health insurance. You can even see if you qualify for a government subsidy and have it applied during enrollment without ever leaving eHealth’s site, since we have a proxy direct enrollment agreement with the federal marketplace.

How to find affordable health insurance using a private health insurance marketplace

Finding affordable health insurance has never been easier thanks to private health insurance markets. As discussed in the preceding section, private health insurance markets are designed to help you find individual health insurance plans and family health insurance plans in minutes. You can even receive free health insurance quotes without having to speak to someone on the phone. In this vein, comparing health insurance plans offers a variety of benefits.

  • You can find the plan that best fits the current and future medical needs of you and your family.
  • You can easily weigh all of your options on one website before selecting the right plan.
  • You can choose the right plan based on affordability, coverage, flexibility, and tax credits (if applicable).
  • You can avoid spending extra money by working with a private health insurance marketplace that doesn’t have broker fees.
  • You can ensure that you (and your family) have the right health insurance plan when you need it most.

Purchasing personal health insurance is made easier when you compare health insurance quotes.

Whether you have recently started a new company or are transitioning between jobs, you don’t want to be left unprotected. By using a private health insurance marketplace you can easily compare health insurance plans so that you and your family remain protected in the event of unexpected illnesses or injuries. If you take a few moments to compare health insurance quotes, you can more easily find the plan that best fits your unique medical needs. From choosing the most affordable plan to selecting a plan with the best health insurance companies, private health insurance marketplaces, such as eHealth, make it easy for you to get free online quotes, compare plans, shop, enroll, pay, and discover if you qualify for subsidies. Don’t delay, take a few minutes to find the health plan that is right for you and your family by visiting eHealth today.

Guide to Low-Cost and Free Health Insurance Options

Most of you know that the increasing cost of medical coverage has presented a big obstacle for many families and individuals. However, you should not assume that you cannot afford a health plan; instead, you should explore many low-cost and free health insurance options that are available to many people.

What to know about free and low-cost health insurance alternatives

Before you explore free and low-cost health insurance options, you should understand that robust benefits will always cost money. When you find a health plan that appears much more affordable than other alternatives, you should compare it with other health insurance to determine why the insurer can offer this low-cost or even free health insurance for less than competing plans.

For instance:

  • Subsidized premiums: Plans from work or the Obamacare Marketplace may appear to be low-cost health insurance because the government or an employer pays a large part of the premiums. It’s important to understand the difference between the true cost of low-cost and free health insurance alternatives even if you don’t have to pay the entire premium yourself.
  • Fewer benefits: Some low-cost health insurance alternatives, like temporary health insurance, won’t usually include as many guarantees and benefits as true major medical policies, like the ones on the Obamacare Marketplace or group coverage at work. At the same time, you might choose a low-cost health insurance plan with benefits you urgently need and a price you can afford.

Low-Cost and free health insurance options

Explore these low-cost and free health insurance alternatives:

1. Medicaid

According to the government, Medicaid covers almost 70 million Americans. Since the federal government cooperates with each state to offer very low-cost or free health insurance to people with low incomes and few assets, qualification rules will depend upon where you live.

These are some quick facts about this type of low-cost or free health insurance:

  • In states that expanded Medicaid, households that earn less than 138 percent of the federal poverty level may qualify. For instance, this would equal about $16,753 for one person and about $34,638 for a family with four people.
  • In other states, applicants may have to be elderly, children, or disabled to qualify for Medicaid.
  • The Children’s Health Insurance Program, usually called CHIP, typically accepts children or pregnant women with a household income that doesn’t exceed 200 percent of the federal poverty guidelines.

2. Short-term health plans

Families and individuals who need to fill in coverage gaps with low-cost health insurance may benefit from short-term health insurance plans. Just this year, the government relaxed rules about short-term health insurance to allow initial enrollment for 12 months and renewals for three years.

Americans also don’t need to worry about tax penalties for failing to have ACA-compliant coverage; however, it’s important to understand that short-term policies won’t typically cover maternity, mental health, or any number of pre-existing conditions that Obamacare policies must include benefits for. Short-term policies will almost always cost less than true major medical, but because of the limitations, you might consider it to fill in gaps between job-related or Obamacare insurance and not as a permanent solution.

3. Obamacare subsidies

Just about 12 million Americans enrolled in Obamacare medical plans. While you may not consider the base premiums for many of these plans a low-cost health insurance option, you should know that about 83 percent of all enrollees qualified for a subsidy that reduced the actual premium they needed to pay, according to the Chicago Tribune.

Typically, American citizens and legal residents can qualify for a subsidy if they earn between 100 and 400 percent of the federal poverty level and don’t have access to other affordable coverage.  As a government partner, eHealth lets you compare, apply for, and buy Obamacare policies–and you don’t even have to leave our site in order to find out if you qualify for subsidies, or enroll in an Obamacare plan.

4. Employer group health plans

Over half of all American employers offer group health plans to at least some employees, according to the Kaiser Family Foundation. The average employer pays for about three-quarters of the premium, though some may pay as little as half.

Small business owners may also find that they can benefit from offering low-cost health insurance to their employees in several ways:

  • The employer and the employer’s family can also enroll in group coverage.
  • Businesses can take advantage of tax deductions and incentives for offering group health plans.
  • Employers may find that high-quality employees prefer to work for companies that offer group health insurance.

If you’re a small business owner, you can also compare small business health insurance at eHealth.

5. Coverage from other family members

Obviously, many people rely upon their spouse’s low-cost health insurance. In addition, even adult children can remain on a parent’s plan until they turn 26. If you’ve lost your low-cost health insurance, you might need to wait until the Obamacare Open Enrollment Period if you don’t qualify for a Special Enrollment Period. Some life events that trigger a Special Enrollment Period include death, birth, marriage, and job loss.

How to Find Low-Cost and Free Health Insurance Options

Typically, you can use the same application that you use for Obamacare to find out if you or any family member qualifies for free health insurance from such government programs as Medicaid and CHIP. You can start your search for low-cost health insurance alternatives online at eHealth. This includes Obamacare, short-term health insurance, small business group plans, and other options.

Defining Private Health insurance

When it comes to insurance coverage, the options can be a little overwhelming. Understanding all of the terms and how they apply to you is pretty important if you are going to make a good decision. One of the terms that you are likely to run into when shopping for an insurance plan for you or your family, is “private health insurance.“ Having a good definition for private insurance can make it easier to understand your options, and why  private health insurance might work better for you than what’s offered on the government-run marketplaces associated with the Affordable Care Act (ACA).

What you need to know about private health insurance

The term “private health insurance“ simply refers to any health insurance coverage that is not offered by a state or federal government. Private health insurance is, instead, offered by a private entity instead (most often a for-profit company). You may also hear private health insurance plans called “off-exchange” plans–this means it’s a major medical plan (offers everything that an Obamacare is required to), but not sold on the ACA’s exchanges. Some people may mistakenly refer to all private health insurance as “off-exchange”, but really it only applies to major medical plans, and not alternative options like short-term health insurance or medical insurance plans that do not meet Obamacare standards.

There are a number of private health insurance options available. These can include:

  • plans purchased directly from a health insurance carrier
  • plans purchased through an agent or broker (like eHealth)
  • employer-sponsored health insurance plans

Some private health insurance options are created to fit the requirements of the Affordable Care Act (also known as Obamacare). However, there are other private health insurance plan options that offer different benefits and coverage.

Private health insurance dominates the market

According to the CDC, 65% of Americans under the age of 65 are insured by private health insurance (after the age of 65, many people become insured by Medicare, which is a federal health insurance program).

This impressive statistics suggests that, despite growth of government Marketplaces since the Affordable Care Act (ACA), private health insurance is still an incredibly important component of health coverage in America. Most of this comes from Americans getting group coverage from their employer–in fact, 60% of Americans under 65 receive health insurance as a benefit from their employer according to a Kaiser Family Foundation study.

Although most people get private health insurance through their employer, individual and family private health insurance if available for those who are self-employed, or either do not want, or have access to government or employer-sponsored health plans. eHealth is here to help guide those individuals who are shopping for private health insurance on their own. You can even use eHealth to look at ACA (Obamacare) plans too, and see if you apply for a government subsidy.

Where can I get private health insurance?

There are a number of avenues someone can pursue to find private health insurance. Many people buy private health insurance directly through a health insurance company, or through their local health insurance broker, or an online broker like eHealth.

With eHealth, you’ll get free quotes to compare different plans, and clarity throughout the enrollment process without any extra cost to you. You can also shop for a variety of types of private health insurance, not just traditional individual and family plans that offer a large amount of benefits. If you’re looking for more affordable options, you can check out alternatives, like short-term health insurance.

More options with private health insurance

Outside the federal marketplace, you can find a wider array of insurance options. For instance, someone who is young and healthy may wish to look at more bare bones insurance policies such as catastrophic or short-term insurance. These policies often contain less benefits, but cost significantly less on a month-to-month basis (you’ll see this reflected in your premium cost).  Someone who is older or has a chronic health condition may not find this sort of coverage adequate, and might choose to stick with more bulky private health insurance plans, found on eHealth.

When looking for the right coverage for yourself, make sure you check out your private health insurance options. With private health insurance through eHealth, you’ll have convenient access to free quotes on plans, and plenty of options to choose from. Carefully weigh the choices ahead of you so that you can find a policy that offers what you need at a price that makes sense for your specific circumstances.

What Is the Best Insurance Company for Small Businesses?

A small business that provides group health insurance to their employees is better able to attract the talent they need to meet their goals. Finding the right group health insurance plan means that a small business has to keep their specific needs, as well as their budget and their employees, in mind when they are looking at the options offered by health insurance companies.

Best Health Insurance Companies for a Small Business

Whether a small business is searching for their first small business (also called group) health insurance plan or they are hoping to switch to a more affordable one, it’s important to know that you’re being covered by a reputable company. When shopping on eHealth you’ll have options from some of the best health insurance companies for your group health insurance plan. Check out some of the amazing health insurance companies that eHealth carries group health insurance plans from.

Aetna

Aetna is a health insurance company that has been in existence since 1853. According to an annual report released by the National Association of Insurance Commissioners (NAIC), the company has a market share of 5.54 percent which equates to providing coverage to about 22.1 million people.

Aetna is well respected, having been recognized by J.D. Power as being “better than most“ in its Florida Member Satisfaction Index Ratings and by Forbes by being named to its “World’s Most Admired Companies“ list. EHealth offers group health insurance plans from Aetna, as well as many other products.

United Healthcare

Founded in 1977, United Healthcare (UHC) is the top health insurance company in regards to market share with a 12.75 percent share of the market, according to NAIC’s annual report. As of this writing, United Healthcare offers health insurance in all 50 of the United States.

J.D. Power ranked United Healthcare as being “among the best“ Texas health insurance companies. The company also earned accolades in Arizona for the “highest overall experience.” EHealth carries group health insurance plans for small businesses from UHC, as well as many other products.

Anthem

Anthem provides health insurance, including options for a small business, for 40 million members, making it the Blue Cross Blue Shield Association’s biggest managed and for-profit health care company. The NAIC report noted that Anthem’s market share is 6.07 percent.

According to the J.D. Power Member Satisfaction Index Ratings, Massachusetts members ranked Anthem Blue Cross Blue Shield (Blue Card) as being “among the best.” Visit eHealth’s site to see if Anthem group health insurance is available in your area. 

Kaiser Permanente

Kaiser Permanente was founded in Oakland, California in 1945. Over the past 70 years, the company has become the country’s largest managed care organization. According to the NAIC annual report, Kaiser Permanente has 7.37 percent of the health insurance market share.

There are six regions and states that ranked Kaiser Permanente as being the highest according to rankings released by J.D. Power. These include the Northwest and South Atlantic regions, as well as the states of California, Maryland, Colorado and Virginia. EHealth offers Kaiser Permanente group health plans–by simply providing some information about your small business, you can see if thre are Kaiser Permanente group plans offered in your area.

Humana

Humana is a company that has its roots in the nursing home industry. Twenty years later, in the 1980s, Humana started offering health insurance. It has since grown to secure 5.46 percent of the market share, according to NAIC.

The “Social Responsibility” category, according to Fortune, ranked Humana as number one in the category. In addition, Florida members stated that the health insurance company was “better than most,“ as reported by Member Satisfaction Index Rankings from J.D. Power. Depending on where you live, you can find small business health insurance from Humana.

Health Care Service Corporation (HCSC)

The Health Care Service Corporation (HCSC) is another independent Blue Cross Blue Shield Association licensee. According to the NAIC, the company has a market share of 3.28 percent and provides 16 million customers with health insurance.

J.D. Power noted that HCSC has secured high rankings fro its members in both Florida and Illinois with “highest customer service” and “highest overall experience,“ respectively. HCSC group plans can be found through us, along with several other products from this health insurance carrier.

How to choose a group health insurance plan for your small business

eHealth offers group health insurance plans for small businesses from all of these renowned health insurance companies. Depending on where you live though, group health insurance plans might not be available from all of these health insurance companies. Visit eHealth to see what’s offered in your area, and compare group health insurance plans for your small business for free. There is no charge when using eHealth to see quotes, compare plans, and get help with enrolling in your group plan. Group health insurance plans on eHealth are the same price as anywhere else, so you won’t be surprised by extra costs at any point when using our services to shop for your group health insurance plan.

When searching for group health insurance for a small business, it’s important to remember that there is no one-size-fits-all solution. For example, not all health insurance companies provide group health insurance plans for a small business in all 50 states. In fact, the health insurance options that are offered can vary between states across the country.

Should I Offer Telemedicine to My Employees?

In recent years, telemedicine has begun to transform how patients obtain outpatient healthcare services. With benefits for both employers and employees, this is a service that more employers are including in their health plan coverage and you may want to include in your small business health insurance group plan as well.

Providing outpatient medical care remotely

Telemedicine utilizes modern communications technologies to provide patients with remote access to healthcare service. It’s primarily used for outpatient services, where there isn’t a need for hands-on care. For example, patients might make telemedicine appointments if they have a cough, fever, stomach issues or similar symptoms.

The definition of telemedicine encompasses both phone conversations and online video chats, so medical providers have technically been able to offer these services for some time over the phone. The increase in video chat’s popularity, however, has rapidly accelerated the adoption of these services.

Helping employers control health insurance costs

For employers, telemedicine can help mitigate increasing health insurance plan costs. Telemedicine appointments generall bill for less than comparable in-office services, which means insurance companies don’t have to pay providers as much for claims. This savings helps insurers keep premiums more affordable for employers and employees, ultimately lowering both parties’ premium payments.

Because small business health insurance group plan premiums are so high, any way they can be kept in check is welcome by employers. The average annual premium for an employer-sponsored family plan was $19,616 in 2018, and employers commonly ended up paying around $14,069 of this for each employee who had a family plan. At over $14,000 per employee family plan, just a small reduction in premium costs results in substantial savings.

The advantages that telemedicine can offer employers is confirmed by how many businesses have chosen to include it in their plans’ covered services. There has been nearly a 50-percent increase in the number of employers who have plans that cover telemedicine in the past three years, with just 27 percent including coverage in 2015 and 74 percent offering coverage in 2018.

Providing convenient care for employees

For employees, the benefits of telemedicine are obvious. In addition to any financial incentives offered by a plan (and many group plans offer incentives), it’s far easier to get treatment remotely than by going to an office, clinic or hospital. This is especially true when seeking after-hours care, trying to manage childcare and/or work needs, when living in a remote location, or during inclement weather.

Telemedicine isn’t right for every situation, but it’s a very attractive option when it’s a viable and medically responsible one.

The total number of telemedicine appointments remains quite small — just over 0.5 percent of all claims according in one dataset — but the numbers suggest that employees might be quickly making the switch to the more convenient care.

For one, this data only goes through 2016. It doesn’t reflect 2017 and 2018 numbers, when employers were adopting the service at a rapid rate. Many more employees may have tried these services in the past two years since 2016.

Additionally, the percentage of telemedicine claims has increased dramatically between 2013 and 2016. Even though the total number of these claims accounted for just 0.51 percent of all claims in 2016, that was more than six times the 0.08 percent rate in 2013.

While not as conclusive as the employer data, the employee data certainly suggests that more and more employees are using telemedicine because of its convenient care.

Deciding for your small business health insurance group plan

Determining whether telemedicine is a service that your business should include in its employer-sponsored small business health insurance group plan is ultimately a decision that you must make based on the specific circumstances surrounding your business and employees. Keep in mind, though, that providing any extra benefits (and especially benefits that employees use) could help your business attract more quality employees, improve overall employee satisfaction and reduce annual turnover.

For help assessing your business’ situation and whether telemedicine makes sense for your employees, contact one of our knowledgeable agents. Small business health insurance agents are available from 8:00 a.m. to 8:00 p.m. EST and would be happy to help you make a decision that’s right for your company.

Providing a Small Business Pension Plan

Creating pension plans for your employees might be a smart move as a small business owner. Let’s explore some reasons why a small business pension plan could be beneficial to both you and your employees.

What are small business pension plans?

Pension plans are retirement plans in which an employer contributes to employees’ retirement funds, according to Investopedia. Usually, they promise a specific amount of benefits at retirement.

  • There are Defined Benefit Plans where a certain amount of money is guaranteed for retirement, usually based on income earned and years of service—this is probably what you think of as a more traditional pension in which the employee is guaranteed a defined amount of monthly income after retirement.
  • Another type of retirement plan is a Defined Contribution Plan, like a 401k, in which the employer can match a percentage of what the employee puts into to a fund that is invested, and the returns on those investments are used for an employee’s retirement. This plan may rely more on the employee making choices about contributing and investing wisely.

Creating pension plans for the employees of your small business has certain benefits that might be worth the cost. Let’s look at the pros and cons of creating pension plans, and the different options out there for choosing a small business pension plan.

Creating pension plans could help you as well as your employees

The benefit of a small business pension plan is clear for employees—they’ll have a retirement to lean back on once they are done working. But did you know there might be benefits to you as the employer as well?

  • Recruiting good workers. If you want to attract the top talent to your small business, including benefits like a small business pension plan may help. AARP reports that nine out of ten Americans believe everyone should have a pension plan. And a skilled worker with a desirable skillset has the luxury to wait for a job that does offer that benefit.
  • Lowering employee turnover. Losing employees and having to re-hire is neither cost-effective nor productive for a small business. If you offer employees what they need to be well covered, they might be more likely to stick with your small business.
  • Keeping employees motivated. Cultivating a feeling of support with a small business pension plan may give your employees reason to stay motivated. Since some pension plans may even be based on the employee’s salary while working, your employees might be encouraged to perform well and earn more throughout their career.

Tax benefits: all the more reason for a small business pension plan

You may be eligible for a tax credit for establishing a qualified retirement plan to offer to your employees. This could help offset the cost of creating pension plans for employees.

Talk to your accountant or a tax specialist to discuss your options for saving on taxes by offering a small business pension plan.

What’s the difference between qualified and non-qualified pension plans?

There are plenty of different types of small business pension plans to choose from when creating a pension plan, such as the “defined benefits plan” and “defined contribution plan.” But another distinction is whether the plan is qualified or unqualified.

Qualified plans, such as a 401k, let you take a tax deduction when you’re still contributing to the plan, according to Investopedia. So when employees retire and start using their pension plans, they will be taxed on the money that comes from it.

Non-qualified plans are funds made up of after-tax money, reports Investopedia. A Certificate of Deposit (CD) is one example of a non-qualified plan. When the employee retires and withdraws the funds from the small business pension plan, it will not be taxed again.

Pros and cons of a small business pension plan

Pros. The nice thing about a pension plan is that it gives employees some type of financial support after they are retired. From the employer’s perspective, it might create a positive work experience that attracts quality employees.

Cons. Pension plans could require the employer to shoulder a lot of the responsibility of funding retirement for employees, depending on what type of plan you choose. But there are also other options out there, such as Defined Contribution Plans, so that your employees aren’t left completely without retirement savings if you can’t afford to provide a Defined Benefit Pension plan.

Creating a pension plan for your employees is up to you. You might find that there are plenty of benefits to offset the cost to your business, including motivation and loyalty of your employees.

This article is only for general information and is not tax or legal advice. Consult your tax or legal adviser for guidance.

Why Use eHealth for a New Group Health Insurance Plan?

Maybe you’re happy with your current group health insurance plan, or maybe you’re looking for a refresh on the coverage you currently offer to your small business employees. Either way, eHealth is here to help you see the wide variety of options you have for group health insurance.

Revisiting your health insurance options

The health insurance market is constantly changing–for both the individual and small business market. This is just one reason why it’s important to revisit your coverage, so that you’re not missing out on more savings, more health benefits, and better services. eHealth is a great place to begin if you’ve been thinking about looking for a new group health plan, for other reasons, including:

  • Your business has begun making more money, and you’re considering a plan with more benefits
  • You have more or less employees, and want to see if there’s a plan that fits your business size better
  • You need to cut down on costs, and want to see what more affordable plans are out there

Keep reading to see everything you gain by buying group coverage through eHealth.

Why should I shop on eHealth for a group plan?

Health insurance can be difficult–some people don’t even know the savings they could be benefiting from, simply because it’s not worth the time and effort to begin looking for better group health insurance options. When you shop on eHealth you can benefit from:

  • no broker fees
  • host of resources to learn more about health insurance
  • free quotes on group health plans
  • online tools to help compare plans
  • licensed health insurance agents at your service
  • easy step-by-step process to manage your paperwork
  • and much more

Will I spend more money by using eHealth to get a group health plan?

The simple answer to this will always be, no. eHealth does not add broker fees regardless of how much help and services we provide to you. Our online services and tools come at no extra charge to you, and the plans that we offer on our site will never cost more than they do anywhere else (by law, the price of a health insurance plan, must be the same no matter where you buy it).

Many small business owners may find that they spend less money when buying group plans with eHealth, because we put time and effort into each client in order to find the right plan to fit the needs of their small business.

Can I buy my group health insurance plan directly on eHealth?

Not only will eHealth take care of finding you the right plan, but we make enrolling easy as well. We’ve broken the enrollment process down step-by-step for you, and clearly outline the paperwork that you’ll need to provide. We’ll deal with managing the process with the health insurance company too, so that you don’t have to visit any other sites than ours.

With our streamlined enrollment process, you’ll be covered with your small business health insurance plan in absolutely no time.

Will I miss out on the small business tax credit by going through eHealth?

If you’ve heard about the small business health care tax credit, you’re probably going to want to make sure that you check out whether or not you qualify for it. Luckily, you can do this even if you’re shopping with eHealth, and not the Small Business Health Option Program (SHOP). You won’t even have to go to their website in order to see whether or not you qualify for this small business tax credit. But if you don’t qualify, you have the benefit of being on eHealth and having access to both government SHOP plans, and private small business health insurance plans. This wider variety of plan options could help you save money. For example, some small businesses may have lower budgets and need to purchase a group health plan with less benefits but lower prices–and you’ll have access to that kind of variety when shopping on eHealth for small business health insurance.

How Much Does Individual Health Insurance for Self-Employed People Cost?

According to the U.S. Census, about 16 percent of all Americans rely upon individual health insurance plans. Slightly more than half of insured people in the U.S. have group health plans, and about 26 qualify for Medicare and/or Medicaid. Even though group and public health insurance are more common, individual health insurance helps protect the health of the families of millions of self-employed people. Take a moment to explore the typical cost of individual health insurance.

How much will individual health insurance cost?

Naturally, your own individual health insurance premiums will depend upon several factors. For instance, do you just need single coverage, insurance for both you and your spouse, or a family plan for both adults and children? Insurers also consider age and tobacco use, your ZIP code, and the kind of individual health insurance that you choose. You also might balance the premiums versus the benefits of choosing Obamacare or a non-Obamacare alternative for individual health insurance. Whatever kind of plan you decide upon, eHealth has the options for you–so keep reading to figure out price expectations, and see what kind of plan may work for you as a self-employed individual.

Obamacare individual health insurance premiums

This eHealth data for ACA Marketplace individual health insurance premiums can give you a good idea about the average monthly price that other people pay for family and individual health insurance plans:

  • Average premium for single coverage without Obamacare subsidies:  $393
  • Average premium for families without Obamacare subsidies:  $1,021
  • Average plan deductibles: $4,328 for individuals and $8,352 for families

Note that individuals and families may qualify for Obamacare subsidies that can decrease the premium they must pay dramatically.  People with modest incomes might also qualify for cost-sharing subsidies that will further reduce out-of-pocket health costs.

There are some basic facts to know about comparing Obamacare individual health insurance:

  • Typically, your family income needs to fall within 100 and 400 percent of the federal poverty level, and you must lack access to other major medical insurance to get a subsidy.
  • When you apply for Obamacare individual health insurance, you can also find out of one or more family members are entitled to a government program like Medicaid or CHIP.
  • Some families choose different individual health insurance options for various family members, depending upon medical needs and budgets. For example, children may qualify for CHIP or low premiums with Obamacare health insurance, but healthy adults in the family might decide to fill in coverage gaps with such alternatives as short-term health insurance or medical insurance packages.

Cost-saving individual health insurance alternatives for self-employed people

While you won’t get all of the benefits and protections that you would with an ACA-compliant individual health insurance plan, you could consider some alternatives to Obamacare if you need to save money. Typically, people consider these individual health insurance alternatives as temporary solutions that can help fill in a gap in permanent individual health insurance coverage:

  • Short-term health insurance for individuals and families: In most states, you can buy short-term health insurance for up to a 12-month term. You may have the option to renew this kind of coverage for up to three years. About half of the respondents to an eHealth survey said they probably wouldn’t have been unable to afford individual health insurance if they couldn’t buy short-term coverage.
  • Medical packages: You can also combine such coverage as short-term health insurance, dental insurance, prescription discounts, and emergency indemnity policies to give you and your family a variety of health benefits. Learn more about medical insurance packages here.

These alternatives to individual health insurance can protect your pocketbook if you have an accident or unexpected health issues. Unlike Obamacare individual health insurance policies, they won’t cover some health issues like maternity, mental health, or routine care for pre-existing conditions.  They individual health insurance policies can’t exactly replace an ACA-compliant major medical plan, but they can help self-employed people get important protection at a typically lower cost.

How to compare individual health insurance for self-employed people

At eHealth, we’ve helped millions of Americans find individual health insurance that they can afford and truly benefit from. If you enter your ZIP code in the form and answer a few, short questions, we will help you find the perfect individual health insurance for you and your family too. In addition to different kinds of individual health insurance plans, we can also help you find group health insurance and dental plans for yourself and your growing business.

What Is a Platinum Health Plan?

The health plans offered under the Affordable Care Act are categorized into different metal levels based on the cost and level of coverage offered. As most people can guess, the Platinum health plan is the highest level plan. This health plan is the one that results in the insurance company paying the highest share of medical costs. However, this generous coverage is paired with a higher price tag than the one that comes with other plans. Is a Platinum health plan the right one for you? The answer will depend on a number of factors related to your health, your income and others unique to you.

What is the Platinum health plan?

Platinum is the highest of the four metal levels: these are Bronze, Silver, Gold and Platinum health plans. While a Platinum health plan offers the lowest out of pocket costs when medical services are needed, it also comes with a premium that is significantly higher than those associated with other plans.

What does a Platinum health plan offer?

As with every ACA-compliant plan, a Platinum health plan must offer 10 services that are deemed essential coverages. These include:

  • Prescription medication coverage. Most plans have a flat out of pocket fee for prescription drugs that are covered by the health plan.
  • Preventive care, wellness checks, and chronic disease management.
  • Emergency health care and services.
  • Pediatric health care coverage: a Platinum health plan for minors must include dental, vision, and medical coverage.
  • Hospital stays. Even with a Platinum health plan, there will often be out of pocket costs associated with hospitalization.
  • Mental health and addiction care.
  • Pregnancy and maternity coverage. The health plan will also cover newborn care.
  • Ambulatory services. These are procedures that are performed on an outpatient basis, such as some minor surgeries.
  • Lab services. These are tests performed for diagnosing potential health issues.
  • Rehabilitative services and devices. These include assistive devices like crutches, as well as health services such as physical therapy.

In most cases, there is a copay or coinsurance payment before the insurer’s share kicks in. However, certain health services are fully covered without any additional cost to the patient. These include a number of preventive care services. These can include the following:

  • wellness check-ups.
  • immunizations, including the flu shot.
  • diagnostic screenings like blood pressure checks, lung cancer screenings and mammograms.
  • preventive medicine such as aspirin to reduce heart attack risk or statins to lower blood pressure.
  • fall prevention for people who are over the age of 65.

Additionally, your plan may offer other coverages at their option. Look at plan details through a licensed broker like eHealth to learn more and compare plan options.

Does the Platinum health plan come with a subsidy?

If you qualify for a healthcare premium subsidy, you can use it to defray the costs of a Platinum health plan. However, the subsidy amount will cover a smaller portion of your premium cost than if you had a lower tier plan. This is because the subsidies are linked to the average cost of a Silver plan in your market.

How much will a Platinum health plan pay?

As a rule, all of the health plan metal levels add up to a different percentage of the cost of medical care. Healthcare.gov estimates the average percentages as the following:

Plan Category  The insurance company pays   Insured pays 
Platinum 90% 10%
Gold 80% 20%
Silver 70% 30%
Bronze 60% 40%

Who should have a Platinum health plan?

A Platinum health plan offers the highest percentage of medical costs covered out of all the of the metal levels. Someone who expects to use a great deal of health care services may find that it is more economical to opt for a Platinum health plan. While the initial premium is far higher than other options, the peace of mind of knowing that out of pocket expenses for care are covered can provide significant peace of mind.

The right health plan tier for you is a highly personal decision that is influenced by a number of factors. If you are having trouble making a decision, we can help. eHealth can provide information about a number of health coverage options and help you identify the one that will serve you best.

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What Is a Silver Health Plan?

ACA Marketplace healthcare plans come in four metal levels — Platinum, Gold, Silver and Bronze, plus, in some markets, catastrophic health plans available to those under 30. The health plan you choose during open enrollment is the one you will use all year. This is why it is so important to choose the metal level that works best for you. For some people, this will be the Silver health plan. Understanding the benefits and drawbacks of each health plan level can help you choose well and get the most of your health insurance all year.

What is a Silver health plan?

A Silver health plan is the metal level that falls around the middle of the pack. The premiums are about halfway between the cheapest and most expensive options. The out of pocket expenses for medical care with a Silver health plan are, as well. In general, your insurer wil pick up about 70% of the cost with a Silver health plan, leaving you responsible for the remaining 30%. However, Silver health plans offer some benefits that can actually make your health costs lower through what is known as Cost-Sharing Reductions.

What are Cost Sharing Reductions?

Cost sharing reductions are extra savings that are available to people within a certain income range who choose a Silver health plan. These reductions work with a Silver health plan in a few different ways:

  • a lower deductible. With most health plans, you will have a specific deductible that you must meet each year before your insurance kicks in. For instance, you may have a deductible of $1200 per year. However, if you qualify for a cost sharing reduction, your deductible may be reduced to $700, $500 or another number based on your income.
  • lower copays or coinsurance. This means that you may see these per visit fees drop, for instance, from $35 to $15 or $20. This means you pay less each time you visit the doctor on your Silver health plan.
  • lower out of pocket maximums. ACA health insurance plans typically have a maximum out of pocket limit. After that is met, the insurance company absorbs all covered costs. With a Silver health plan and cost sharing reduction, your out of pocket can drop significantly.

How much does a Silver health plan cover?

In general, a Silver health plan covers around 70% of medical services. You can see how the plans stack up below:

Plan Category  Insurance pays   Insured pays 
Bronze 60% 40%
Silver 70% 30%
Gold 80% 20%
Platinum 90% 10%

Who should get a Silver health plan?

A Silver health plan is a good choice for many people, because it balances premium and out of pocket medical costs. However, if you are young, do not anticipate using insurance often and have significant amounts of cash in savings, you may find that you save money with a Bronze or catastrophic plan. Similarly, if you are older or have a chronic health condition that results in using large amounts of healthcare services, a Silver health plan may cost you more than a Gold or Platinum plan.

Having a licensed health insurance broker like eHealth to provide guidance can help you make the right decision for you and your health. Get in touch today to learn more about health insurance options that include the Silver health plan and more.

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What Is a Bronze Health Plan?

When it is time to choose a healthcare plan on the Affordable Care Act Marketplace, you have a number of options that balance monthly premiums against potential out of pocket costs. These plans are broken into tiers and then assigned a metallic level: Platinum, Gold, Silver and Bronze. A Bronze health plan is the lowest level plan and comes with the cheapest monthly premiums. While it can be tempting to go straight for the plan that costs the least per month, there are a number of factors to consider when choosing which metal level is the right one for you.

What is a Bronze health plan?

A Bronze health plan is the lowest of the plan levels. It typically offers the lowest monthly premiums, but costs the most out of pocket if you end up needing health care. It’s important to consider how much you anticipate using your health coverage when you are shopping for the right metal level for yourself and your family.

What is included in a Bronze health plan?

Like all ACA-compliant health plans, a Bronze plan includes a range of preventive care without additional costs in the form of coinsurance or copays. Examples of free preventive care includes:

  • check ups.
  • certain diagnostic screenings such as blood pressure screenings and mammograms.
  • diet counseling for individuals at risk for chronic disease.
  • fall prevention for adults 65 and over.
  • immunizations.
  • certain preventive medicines, such as aspirin or statins.

Additionally, a Bronze health plan must also include the 10 essential coverages identified under the ACA. These services may come with coinsurance or copays. They include:

  • Prescription drug coverage. There will typically be a flat out of pocket rate for covered medications.
  • Preventive, wellness, and chronic disease management.
  • Pediatric coverage: a Bronze health plan for children include vision, dental, and medical.
  • Emergency services such as ER visits. These will typically have a large copay or coinsurance fee.
  • Hospitalization. While there will be out of pocket costs, insurance takes over after a certain point.
  • Mental health and addiction coverage. All health plans are required to offer these services.
  • Pregnancy and maternity care.
  • Ambulatory services, which refers to procedures performed on an outpatient basis.
  • Laboratory services.
  • Rehabilitative or habilitative services and devices. These include services like speech or physical therapy.

Your health insurance plan may, at the insurance company’s option, include other coverages in addition to the essential coverages listed above. Check with plan details to learn more about what is offered with this sort of plan.

How much will a Bronze health plan pay?

Each of the health plan metal levels pay a different percentage of the cost of medical care. On Healthcare.gov, they estimate the percentages as the following:

Plan Category  The insurance company pays   Insured pays 
Bronze 60% 40%
Silver 70% 30%
Gold 80% 20%
Platinum 90% 10%

Can you get subsidies with a Bronze health plan?

When you get a Bronze health plan, you are eligible for premium subsidies, which are paid as a tax credit. However, you will not be eligible for other cost saving subsidies with a Bronze health plan, such as the cost-sharing subsidy. The lowest level of plan eligible for this subsidy is the Silver health plan.

Who should consider a Bronze health plan?

A Bronze health plan is a good fit for some individuals and a poor fit for others. The low monthly premium cost from a Bronze health plan can be a boon to younger individuals who do not anticipate using their health plan very much. The included preventive care can mean catching any potential health problems early, so people with Bronze health plans can still plan to stay healthy. And, the lower premium from a Bronze health plan means more money in your pocket each month.

However, if you are at risk for chronic illnesses or if you are older, a Bronze health plan can wind up costing more in the end. A Bronze health plan typically has very high out of pocket costs before the insurance company starts chipping in. As a result, serious medical events can leave the person who is insured with far higher costs. So if you expect to be consistently using your health plan, you may want something with a higher monthly premium, but lower costs elsewhere (like in your deductible, out-of-pocket maximum, etc).

Every individual’s situation is different. What works well for one person could result in far higher costs for someone else. Before buying a Bronze health plan or any other health plan, consult with a licensed insurance broker like eHealth.  At eHealth, we have a range of ACA plans from Bronze health plan level up to Platinum. We will work with you to find the health plan that best fits your needs.

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Short Term Health Plan: What Is It and What Does It Cover?

Short term health insurance appeals to a variety of people. Some might suffer from a lapse in permanent coverage because they’ve changed jobs, are looking for work, or have to wait for the annual Open Enrollment Period. Certainly, typically modest premiums for short term coverage and an easy enrollment process also attract many applications for short term coverage. Still, it’s important to weigh both the pros and cons of this kind of health coverage before making a decision.

What is short term health insurance?

In most states, Americans can buy short-term health insurance for a term of several months to a year. You also have the chance to renew your policy up to three times (meaning, for now, people can have short term health insurance for up to three years). In the past few years, health insurance companies designed their short-term health insurance plans to help people who needed to quickly obtain an affordable medical plan that could bridge the gap between permanent policies.

Going forward, health insurance companies that sell short term health insurance will try to attract more people who need cheaper premiums and intend to keep their coverage longer than a few months. Because of new government rules, allowable terms for short-term health insurance have expanded from nine to twelve months in 2019.

In addition:

  • Plan members can opt to renew their short-term coverage for up to three years.
  • There’s no need to wait for an Obamacare Open Enrollment period to sign up either, so short-term health insurance can provide immediate protection.
  • For 2019, the government also did away with the Individual Mandate, so there’s no penalty for failing to have major medical insurance either through the ACA website or work.

Pros and cons of short term coverage

While the federal government has relaxed the rules for short-term health insurance, each state can make its own insurance regulations. In fact, insurance is largely regulated by the state and not the federal government.

The following states still completely prohibit short-term health insurance, according to this report:

  • New York
  • California
  • New Jersey
  • Massachusetts

Vermont has moved in another direction. Instead of prohibiting short-term health insurance, the state has tried to force these temporary policies to offer all of the Essential Health Benefits that Obamacare policies must provide. Also, even though the federal government now allows for a 12-month term, Oregon, Illinois, and Maryland have passed state laws that only allow for more limited periods.

Yes, short-term health insurance can provide many people with a great value and a good solution when they need affordable coverage quickly. It’s just that these non-ACA plans aren’t regulated the same way that ACA policies are, so people must understand some risks they may take by opting for the temporary protection of short-term health insurance. The majority of states recognize that short-term health insurance performs a vital role, so they rely upon licensed agents to explain the pros and cons of various health insurance choices to their clients.

These are some potential drawbacks of short-term health insurance:

  • Short-term coverage may not offer any benefits for maternity, mental health, or any sort of pre-existing condition. If you suffer from some pre-existing conditions, you could be denied coverage, unlike with Obamacare.
  • While some short-term coverage is guaranteed renewable, some is not. This means that you have to re-apply for short-term health insurance at the end of every term. The problem is that if you or a family member has developed a serious illness, they may not get accepted.

ACA policies cannot decline applicants because of pre-existing conditions. Even with the federal government’s relaxed rules for short term coverage, most people should still consider these temporary policies as a temporary solution. It’s just that people in most states can rely upon them for longer periods of time than they could in the past.

Who should consider short term health insurance plans?

In most cases, short term health insurance typically costs much less than ACA major medical health insurance. According to eHealth’s own data:

  • Premiums for unsubsidized ACA plans average about five times as much as for short term health insurance.
  • Even premiums for subsidized Obamacare plans average about three times more than premiums for short term coverage.

Short term coverage could offer a good solution for people who want an affordable way to protect themselves against unexpected or emergency medical bills. In addition, short term health insurance can provide the proof of coverage that people need to participate in various activities or vocations.

Easy applications, modest premiums, and no waiting for enrollment periods can all make short term health insurance seem like an attractive choice for people who lack affordable access to permanent medical insurance. Good examples of people who can benefit from short term health insurance might include:

  • Young people who have just aged off their parent’s plan
  • Families who missed Open Enrollment for the ACA Marketplace
  • Seniors who will turn 65 and collect Medicare benefits in a few months
  • New employees who have to wait for group benefits to begin

Note that even if you missed this year’s Obamacare Open Enrollment, you may still have the option to enroll in a plan if you qualify for a Special Enrollment Period. Some examples of events that will trigger a Special Enrollment Period include loss of job-related group health, divorce, marriage, income changes, and moving away from a network plan’s service area. If you don’t qualify, you still have the option of enrolling in short-term health insurance at any time of year.

How to compare short-term health insurance policies

At eHealth, we don’t just make it easy to compare short term health insurance, we also allow you to compare short term health insurance with other health insurance options. Additional choices can include both Obamacare and non-Obamacare medical plans. Besides individual and family medical plans, we can also help you shop for dental and group health insurance. Explore your health insurance options now.

How Many Employees Do You Need To Get Group Health Insurance?

Group health insurance can often be less expensive than individual plans that offer the same benefits and coverage options. But not everyone qualifies for group coverage plans. If you have a small business, you’ll want to determine whether you qualify for group health insurance before you try to apply for group coverage. Here’s what you need to know about group health insurance, so you can get the right group coverage and plan for your needs and the needs of your employees.

The number of employees matters

In order to be eligible for group health insurance, a company has to have between one and 50 employees. That is considered a small group, and means you can apply for group coverage instead of individual. If you have more than 50 employees, you’ll need to:

  • apply for large group coverage
  • meet group coverage reporting requirements
  • meet minimum group health insurance standards

A lot of businesses have fewer than 50 employees, and they can get group health insurance through the SHOP marketplace. To qualify, though, you’ll also need to make sure you have a work site or office in the state where you’re applying for insurance, even if you only have one qualifying group coverage employee there.

The type of employees matters

One of the employees on the group health insurance plan can be the employer or owner, but you have to have at least one other employee who is not an owner. Even one other employee counts for the group coverage designation. Understanding the type of employees needed for group health insurance matters, or your health insurance application for group coverage could be denied.

For group health insurance approval, you need at least one employee who is:

  • Not an owner or employer
  • Not a spouse of an owner or employer
  • Not a family member of an owner or employer
  • Not a partner of an owner or employer
  • Essentially, completely unrelated to any owner or employer

If you don’t have at least one employee who meets this criteria for group coverage, your business may not qualify for group health insurance. That can make it harder for family-run businesses to get coverage, as they might need individual instead of group health insurance. That can come with higher rates than many group coverage options.

There are some other requirements

An employee who is part of the group coverage pool for insurance purposes has to work for you on a full-time basis. You can offer group health insurance to part-time employees, but you don’t have to. They won’t help you add to the group of qualifying employees for group health insurance. Instead, to get group coverage your employees will need to be:

  • Full time (which is categorized as working for you at least 30 hours per week)
  • Not part time (working for you less than 30 hours per week)
  • Not seasonal (working for you only during certain times of the year, even if they work more than 30 hours per week during those times)

In short, you can offer group health insurance to part-time and seasonal workers if you choose to. But they won’t count toward the employees you need to have in order to qualify for group coverage. You also need to enroll at least 70 percent of your uninsured employees. If your employees have other individual or group health insurance coverage, they don’t count toward the 70 percent rule.

You should also know of one other important issue. You can enroll from November 15 to December 15 in any year, and the 70 percent participation rule won’t be enforced during that time. That means you can just cover a couple of employees if you want, and you don’t have to worry about the rest of your employees refusing group health insurance coverage. It won’t stop you from being approved for group health insurance if your business meets all the other group coverage requirements.

You can’t count a spouse

If there is only one other employee joining you for group health insurance coverage, it can’t be your spouse. You would need to apply for a family health insurance plan instead. If you have other employees signing up for group coverage, you can also put your spouse under your group health insurance plan, but it must be in addition to those other full-time qualifying or full-time equivalent employees.

They just won’t count toward your group health insurance requirements, even if they work for the business on a full-time basis. Employees can get their spouses covered by your group health insurance plan, as well. But even with group coverage it may be expensive to cover a spouse.

Sole proprietors need individual coverage

If you’re the only one who works at your company, even if you take a salary and consider yourself an employee, you’re actually a sole proprietor and don’t qualify for group coverage. While you’re still in business, you’re not technically a small business by health insurance’s standards, and you will need to look into options for individual health insurance.

Already have group health insurance?

Are you already a qualifying small business and have been, or are currently covered under a plan you bough from a local broker or on the government exchange? Well, we believe that you should still look at your options for group health insurance with eHealth, as we’ve helped thousands of Americans save, we have online tools to help small business owners find the best plan for them, and we have zero broker fees–so you won’t be spending any more money than you would elsewhere, and you’ll be seeing the largest online selection of small business health insurance. Visit eHealth or get in contact with one of our small business health insurance agents today.

What Is a Gold Health Plan?

Under Obamacare, which is also known as the Affordable Care Act (ACA) each health insurance plan is assigned a certain metal level. This means that there are bronze, silver, platinum, and gold health plans. Each type of metal level has a certain set of benefits, costs, and services. Additionally, the health plans for each metal level also include a certain actuarial value (AV). For example, a gold health plan has an AV level of 80 percent, which means that the insurance provider will pay 80 percent of the covered medical expenses up to the plan’s designated out of pocket maximum. For anyone interested in choosing a gold health insurance plan, it is important that the other metal levels are also considered.

Understanding the difference between a gold health plan and the other metal levels.

In order to choose the health plan that is right for you (and your family) it is important that you first understand the differences between the gold health plan and the other metal levels. It is important to note that each insurance provider will offer slight variations on their gold health plans, which means that the following information should be viewed as a general guide. Be sure to carefully read each plan’s offering, before you select a gold health insurance plan.

  • Bronze. — The bronze health plan typically has the lowest monthly premium. It also typically has the highest costs when medical care is needed, and often has a very high deductible that can reach thousands of dollars on an annual basis. Bronze health plans are typically good for individuals who need protection from the worst-case medical scenarios, such as serious illnesses or injuries.
  • Silver. — The silver health plan typically has moderate monthly premiums. It also has moderate monthly costs when medical care is needed, and typically features a lower deductible than bronze plans. Silver health plans are often a good choice for individuals who anticipate only needing moderate medical care throughout the year.
  • Gold. — A gold health plan typically has higher monthly premiums than silver or bronze plans. It also has lower monthly costs when medical care is needed, and typically features a lower deductible than the silver or bronze health plans. The gold health plan is often a good choice if for an individual who anticipates needing medical care on a regular basis throughout the year.
  • Platinum. — A platinum health plan typically has higher monthly premiums than a bronze, silver, or gold health insurance plan. It also features the lowest costs when medical care is needed, and typically has the lowest deductible out of all of the plans. The platinum health plan is often a good choice for individuals who can pay high monthly premiums and expect to need a lot of medical care throughout the year.

What are the other costs associated with a gold health plan?

Whether you want to choose a gold or a different metal level, it is important that you think about the total health costs. This means that you need to consider more than your monthly premium when you choose your insurance plan. For example, you should consider out of pocket expenses, as well as the list of following potential costs.

  • Copayments. — The payments that you need to make each time you receive a medical service after you have reached your deductible are referred to as copayments.
  • Deductible. — The deductible is the amount of money that you will need to spend on covered medical services before your insurance provider will begin to cover the costs. Preventive services are often the exception to the later rule, whereby these services will often be paid for in your gold health plan.
  • Out of pocket maximum. — This payment refers to the most amount of money that you will spend in covered medical services for an entire year. Once you have reached your deductible your insurance provider will often pay for 100 percent of covered medical expenses.

How can you decide if a gold health plan is right for you?

Once you have compared the features of metal levels and reviewed the costs, it will be time for you to decide if a gold health insurance plan is right for you. To answer this question, you will need to review your anticipated medical needs for the upcoming year. For example, if you expect to have a lot of doctor visits, and anticipate needing regular prescriptions throughout the year, then the gold health plan will probably be the right choice. In conclusion, it is important that you take your time reviewing all of the available health insurance plans before deciding if the gold health insurance plan is right for you.

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What is a Catastrophic Health Plan?

For many individuals, choosing the right type of health insurance can be a slightly overwhelming experience. Fortunately, there are a wide variety of health plans that can provide individuals and their families with the coverage needed throughout daily life and in the event of emergencies. For younger individuals, and those not requiring consistent medical care, a catastrophic health plan might be the ideal option.

Who can buy a catastrophic health plan?

A catastrophic health plan, typically has low monthly premiums with high deductibles. This type of plan is ideal for individuals who want to protect themselves during worst-case scenarios. For example, catastrophic health plans are particularly helpful in the event of an unexpected and prolonged illness or injury. However, catastrophic health plans are often less helpful for “ordinary” or “routine” medical expenses, since the individual will be responsible for paying the majority of “ordinary” medical expenses.

In this vein, a catastrophic health plan isn’t for everyone. In fact, there are specific eligibility requirements, including:

  • Individuals under the age of 30 may apply.
  • Individuals with a hardship or affordability exemption may apply.

How much will a catastrophic health plan cost?

The cost of catastrophic health plans will vary. However, as a general rule of thumb, most catastrophic health plans feature low monthly premiums. It is important to note that a premium tax credit can’t be used to reduce the monthly premium for catastrophic health plans. With this in mind, if an individual does qualify for a premium tax credit, then the bronze or silver metal levels will typically offer a better value.

In addition to monthly premiums, catastrophic health plans typically feature higher deductibles. In 2019, the majority of catastrophic health plans had a deductible of $7,900, which means that individuals are required to spend the latter figure before the insurance provider will begin to pay for all covered services. Once again, it is a great idea to compare the cost of catastrophic health plans with metal levels to determine the best value based on cost vs. services covered.

What does a catastrophic health plan cover?

Each catastrophic health plan will cover slightly different services. With this in mind, all catastrophic health plans will cover the same 10 essential health benefits that are offered by other Obamacare plans. These services include, but are not necessarily limited to: inpatient and outpatient hospital care, doctors’ services, pregnancy and childbirth, mental health services, and prescription drug coverage. It is important to note that the level of coverage will depend on the selected catastrophic plan.

Catastrophic health plans also cover a variety of preventative services. These preventative services could include shots and screening tests. Finally, catastrophic health plans cover at least three primary care visits per year. These visits are covered even if the individual hasn’t met their deductible. Keep in mind, that like other metal levels, primary care visits should be made with an in-network doctor to avoid additional costs.

How does a catastrophic health plan compare to other types of plans?

A catastrophic health plan has similarities and differences to the metal level plans. Metal level plans include: bronze, silver, gold, and platinum. The basics of each type of metal level are as follows:

  • Bronze. — The bronze plan typically offers the lowest monthly premium with the highest costs when care is needed. This metal level also features higher deductibles, but are a good choice for individuals who want to protect themselves in worst-case medical scenarios.
  • Silver. — The silver plan typically offers moderate monthly premiums with moderate costs when care is needed. This metal level also features lower deductibles than bronze plans.
  • Gold. — The gold plan typically offers high monthly premiums with low costs when care is needed. This metal level also features lower deductibles than bronze and silver plans. It is typically a good choice for individuals who require a lot of medical care throughout the year.
  • Platinum. — The platinum plan typically has the highest monthly premiums with the lowest costs when care is needed. This metal level also features the lowest deductible, which means that the insurance provider typically starts paying for costs far earlier than the other metal levels. This type of plan is typically a good choice for individuals that need a lot of care throughout the year and can afford to pay a high monthly premium.
  • Catastrophic. — The catastrophic plan features low monthly premiums with higher deductibles. It is typically a good choice for individuals that need protection during the worst-case medical scenarios, such as unexpected injuries or prolonged illness.
In conclusion, determining if a catastrophic health plan is right for you, will require you to analyze your medical needs vs. the amount of money that you want to spend throughout the year on medical expenses. In this vein, catastrophic health plans are typically the optimal solution for individuals who need medical coverage during the worst-case scenarios. Before making a decision, be sure to compare the coverage offered by a catastrophe health plan against the coverage offered by various metallic health plans.

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Six Predictions for Health Care in 2019

2018 marked a period of dramatic change in health care, and this year promises to be no less active. With a front row seat for events in Washington DC and among health insurance companies, here are six trends eHealth expects to shape the market, and change the way Americans access and pay for medical care in 2019:

1. More Medicare managed care

Migration into Medicare managed care will continue, with CMS explicitly encouraging Medicare Advantage program growth. The elimination of first dollar coverage Medicare Supplement plans in Jan 2020 will further support growth in Medicare Advantage.

2. New Medicare benefits

Insurers offering Medicare Advantage plans will likely attempt to differentiate themselves through products that include newly authorized benefits like home-care meals, over-the-counter drug credits and transportation to the doctor’s office. At the same time, plans will continue their slow and steady embrace of narrower provider networks to reign in costs and support accountable care initiatives that don’t work with broader networks. We’re probably in the 7th inning of this transition, which has become the instrument of choice for Medicare insurers wanting to control costs.

3. Rise in Part D preferred pharmacy networks

Insurers offering Medicare Part D drug plans will continue to develop and leverage preferred network pharmacy relationships to control costs and provide key benefits at those pharmacies. This will place continued pressure on independent community pharmacies who may not benefit from the relationships and efficiencies of chain pharmacies, with meaningful health care implications.

4. Short-term plans may continue to stretch

The government will likely push to extend renewable limits on short-term plans beyond 36 months. We may see the recently extended outer limits of short-term plans stretched even farther to allow these policies to remain in place for four or five years —possibly even longer.

5. A return to pre-ACA coverage

 Protections for some pre-existing medical conditions are likely to be included in short-term health insurance policies. Right now some insurers offer “stacked” 36-month products, where you apply once for three consecutive 12-month policies. However, medical conditions developed in the first term aren’t always automatically covered in the second and third terms. Ensuring that they are will make today’s short-term plans look even more like coverage did in the individual and family market before the Affordable Care Act.

6. Association health plans will fail to materialize

New federal rules make it easier for small businesses and other groups to hand together for the purpose of buying group health insurance. However, these products have been around in one form or another for a while and we’ve never been broad interest. There’s no indication that major insurance companies will be offering such plans, and there’s no coordinated effort to create new employer associations to take advantage of the updated rules.

Health insurance, as with the broader health care market, will continue to evolve in the coming year as regulatory and market forces shift. This will require carriers, providers and other key industry players to adapt – and by extension, the millions of Americans covered by Medicare, individual and group health insurance.

Can I Get Health Insurance If I’m Self Employed?

As a self employed person, you may be wondering what kind of health insurance plan you should look for, or if you should have health insurance at all. Whether you are only temporarily working for yourself, or are planning on starting your own business, it is important that you make sure you some form of coverage in order to protect yourself against unexpected medical costs. Not only could going uncovered result in you having to pay costly medical bills entirely out-of-pocket, but you’re also likely losing the opportunity to maintain your health and have affordable access to health care providers and facilities. Fortunately, with the following guide, you’ll be able to not only understand the ins-and-outs of self employed health insurance plans, but you’ll also receive the insights that you need to choose the plan that is right for you in the upcoming year.

Understanding the ins-and-outs of self employed health insurance

By definition, self employed persons are those individuals who are in business for themselves and don’t have any employees. With this definition in mind, there are several individual health insurance plans that can be purchased by self employed individuals. Whether you need to choose individual coverage, or want a family plan, there are three key factors that you should keep in mind as you choose your individual health insurance:

1. The individual coverage of your selected plan. — Choosing your self employed health insurance plan will require you to examine its health benefits, physician network, cost, and prescription drug coverage. At eHealth, you can use easy to navigate tools to discover the individual health insurance plan that is right for you. Whether you are looking for a specific brand-name insurer, or need to have specific prescription drugs covered by your insurance, eHealth is here to help you weigh the potential benefits of each individual plan.

2. Choose a plan during the open enrollment season for health insurance. — Under the Affordable Care Act, also known as Obamacare, there is an annual open enrollment period. During this time frame, you can explore various self employed health insurance plans. It is important to note that the time period for open enrollment can vary each year, however it is typically from November 1st – December 15th. However, if you miss an open enrollment period, then you might still qualify for a special enrollment period or you can choose a coverage alternative like short-term health insurance.

3. Do you qualify for a special enrollment period? — When open enrollment ends, you can still qualify for a special enrollment period if you experience certain life events. These events could include a divorce, loss of employer-based health insurance, the birth of a child, or a marriage.

Watch the video below to get more information about choosing affordable self employed health insurance:

After you have reviewed the above three factors, you will need to choose your self employed health insurance plan. You can purchase your individual health insurance through online marketplaces like, eHealth, or through a government-run exchange or directly from your chosen health insurance company. With this in mind, a private online marketplace typically has the tools needed to help you thoroughly understand the ins-and-outs of the available plans.

Do you qualify for small business health insurance?

As a self employed individual, you might qualify for small business health insurance if you employ one additional person who is not a family member. If you do qualify for small business health insurance, then there is a chance that you can also qualify for the small business health care tax credit. This credit can save you up to 50 percent of the costs that you will pay for your employees’ premiums; however, in order to qualify you must meet all of the following criteria:

  • Your small business should have fewer than 25 full-time equivalent (FTE) employees.
  • The average full-time employee salary should be approximately $50,000 per year or less.
  • You should be paying at least 50 percent of your full-time employees’ premium costs.
  • Your small business offers the appropriate coverage options to all of your full-time employees. It is important to note that you don’t have to offer coverage to individuals who work fewer than 30 hours per week.

Even if you do not qualify for the small business health insurance tax, small business health insurance is usually more affordable per individual, and you may find that you qualify for other tax breaks. So before assuming you’re simply self employed and purchasing individual health insurance, see if you qualify as a small business–you might be able to, even with just one employee.

Choose your individual coverage today

Choosing self employed health insurance can be an easy process if you have the right resources and tools. On eHealth, you can learn more about health insurance as a self employed individual with hundreds of articles on our Resource Center , you can shop plans and compare quotes for free, and you can complete your entire enrollment process on our website. Make sure to get coverage and protect your health and your wallet.

How Do I Get Medical Insurance?

If you do not get medical insurance through an employer or through a professional or other group, you can apply for a plan yourself. Even though health insurance may seem confusing and difficult to navigate, it doesn’t have to be. Keep reading for some tips and tricks to finding medical insurance plans and enrolling without the headache.

Overview of the types of medical insurance plans

If you are looking for medical insurance, you will need to make some decisions. First, you need to decide if you want:

  1. An individual plan to cover just yourself
  2. A family plan to cover yourself, your spouse, and/or your children
  3. A small-business plan for yourself (or for yourself and your family) and for your employees (or for your employees and their families) if you have a business with at least one full-time employee (not including your spouse)
  4. Short-term health insurance, which allows you a minimal amount of coverage but often costs significantly less than other options for medical insurance
  5. Critical illness and accident insurance, which provides extra protection as a supplement to major medical insurance.

The second decision you need to make is whether you want to get insurance that is:

  1. An Obamacare plan, also called an ACA plan or a Marketplace plan, or
  2. A private plan that is outside the Marketplace.

Making these decisions may seem overwhelming at first. It is much easier when you can see all the relevant information in the same place, so that you can compare different types of plans with each other and see at a glance which has the best benefits for you at the lowest cost.

The best way to compare plans

You may not know if an Obamacare plan or a private plan will be the best choice for you. The answer is different for everyone and depends on your healthcare needs, your income, and your budget. The best way to make that choice is to compare the Obamacare and private plans that are available for you to each other at the same time. eHealth will show you different plans you are eligible for that are offered by both Obamacare and private insurers. This makes the decision process much easier. You can compare quotes from all the plans and then apply for coverage in the same place.

You can buy both private and Obamacare plans at eHealth

It’s a common misconception that you can only buy Obamacare plans on the government Marketplace sites. That’s not true. You can buy Obamacare plans from a licensed insurance broker like eHealth.  These are exactly the same plans at exactly the same price.  Medical insurance plan premiums and costs are the same no matter where you buy your insurance. That’s true for both private and Obamacare plans.

Given that the costs are the same, there are several advantages to buying medical insurance through eHealth:

  1. The Marketplace sites are confusing and difficult to navigate. The eHealth site is user-friendly and simple to navigate.
  2. The eHealth site lets you directly compare Obamacare and private plans.
  3. eHealth may have medical insurance plans in your area that are not available on the Marketplace sites.
  4. eHealth has a greater variety of types of medical insurance plans available, including short-term and supplementary plans.
  5. If you ever have any questions when you shop for plans or apply for coverage at eHealth, you can call our helpful agents for assistance.

Shopping for individual or family medical insurance does not have to be difficult. If you have ever tried to apply for coverage through a Marketplace site, you will appreciate the simplicity and ease of using eHealth to find and purchase insurance. If this is the first time you have applied for insurance on your own, eHealth will give you all the information you need to make the best informed choice.

Special Enrollment Period 2019

Can I still qualify for a Special Enrollment Period in 2019?

There have been plenty of changes to the how health insurance works in the past year, but special enrollment did not face any major changes in 2018. You can still qualify for a Special Enrollment Period (SEP) in 2019 outside of the Open Enrollment Period (OEP).

Some qualifying events that could trigger a special enrollment period in 2019 include:

  • loss of health coverage
  • moving
  • marriage
  • birth of a child
  • adoption
  • divorce

Oftentimes, once a Special Enrollment Period is triggered you have 60 days to enroll in a health insurance plan. So if you believe that you’ve experienced a qualifying life event and have triggered a Special Enrollment Period in 2019, then make sure to get on eHealth and start looking for health insurance plans before your enrollment period is up.

Other options outside of the 2019 Open Enrollment Period

If it turns out that you do not qualify for a SEP, it doesn’t mean you have to go all year without any coverage. Even though you won’t be fined in 2019 for not having health insurance, there are still plenty of reasons to get coverage for yourself and any dependents you have.

If you missed the Open Enrollment Period, and also do not qualify for a Special Enrollment Period in 2019, then you still have options outside of typical health insurance plans. For example, if you’re interested in getting coverage to hold you over for some time, short-term health insurance plans are available for individuals to enroll in year-round. Short term coverage often has a fairly quick enrollment and approval process, so you won’t have to go without some kind of health insurance for very long.

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What Is a Qualifying Event for Special Enrollment?

Whether you’re buying it for your family or just yourself, it’s essential that you jump through all the necessary hoops when purchasing health insurance. That starts with buying health insurance at the right time—the Open Enrollment Period.

What is a qualifying life event?

Under the Patient Protection and Affordable Care Act, most people are required to get their insurance during the Open Enrollment Period, which typically comes at the end of each year. If you have a qualifying life event, you may be eligible for a special enrollment period outside of the ordinary OEP. Keep reading to see what counts as a qualifying life event (QLE), and watch this video to get an overview of QLEs and special enrollment periods.

The loss of coverage

If you find yourself suddenly without health insurance, there is a good chance that you’ve experienced a qualifying life event that could trigger a special enrollment period. Some of the reasons for loss of coverage that usually count as qualifying life events include:

  • Turning 26– The Affordable Care Act allows children to remain on their parents’ insurance until they reach the age of 26. This means that when they turn 26, many children lose their coverage. They are thus eligible for a special enrollment period to get coverage for themselves.
  • Losing Program Eligibility– Public programs like Medicaid and SCHIP provide health insurance to individuals and families that cannot afford it themselves. If you currently rely on one of these programs but your income increases, you may become ineligible. In this case, you can use a special enrollment period to buy insurance without government assistance.
  • Losing Your Source of Coverage– Most working people get their insurance from their jobs, and many students get it from their schools. Thus if you lose your job, graduate, or drop out of school, you need a special enrollment period to replace that coverage.

If you find yourself suddenly without health insurance, make sure to find out if you qualify for a special enrollment period. Loss of coverage for various reasons will often trigger a special enrollment period, except for when it’s due to loss of coverage.

Domestic developments

In addition to developments that directly cause you to lose coverage, there are events within your household that affect the amount of coverage you must buy and how much you have to pay for it. These include:

  • Marriage & Divorce– The beginning or end of a marriage often counts as a qualifying life event.
  • Having Children– Whether you have a baby or adopt a child, you’ll need to provide insurance for them, so this life event usually counts as a qualifying life event, resulting in a special enrollment period.
  • Death– If someone in your family dies, you’ll lose the need to cover them, but you also won’t have their income to help pay for coverage. For these reasons, the death of someone you share a health insurance plan with can count as a qualifying life event.

Whenever your household changes, think about how that change will affect your health insurance. It’s likely that major events in your household—like gaining or losing a member—will result in a special enrollment.

Residency shifts 

Health insurance regulations and availability vary from state to state and even from county to county. Thus if you move anywhere in a different county or with a different zip code, you’ll probably be able to count this change as a qualifying life event. You can also qualify for special enrollment if you’re a seasonal worker moving between your permanent home and your work, a student moving between school and home, or someone moving in or out of transitional housing.

Other qualifying life events 

Some more qualifying life events include:

  • Becoming a member of a Federally-recognized indigenous tribe
  • Becoming a shareholder for the Alaska Native Claims Settlement Act Corporation
  • Experiencing any change in income that alters your eligibility for coverage
  • Beginning or ending service with AmeriCorps
  • Gaining US citizenship or another form of lawful status you didn’t have before
  • Becoming eligible or ineligible for subsidies under the Affordable Care Act
  • Getting out of jail or prison

Whether you experience any of these qualifying life events or are signing up during the open enrollment period, eHealth is committed to helping you get the coverage you need at a price you can afford. For more information on health insurance laws and options, visit our website today.

How Do Group Health Insurance Plans Work?

If you’re considering a group health insurance plan for your small business, there are some things about it that you’ll need to know. After all, it’s important to have all the information before you choose a group plan, or join an existing one. In some cases you may not qualify for the kind of group health insurance you want, so you need to know if there are other options. Here are some of the most significant issues to consider, so you can learn more about how group health plans work.

How many people do you need for a group health insurance plan? 

When you buy group health insurance, you have to have a “group”. When it comes to health insurance, a small business is defined as a group of 2-50 people applying for coverage together. This means a small business owner with just one employer could qualify for a group health insurance plan (but the one employee cannot be a spouse). If you fall within this range of group members, you’ll be able to benefit from all the perks that come with getting coverage through a group health insurance plan. You’ll even have the chance to benefit from special incentives for small businesses offering health insurance that larger companies miss out on.

Why is group health insurance more affordable? 

Group health insurance is more affordable because there are more people participating in it. The larger the risk pool, the lower the rates. That’s why it can offer you a lot lower premiums than you would typically see when you look for individual insurance coverage. In other words:

  • few people mean higher risks for the insurance company
  • more people mean lower risks for the insurance company
  • higher risks cost more money to insure a group
  • lower risks cost less money to insure a group

As the pool of people in the group health insurance plan gets bigger, the cost of that group health insurance plan comes down. It’s one of the best ways to get affordable insurance for employees, and to help employers afford to properly cover the people who work for them. It can also help cover employees who may not be able to afford insurance otherwise.

What is considered a “small” employer for group health plans?

In the context of a group health plan, a small employer is one that has from two to 50 employees. Sole proprietorships with only one employee (the owner) aren’t eligible, and if you have more than 50 employees you’re not considered small anymore. While small businesses aren’t required to give their employees health insurance, many small employers offer it for reasons beyond legal obligation.

Watch this short video to get an idea of what applying for a small business health insurance plan generally looks like:

How does the shared cost of a group health plan work?

The cost of a group health plan is shared by everyone in the group, and by the employer and employees. In other words, these plans cost less because there are more people in them. Also:

  • Employees pay a portion of their own health insurance premiums
  • The employer pays a portion of the employee health insurance premiums

Employers who own small businesses can put most or all of the cost of their group health insurance over onto their employees, but it’s better for getting and retaining talent if they pay a portion of the premiums. That shows the employees that their employers are truly offering them help with their group health insurance, and not just another option the employee has to pay for.

Can you get a tax credit for your group health insurance?

If you offer group health insurance to your employees, you may be able to get a tax credit up to 50% of what you pay in. That’s a great way to be able to afford group health insurance, since it can be expensive. If you really want to give your employees group health insurance, but you’re not sure if you can afford it, tax breaks can really make a difference.

Can you shop off-market for your group health insurance plan?

When you shop off-market for your group health coverage you can work with a licensed insurance broker like eHealth. That gives you the option to get a policy you might not be able to get on the exchange, and opens up coverage that’s available without subsidies or tax credits. It’s important for you to know all your options so you can pick the best one for your company and its employees

What Are the Advantages of Group Insurance?

Having group health insurance typically comes from an employer. There are many advantages to it when compared to individual insurance, and those advantages are for both the employee who gets the insurance and the employer who offers the insurance. If you are looking to understand group health insurance advantages, either as en employer or an employee, here are some things to carefully consider.

1. Small business health insurance can save money 

There are a lot of advantages of group health insurance, and one of the biggest ones is the cost savings. This helps the employee who finds that they can afford insurance for themselves and their family, but it also helps the employer who wants to give their employees good insurance that they can afford to help with. If insurance premiums are too high, neither group is going to benefit.

2. Lower cost due to a larger risk pool

Among the advantages of group health insurance for employees is the higher number of people in the pool (group) that is getting the insurance. When more people are included, there are more options for more people, generally at a lower price than what would otherwise be available. In short, this means a lot of value, including:

  • Better insurance plans offered
  • A lower price for insurance plans
  • More coverage for pre-existing conditions

When you look carefully at the advantages of group health insurance, it is easy to see that there are a lot of reasons to consider it from the employee standpoint. Employees who qualify for this kind of insurance through their employer are generally wise to get it.

That’s because the cost savings are often significant, and the other advantages of group health insurance also outweigh what a person could get through an individual insurance plan. There are times when this is not the best choice, but finding that individual insurance is better is not the norm for most people.

3. Tax incentives for offering health insurance to employees 

The advantages of group health insurance are not just for the employee. They are also available to the employer, in the form of a small business health care tax credit. This is offered to businesses that give their employees insurance and pay part of their premiums. These businesses may qualify to get a credit back on their taxes, so they can be compensated for the money they are paying out toward insurance premiums. This is one of the biggest advantages of group health insurance from a employer’s perspective.

4. Positive work environment and happy employees

Employees that are happy are employees that work hard for the company. That is one of the more subjective or hidden advantages of group health insurance. When an employer offers this insurance to employees, they may get:

  • Employees who appreciate their insurance
  • Employees who care about their employer and their job
  • Employees who see that they can build a career at that company
  • Employees who feel valued and appreciated
  • Employees that want to make the company better for everyone.

All of those things are pretty important as advantages of group health insurance, and they can go a long way toward making employees and employers feel better about their working relationship. Of course having insurance will not solve all company or employee problems, but it can certainly go a long way toward making sure that employees and employers feel better about everything they have at a particular company.

Insurance is an important part of feeling safe and having peace of mind, and when employers provide that for employees, it most often does not go unnoticed by those employees.

Why get a small business health insurance plan to cover my employees? 

When it comes down to it, if you meet the requirements of a small business, you aren’t legally required to offer health insurance, so it depends on your financial situation and preference whether or not to offer medical coverage. When a company has healthy employees, including the employer who can join the plan, too, there are even more advantages of group health insurance. Being healthy has a lot of perks, both on the job and off, but healthy employees are an asset to any business. These employees will take fewer sick days, and they will be more likely to focus on their jobs, see the doctor for regular checkups, and be open and upfront with their employer about any health problems.

There are big advantages of group health insurance, and you’ll want to consider all of them when deciding whether or not to offer a group plan. Offering important benefits and perks will likely help to form a better bond between employers and employees, and that bond is one of the ways everyone in a company manages to get more done and feel better about themselves and their working environment. Group insurance can play a significant role in all of that.

Are Employers Required to Offer Health Insurance in 2019?

Employees usually prefer jobs when employers provide health insurance. Sometimes, they value medical benefits even more than extra pay. A savvy employer also understands that the company may benefit from better retention, improved health, and even the satisfaction that offering small business health insurance can bring.

At the same time, some small business owners don’t believe they can remain competitive and profitable if they have to shoulder the expense of offering small business health insurance. According to the Kaiser Family Foundation, just about half of all U.S. employers provide health insurance to employees.

Must employers provide small business health insurance in 2019?

Even with the Obamacare Individual Mandate, employers never were forced to offer small business health insurance. Larger companies may have faced a fine for failing to offer group coverage, and some small businesses could have missed out on a health-care tax credit. However, the 2017 Tax Cuts and Jobs Act repealed the mandate (according to Nolo Press), so employers might not face penalties in 2019 for failing to offer qualified group health plans.

Even though companies aren’t legally required to provide health insurance, many can still benefit. The health-care tax credit might still apply in 2019. Small business can qualify with:

  • A maximum of 25 full-time employees
  • An average salary of no more than $50,000
  • Payment of at least half of the premiums
  • Purchase of a Health Insurance Marketplace plan through a partner like eHealth or the Marketplace

Typically, smaller businesses with lower average salaries can qualify for a higher health-care tax credit. For example, businesses that employ fewer than 10 people and pay average salaries of less than $25,000 qualify for the most in credits. These credits can make the purchase of small business health insurance much more affordable, because they can be used to defray the cost of premiums in the year that they’re earned, or saved to be applied against a tax bill.

Why do employers provide small business health insurance if they don’t qualify for tax credits?

Typically, only small employers that mostly pay modest salaries can qualify for a health-care tax credit. So why do many employers help pay for health insurance, even if they don’t qualify for that credit? There are plenty of reasons to get group health insurance for your employees, even if you don’t qualify for the small business tax credit.

Small business health insurance may help employers compete for good employees

According to the Bureau of Labor Statistics, large employers usually provide health insurance. So do most mid-sized companies and government employers. In contrast, just about half of companies will fewer than 100 employers provide small business health insurance. When it’s offered, employees often sign up, even when they have to pay a portion of the premiums.

This popular benefit can help improve morale, encourage proactive health care, and boost employee retention. In these ways, some employers believe they’re making a good investment by sponsoring a small business health insurance group.

Employers can still save money on small business health insurance premiums

Businesses can still buy Marketplace health insurance if they don’t qualify for health-care credits. They may still have a chance to deduct the cost as a business expense and ask their employees to pay a portion of the bill out of their paychecks. Also, many employers decide to purchase non-Marketplace plans.

Companies may make this choice because they find a plan that doesn’t qualify as an Obamacare plan, but costs less and suits their requirements better. In some cases, they may even want to purchase better coverage than the available Obamacare policies. For instance, some counties only have HMOs on the marketplace, and the employer may choose to buy a PPO.

Where do employers shop for small business health insurance?

One of the many benefits of shopping for small business health insurance through eHealth is that it’s easy to compare a variety of available group medical plans – not just the ones offered in the exchange. In addition to health insurance group policies, it’s also simple to compare and buy dental, vision – and all types of individual plans.

To get started, simply enter the number of employees and the company’s ZIP code in the online form. You can also speak with licensed health insurance brokers about small business health insurance by dialing the toll-free number. Even if you don’t have to offer health insurance, you may find that it’s a good choice 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.

Is Group Health Insurance Better than Individual Health Insurance?

Is group health insurance better than individual health insurance? 

There is a difference when considering individual health insurance vs. group health insurance, and if you want to choose the right one for you, it’s important to understand the value of both. While one is not necessarily “better” than the other, there are definite differences. These can help you decide whether to choose one option over the other, so you can get the health insurance coverage that is right for your needs.

Here’s what you should know about individual health insurance vs group health insurance, so you can choose the best option for your situation and the kind of coverage you’re most likely to use.

Group health insurance usually comes from an employer

In most cases, group health insurance plans are handled by an employer, union, or other organization. These plans are often provided only to full-time workers, and there you might not be eligible for coverage until you’ve worked a certain length of time. That isn’t always the case, though, and your employer may do things differently. Some workplaces don’t have waiting periods, and some may also let part-time employees buy into these insurance plans.

Many group health insurance plans offer:

  • Thorough and comprehensive coverage
  • A number of doctors to choose from
  • The chance to add dental and vision coverage, if it’s not included in the basic plan
  • Discounts for family members
  • Choices that individual coverage may lack
  • Pre-existing condition coverage

Because of these options and selections, many people feel group health insurance is the right choice for them. It might not be best for everyone, but if group health insurance is offered to you, there are plenty of good reasons why you may want to buy it instead of finding your own, individual insurance plan.

Choosing group health insurance can save you money

One major reason to consider individual health insurance vs. group health insurance is to discover which one is going to be more affordable. With group health insurance, you’ll generally see that there are cost-saving benefits such as:

  • A larger risk pool for the plan
  • An employer contribution toward your premium (often 50%)
  • Employer-based tax incentives

When there are larger risk pools, the price comes down because more people are in the pool (group). That means there are usually a lot of healthy people who can offset the cost of the medical care for the people who aren’t as healthy. Also, having your employer pay half of your health-care premium can make things a lot more affordable to you.

Your employer might get a tax break for helping insure you and other employees. But that still doesn’t mean that you wouldn’t be better off with individual health insurance in some cases.

Other ways to qualify for this health care option

If you don’t have an employer to provide group health insurance for you (you’re self-employed, for example, or your employer doesn’t offer it), there may still be other ways you can have a choice of individual health insurance vs. group health insurance. These ways can include:

  • Being part of a group or organization
  • Being an employer yourself, with at least one employee
  • Searching for state-specific options that might apply to your situation

You might still be able to get group insurance. Some people who are part of a group, such as a freelancer’s union or an actor’s guild, may have more choices for group health insurance even though they don’t have an employer offering it to them. It’s worth looking into, in case there are options you’re not aware of that could really benefit you.

Minimum essential coverage may be a requirement

If you’ve thoroughly checked out the individual health insurance vs group health insurance information and determined that you need to get individual coverage, that can also work well. Depending on your income and other information, you may qualify for tax subsidies and other perks that can help you get affordable insurance on your own.

If you can’t get group insurance, check your state department of insurance to see what your options are.

You might want to consider short-term health insurance that may protect you if you get sick or have an accident. Enter your zip code on this page to start comparing plans.

What Is the Penalty for Not Having Health Insurance in 2019?

One of the biggest changes that the Affordable Care Act brought with it was the health insurance penalty. This penalty changed by year and was part of the healthcare law that people were most likely to find confusing. As rules around the ACA have continued to be challenged and to change, many people are unsure of the penalty for not having health insurance in 2019. Learning whether you would be subject to a penalty and what that penalty would be can help you make the best health insurance choices for the coming year.

There is no federal health insurance penalty in 2019.

In past years, a penalty was assessed for every month that individuals went without health insurance coverage. The amount of the penalty increased by year. Penalties, for instance, were higher for people with higher incomes. The penalty was also higher for leaving minors uninsured than it was for adults.

There have been a number of changes in how the Affordable Care Act (ACA) works.

In a tax bill passed by Congress in 2017, the individual mandate that prescribed a health insurance penalty was eliminated. The new law goes into effect for 2019.

What this means for individuals is that the health insurance penalty is no longer to purchase an ACA-compliant health care plan. Many people think that this just means going without insurance. However, this also makes it possible for people to choose other kinds of health insurance policies that may not have satisfied previous requirements. For a plan to comply with ACA requirements, it must provide certain minimum essential coverages. People who would like to avoid these coverages but still have insurance can choose other types of plans without having to pay a penalty. For instance, some people may wish to choose a catastrophic plan that will cover large expenses, but not cover preventative care. Still others may choose to skip coverages that they do not feel that they will need, such as mental health coverage or maternity care.

State-level health insurance penalties still may be in effect.

While there will not be penalties at the federal level anymore for going uninsured or choosing a plan that is not ACA-compliant, it is still important to look at state requirements for health insurance. A large handful of states have their own health insurance penalties that are assessed when people do not have insurance that complies with that state’s laws.

Some places where a health insurance penalty is still assessed:

  • New Jersey. This state has a health insurance penalty that will go into effect in 2019. The health insurance penalty is based on New Jersey’s prices for bronze level health insurance policies.
  • Massachusetts has had a health insurance penalty since instituting a state health insurance program in 2006. In the past, they did not assess a health insurance penalty if someone paid one at the federal level. However, with the elimination of the federal health insurance penalty, they will begin charging a state fee.
  • Vermont has instituted a health insurance penalty for uninsured individuals in that state. The health insurance penalty law goes into effect in 2020.
  • District of Columbia. This city has signed their own health insurance penalty into law. It goes into effect in 2019.

It remains to be seen whether other states will add their own health insurance penalty laws. Keep abreast of changes in your state to make sure that you are not surprised by a health insurance penalty at that level despite no longer owing one at the federal level.

Making the best health insurance choices for you.

Even though there is no longer a health insurance penalty for most people, health insurance can still be a worthwhile investment. Depending on your personal health, your financial situation and where you live, you may be able to save money and more easily access needed medical care by purchasing either a marketplace or individual insurance policy. eHealth offers a range of plans to help you choose exactly the coverage you need.

What Does Health Insurance Through the Marketplace Mean?

What is a health insurance marketplace?

A health insurance marketplace is a place where you can shop and sign up for affordable health insurance plans. A marketplace is sometimes called “the exchange.” Marketplaces sell health insurance policies that may be subsidized by the federal government, depending on your income and family size. If you qualify for a subsidized plan, your costs for health insurance premiums will be reduced.

Are all health insurance marketplaces run by the government?

No. Both the government and private companies run health insurance marketplaces. There are three types of marketplaces:

  1. State government marketplaces. Depending upon where you live, your state may run a health insurance marketplace.
  2. Federal government marketplace.  Not all states have their own marketplace.  People who live in states that do not have a marketplace can use the federal government’s health insurance marketplace.
  3. Private marketplaces. Private health insurance exchanges like eHealth offer a convenient way for people from all states to buy marketplace and alternative health insurance plans.  If you choose to get an ACA plan from eHealth, it will include the same essential Obamacare benefits you would get on a state or federal health insurance marketplace. If you are entitled to federal subsidies, you will get the same amount of subsidies when purchasing insurance on the private marketplaces as you would on the government marketplaces.

Keep reading to learn about more differences between private exchanges like eHealth and the government Marketplace.

Who can buy health insurance through the marketplace?

In order to buy a marketplace health insurance plan, you must:

  1. Live in the United States.
  2. Be a U.S. citizen or national.
  3. Not be incarcerated.
  4. Not be covered by Medicare.

Is it cheaper to buy a health insurance marketplace plan on a state exchange, the federal exchange, or through a private exchange?

You will always pay the same price for a marketplace plan no matter where you buy it. Your premiums and any subsidies you are eligible for will be identical on the federal and state exchanges and on private sites like eHealth.

Note that different people may pay different prices for their marketplace plans. That’s because premiums will vary based on your state, income, and household size. However, the price that you pay will not change from one site to another. You can be confident that you are not going to get a better price somewhere else for the same exact plan, so you can relax, and avoid hopping around to too many

Where can I get a plan that covers all the essential benefits of Obamacare?

Places you can find health insurance plans that cover the essential benefits of the ACA (Affordable Care Act), more commonly known as Obamacare:

  • The federal Marketplace
  • State marketplaces (if the state you reside in runs its own health insurance marketplace)
  • eHealth

The convenient part about eHealth is that you won’t only find ACA-compliant health insurance, but also alternative plans that may work for your health care needs better. And you can look at all the health plan option in one place, quickly comparing different plans with our free quotes.

Are Obamacare plans sold on eHealth different?

If you choose an Obamacare (ACA) health plan from eHealth, it will have the same bells and whistles as plans bought on the federal and state exchanges. You will also still be able to qualify for a government subsidy when you buy an ACA health plan on eHealth. If you end up finding out that you don’t qualify for an Obamacare subsidy, you’ll be able to quickly look at affordable off-exchange options that eHealth offers. You may find that an off-exchange health plan actually works for your situation a lot better.

Do I have to get my plan through the health insurance marketplace?

If you want to apply for government subsidies, you do need to enroll in a plan on a state, federal, or private health insurance marketplace like eHealth that has a direct enrollment agreement with CMS. However, not everyone wants to get a marketplace plan. For example, you might not qualify for government subsidies, or you might find that a non-exchange plan better suits your needs.

If you go to a state or the federal health insurance marketplace, you will see only the exchange plans. However, on eHealth, you will see both on-exchange and off-exchange plans. In many cases, that means you will have a choice of more plans on eHealth than you would on a government health insurance marketplace.

The convenience and large selection you’ll find on eHealth makes shopping for health insurance much easier. You will be able to compare the costs and benefits of on-exchange and off-exchange plans at the same time, all in one place. This eliminates the hassle and frustrations of trying to compare plans on different sites. Visit eHealth to start learning more about health insurance and getting quotes on quality health insurance plans in your area.

Do Michigan Employers Have to Offer Group Health Insurance?

Do Michigan employers have to offer group health insurance?

If you have a small business, or work for a small business, you might be wondering “is group health insurance required in Michigan?”. Of course, most employees are likely hoping that health insurance is a benefit included with their employment, and most employers are probably worrying about whether or not they should (or even can) offer it.

According to Business and Legal Resources (BLR), there is no state law requiring small business employers to offer group health insurance, but most employers do offer this benefit to their valuable small business employees. eHealth also found this to be true in a 2018 study on small business health insurance trends. If you’re a Michigan employer with 50 or more employees though, you’re required by federal law to offer group health insurance. Keep reading to learn more about Michigan group health insurance requirements that might apply to your small business.

Federal laws on group health insurance in Michigan

Although laws vary from state to state, there are federal laws in place that might require small business owners to offer health insurance.

  • Employer mandate for large employers. Obamacare’s mandate for “large employers” (a business that employs 50 or more “full-time equivalent employees) is still relevant despite other changes to Obamacare. This mandate requires “large employers” to provide full-time employees with health insurance that meets minimum essential requirements. Usually large employers who offer health insurance must also pay 50% or more of their employees’ health insurance premiums. This percentage can vary from state to state.
  • Requirements for small businesses.  Small businesses with less than 50 full-time employees are not required to offer health insurance to their employees, but they still have the option to do so. If you offer small business health insurance, it must be offered to all full-time and full-time equivalent employees. In order to qualify for group health insurance, you must have at least one employee besides yourself or a spouse, and you must be a legitimate business.

Small employers and the health care tax credit in Michigan

If you’re a small business owner offering group health insurance in Michigan, you have the opportunity to qualify for the health care tax credit. If you choose to offer group health insurance despite not being legally required to, then you’re in the running for this tax break. This credit can be up to 50% of what you’ve paid for your employees’ premiums. In order to benefit from this tax credit, you must:

  • have no more than 25 full-time equivalent employees
  • pay your employees an annual wage of no more than $52,000
  • pay 50% or more of your employees’ premiums
  • purchase your group health insurance plan through a Small Business Health Options Program (SHOP), which can be done on a federal or state exchange, and also through eHealth

Small business owners in Michigan can qualify for this tax credit for up to two consecutive years. Keep in mind, if you don’t qualify for this tax credit, there are plenty of affordable off-exchange group health insurance plans on eHealth that you can see free quotes for, talk with licensed agents about, and apply for in just minutes. Watch this video to see how simple it is for Michigan small business employers to offer group health insurance:

Should Michigan employers offer group health insurance?

Now that you know the specifics about whether you have to offer group health insurance or not, it’s important to look why you should offer group health insurance. Some of the reasons other small business employers give for offering health insurance include:

  • retaining the best workers
  • offering group health coverage as a business strategy
  • a sense of responsibility towards employees

So while you might not be required to offer group health insurance as a Michigan employer, you have plenty of reasons to do it anyways. Make sure to visit eHealth’s website to check out our resources, tools, and free quotes.

Can I Join a Group Health Insurance Plan?

Are you wondering what your options are for health insurance, but not sure where to start? Perhaps your main question is whether or not you can join a group health insurance plan, because you’ve heard this might be more affordable than buying an individual or family plan on your own.

Let’s look into some options for someone who is wondering if they can join a group health insurance plan:

Join a group health insurance plan if your employer offers it

If you work full-time for an employer (small or large) that offers group health insurance options, then you should be able to join a group health insurance plan through that employer. Some exceptions to this:

  • If you’ve already been working there for some time, and it is not Open Enrollment Period. Usually when you get hired somewhere, you should have your health benefits explained to you, and given a certain amount of time to opt into your plan. If you chose not to join that group health insurance plan within the amount of time set by your employer, then you’ll have to wait until the annual Open Enrollment period to opt in. If you’re confused about your options, talk to your HR department or supervisor to understand more about how group health insurance benefits work at your company.
  • If you are a contracted employee. Sometimes it’s hard to understand exactly how employment works. If you don’t work enough hours to be a full-time employee, or were hired as a contracted employee, there’s a chance you won’t have the opportunity to be covered under health benefits offered by your employer. This is a huge issue with the rise of the gig economy, since many of these workers are not considered “employees” even if they work more hours than they would need to be considered a full-time employee. Make sure you understand what kind of employee you are, or if you’re considered an employee at all.
  • You work for a small business that isn’t required to offer group health insurance. If you are employed by a small business owner, they might not be required to offer health insurance by law. Usually, if a small business has less than 50 full-time employees, they are not legally required to offer group health insurance to employees. Don’t expect this to be the case with all small business owners–your employer still has the option to offer group health insurance, even if they have only one employee.

What to do if you can’t join a group health insurance plan

Although there are many perks to joining a group health insurance plan, it’s not an option for everyone. If you’re unable to join an existing group health insurance plan, there are still plenty of great health insurance options out there that you can choose from:

  • Individual health insurance. eHealth has a wide variety of individual and family health insurance plans, You can choose from an Obamacare (ACA) plan, which will be the same as what you’ll find on the government health insurance Marketplace. If you’re not expecting to qualify for a government subsidy, you might also want to look into a health plan that is not associated with the Affordable Care Act.
  • Short term health insurance. If you’re looking for an affordable way to get some coverage, short term health insurance is a good option. You won’t be getting as many benefits or as much extensive coverage as you would with more traditional individual plans, but you’ll be protected against outrageous medical bills in the case of a serious illness or injury.
  • Medical insurance packages. Another alternative to traditional group health insurance is packaged medical insurance. This kind of coverage combines several different products into a single bundle. Read more about this convenient product here.
  • Critical Illness and Accident insurance. This is another option for coverage that will offer less benefits, but save you money. A critical illness insurance plan pays a cash amount to you directly, in the event you’re diagnosed with a critical illness that’s covered by the plan. If you’re also concerned about getting in a serious accident and want to protect yourself from those medical bills, you can purchase an Accident insurance plan.
  • Join an association health plan. If you are apart of a professional organization, industry group, trade organization, or state or local chamber of commerce, you may have the opportunity to join an Association Health Plan (AHP). Make sure to read up on these associations, because there is some potential risk involved with joining an AHP that might not be legitimate.

If you’re a small business owner – you can enroll in and purchase a group health plan

If you are a small business owner, you can enroll in a group health insurance plan at any time of the year! There is no open enrollment period for small businesses that you need to wait for. As long as you are a legitimate business and have 1 employee besides yourself (and he/she is not a spouse), then you’re likely eligible to enroll in a small business health insurance plan. If you want to know more about enrolling in and joining a group health insurance plan as a small business owner, you can watch our instructional video below:

How Much Will Small Business Health Insurance Cost?

Small businesses often find that offering group health insurance helps them acquire and retain talent in a competitive market. When eHealth surveyed business owners about their reasons to provide group health insurance for their company, respondents also said they usually made the decision to help improve employee health, morale, productivity, and even as a moral choice. At the same time, business owners have reasonable concerns about how much small business health insurance costs. Probably the first question that any business owner is asking: How much will small business health insurance cost? Luckily for small business owners, eHealth not only has a huge online selection of plans, free quotes, and experienced agents, but we have some data on small business health insurarance costs that might help you get a better understanding of what kind of price tag to expect.

Learn what impacts the cost of group health, how much average small businesses tend to pay for coverage, and how to compare quotes easily.

How much do small businesses spend on health insurance on average?

This brief summary can help business owners understand more about costs that other companies incur for health plans:

  • Average premium per company: $1,768
  • Average group size: 3
  • Average premium per individual: $397
  • Percent of companies paying half the premium: 38 percent
  • Percent of companies paying at least 75 percent of the premium: 47 percent

Naturally, small business owners often ask how much other companies spend on their group health insurance plans. Which is why eHealth published this analysis of average health insurance premiums and other group health insurance trends. This kind of information can help companies balance their health insurance costs with offering plans that prospects and current employees will find attractive. It is important to keep in mind though, that these are just averages and your cost will depend on details like:

  • Your small business’ location
  • How many employees you have
  • What kind of plan you want
  • Extra health benefits you may choose to add, like dental and vision

In order to get a more accurate quote concerning how much small business health insurance will cost for you, simply visit ehealthinsurance.com, enter is some basic information about you, your small business, and your employees.

How much does small business health insurance cost?

Not two business or two health insurance plans are exactly alike. These are the most important things that impact the cost of group health plans for small businesses:

  • Expenses: Naturally, any company’s health insurance costs will vary. Insurers set premiums by the ages and location of the employee group and the specific plan features and coverage levels. With ACA policies, insurers can’t consider the health of the employees when they set rates. Employers may also have to spend some time administering their plan or money to outsource the work to a third party.
  • Benefits: Some factors that may offset the total dollar cost of coverage for the company will include the employer contribution and potential tax breaks. Of course, business owners may also reap other business benefits, such as improved moral, better employee retention, and more attention to wellness. Many employers find that offering group medical benefits helps improve their brand image too.

How to compare small business health insurance costs

The only way to know how much small business health insurance will cost any particular company is to gather custom quotes. You can start your small business health insurance quote here at eHealth at any time. You can even apply within minutes, or if you choose, call for help from a qualified representative during business hours. Working with eHealth ensures great customer service, plenty of choices, and a simple process.

Small business health insurance won’t cost a dime more if you purchase it from an agent than it will if you buy your coverage directly from an insurance company. At eHealth, businesses owners get the luxury of comparing variety of plans and insurance companies, so they can make smart decisions for themselves and their employees.

Off Market Health Insurance – What is it? Where can you buy it? What do you need to know?

What is “Off Market” Health Insurance?

The term “marketplace health insurance” is often used to define health insurance policies that meet the standards of the Affordable Care Act (ACA or Obamacare). The term “Off Market” insurance is increasingly being used to define alternatives to ACA coverage that are typically more affordable, but off limited coverage and often exclude pre-existing conditions.

The video outlines regulatory changes enacted in 2018 that go into effect for health insurance plans, in most states, in 2018.

The Trump Administration’s Latest Iteration of “Trumpcare.”

The Trump administration has made three attempts change or replace the Affordable Care Act (ACA or Obamacare).

Round 1 (Past) Round 2 (Present) Round 3 (Future)
The American Healthcare Act Extended Duration Short-Term Health Plans Association Health Plans & Health Savings Account Expansions

“Off Market” Short-Term Health Insurance Plans – The Present Version of Trumpcare

The Centers for Medicare and Medicaid Services (CMS) changed some of the rules that govern short-term (limited duration), or STLD, health insurance plans in August 1, 2018.

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The new rules made it possible for people to stay on a short-term health plan for to up to 364 days starting in October of 2018. In 2019, short-term plans ay be available in some states for up to three years.

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In 2017 the Obama administration limited the maximum duration of short-term health insurance plans from 364 days to 90 days. This new rule reverses the 90-day restriction, but states still have the authority to put restrictions on short-term plans, and many states have done just that.

Short-term health policies have limited benefits and are traditionally used to provide coverage for a fixed period of time.

  • Short-term plans provide many key benefits most consumers want,, but don’t typically cover specific benefits like maternity care, mental health, substance abuse, and pre-existing conditions.
  • Short-term plans are typically 80% cheaper than major medical plans.
  • The terms of coverage on short-term plans can range from three months to three years.

Other “Off Market” Health Insurance Alternatives: Healthcare Sharing Services

Healthcare Sharing Services are commonly known as cost-sharing ministries or faith-based cost-sharing services.

  • Healthcare sharing services are usually groups of like-minded people that agree to help each other pay medical bills. Most are organized around a common ethical or religious beliefs.
  • Healthcare sharing services are typically cheaper than an ACA plans. Most, however, can decline applicants who don’t subscribe the group’s belief system.

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Other “Off Market” Health Insurance Alternatives: Fixed Benefit Plans

Fixed Benefit Plans or Fixed Indemnity plans and GAP plans pay a set cash benefit per specified hospital or physician service provided.

  • Unlike major medical or short-term coverage, that pay all qualified expenses after the deductible is met, fixed indemnity plans pay a flat fee for each service provided.
  • GAP plans are typically used with short-term or major medical plans to pay for out-of-pocket expenses related to an accident or critical illness.

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Other “Off Market” Health Insurance Alternatives: Multi-Policy Coverage

Multi-Policy Plans are being offered by a growing number of insurers and brokers and typically include a combined package of insured and non-insured benefits.

  • These combinations provide more complete coverage than a non-major medical plan can provide.
  • Combinations usually include short-term for medical, GAP for deductible protection and association memberships for Rx discounts and mobile office visits.

The graphic shows all of the major “On Market” and “Off Market” Options

5 Affordable Perk Ideas to Win Over Employees

The philosophy isn’t new – employees who are appreciated are more engaged at work. Even if you don’t have the extra cash for lavish gifts, you can still do nice things for your employees without breaking the bank. Here are 5 low cost ideas to create a happy team!

Flexible schedule

Work-life balance is important to everyone. With family obligations and personal activities, juggling working hours and spending time with loved ones is sometimes challenging. If employees have tasks that can be done remotely, let them work from home once in a while. Or, have them swap working days. Allowing employees a bit of flexibility to accommodate personal matters is one of the top perks you can offer.

Free food

One of the simplest and easiest perks to offer. Regularly bringing in treats and healthy snacks for the week is a great way to keep staff energized and appreciated. Another idea is monthly team lunch. This can promote camaraderie and team bonding.

Paid off birthdays

Give your employees their birthday off. This doesn’t cost a thing and your employee will appreciate not having to work on their special day.

Free stuff & gift cards

Who doesn’t love free stuff? Gift cards, concert tickets, or movie tickets. If your employee works extra hours to get a project done or had the most sales that month, show your appreciation for that hard work with a gift card or free event.

Early finish Fridays

Most of the time, meetings and projects are winding down for the week on Fridays anyways, so why not let your staff leave an hour or so early to get their weekend off to a great start? Employees will appreciate the early release after a long work week.

3 Affordable Marketing Ideas

As a small business owner, you can’t afford to not invest in marketing your business. The key is to pick methods that will pay off in real ROI and not end up wasting your hard-earned money.

Here are three do-it-yourself marketing ideas that won’t waste your time or money.

1. Build up your online reviews

It doesn’t matter what industry you’re in, online reviews matter. Nowadays, most people research a company and check out reviews before making a purchase or using a service.

Start asking your best clients to rate your business or leave you a review. You can use google reviews, yelp, or even your social media pages.

To get more reviews, incentivize people with a coupon, gift card, or other small reward.

 2. Ask for referrals

This is the cheapest, and perhaps the most cost-effective way to market your business. It costs $0 and can drive a lot of new business your way.

When asking for referrals, be thoughtful about who you ask and how you ask.

  • Only ask happy, satisfied customers for referrals
  • Always provide an incentive for the person who refers you AND to the referral
  • Make it a habit to ask for referrals – it can’t hurt!
  • Don’t bug people about it – ask once or twice, but then move on
  • Follow up on referrals right away – don’t waste a hot lead

3. Utilize Social Media

Maintaining a social media presence can attract new customers and help you stay connected to existing customers. It’s free and doesn’t require too much time.

Choose a social media channel that’s relevant to your audience. You don’t need to be everywhere – you just need to be in the right place.

Try a scheduling tool like Hootsuite or Buffer that allows you to setup your posts ahead of time. This is an easy way to make sure you remain active and post regularly.

Make your posts engaging – ask questions, take polls, get reviews. Always respond to comments and build relationships with your followers.