In 2023, group health plans for one person cost an average of $7,739 and plans for a family cost an average of $22,463. Those numbers are expected to have up to a 7% increase in 2024. However, there are ways to lower how much you pay for health insurance. It all depends on how your premiums are calculated. If you know what factors affect your bottom line, you can take steps to lower your total premium.

For group health insurance, premiums are calculated for each worker who signs up for the plan, plus the costs of adding a spouse or children. The total price for the group plan is calculated by adding all of the individual premiums up. Most companies have their employees pay a portion of their plan cost. Then the company takes those payments and then pays the rest of the cost to the insurance company every month.

How Group Health Insurance Works

Since the risk is spread out among more people. The cost of group health insurance is generally much lower than the cost of individual plans. Once the company decides on a plan, employees can choose whether or not to sign up for coverage. However, group health plans usually need at least 70% of a company’s employees to partake, in order to be effective. Companies usually offer different levels of plans so that enrollees can choose between basic coverage or more advanced coverage with add-ons. Depending on the plan, the premiums are then split between the company and its employees. Businesses can offer further protection by allowing their employees to add their spouse or children to the plan. Although doing this typically means the plan becomes more expensive.

The Factors

Since every business is different, your premium could be higher or lower based on a number of factors that are used to figure out how much your plan will cost. It also depends heavily on the group being insured.

• Fully insured with less than 50 employees – Premiums are based on how many people in your area, not just from your business, are signed up for the same plan with the same insurance company. The cost of the insurance is also based on how old the enrollees are. So, everyone the same age with the same insurance plan from the same company will pay the same price. The rates go up every year based on their age. Some of the annual renewal increase at your company will come from the fact that your workers are getting older.
• Fully insured with more than 50 employees – Premiums are calculated based on the age, gender, location (zip code), and medical conditions (expected healthcare costs) of your workers and their dependents who are covered by the plan. 
• More than 100 employees – Groups with more than 100 workers are counted the same way as businesses with more than 50 workers. Rates are based on the age, gender, location (zip code). And medical conditions (expected healthcare costs) of your insured workers and their dependents.

Other factors are included in calculating your premiums such as:

Size of The Group

How much you pay can depend on how many people are on your group plan. This number includes both your employees who choose to join your plan and their family members who join through an employee. By spreading the health risks of a few people over a larger group, a bigger group can help you pay less for your insurance.

Health of The Group

Your rate is affected by how healthy the group as a whole is. Even though the Affordable Care Act says that insurers can’t change premiums or refuse coverage based on a person’s pre-existing conditions or general health. The American Academy of Actuaries says that the health of the group as a whole can play a role in figuring out premiums. If a risk group has a lot of people with higher expected claims, the average premiums will be higher. This can be good for your business, as the Academy also says that premiums will be lower if a risk group avoids people who are likely to make more claims. Or if it can cover the costs of people who are likely to make more claims by signing up a lot of people with lower costs.

Average Age

The Affordable Care Act (ACA) says that insurers can’t change rates based on things like gender, but they can still take age into account. Rating by age is still legal as long as the ratio of the most expensive adult age band to the least expensive adult age band doesn’t go above 3:1. This means that in a group plan, the average age of your group can affect how much you pay.

Claims History

Going to the doctor often can add up. Insurance companies make changes to your prices over time based on how many claims have been made and how much they cost. When it’s time to renew your insurance, an insurer will look at how often your group has filed claims and make changes based on that. If a few of your employees had health problems that required them to go to the doctor often or spend a lot of money. That may be represented in your updated premium cost.

Tobacco Use

The Affordable Care Act (ACA) says that group health plans can charge people who smoke up to 50% more for their health insurance rates than people who don’t smoke. This is called a “tobacco surcharge.”

Industry

Different jobs have different amounts of danger. Your insurance company may change your rates based on what your workers do for a living. For example, office workers don’t face the same health risks as people who work in factories, buildings, or offshore. So their insurance premiums may be lower than those of people in other jobs.

Coverage Amount

Group health plans are not all the same. How much you and your workers pay will depend a lot on how much coverage you get. When you have better coverage and lower out-of-pocket costs, your premiums may go up. Due to the extra covering, adding on extras like dental and vision plans can also raise your premiums.

Can My Employees Be Denied?

A person with a medical problem can’t be kicked out of a group health plan. The health insurance must either cover everyone in the group or not cover anyone. They can’t choose one or more people. A fully-funded health insurance plan cannot be turned down by a company with less than 50 workers. Carrier participation rates are based on a ratio of the number of employees who are insured to the total number of employees who are qualified. This number is different for each insurance company, so you should talk to your health insurance agent about it.

Saving on Group Health Premiums

For a small business owner, health insurance rates can be expensive, but you don’t have to accept what your company is being charged. You might be able to use certain strategies to lower your costs and make your workers healthier.

Start a Wellness Program

Since the number of claims has a direct effect on your premiums. It can pay to make sure that all of your workers are in good health. Through health education and wellness practices, a customized workplace wellness program can help people choose to live healthier lives. This can lead to a healthier, more active workforce. And lower overall rates by reducing the number of doctor visits caused by diseases that could have been prevented. It can also help attract and keep good employees because they know their employer cares about their health and safety. 

Telemedicine Access 

Giving your workers access to a mobile doctor 24/7 is another way to cut down on the number of trips to the doctor. With telemedicine services, your employees can talk to a real doctor by phone, video chat, or online chat. This lets them get the answers they need without making an in-person visit with the doctor. This means they don’t have to pay a copay and your plan doesn’t have to pay for an extra claim.

Economy Scale

Depending on where you get your insurance, you might be able to use the “economy of scale” to your advantage. Larger businesses have more workers and more buying power. But smaller businesses don’t have as many employees to save money through economy of scale.

How To Enroll

There are countless group health plan providers and plans to choose from so choosing can be difficult. But we’re here to help! You can call EZ for a personal agent to help you sort through your plan options, get free quotes, or to simply find out more about group health insurance plans. Our experts can help you save hundreds of dollars a year by finding the best plan for your business. You can reach one of our highly trained agents at 877-670-3531, or enter your zip code in the box below for free instant quotes.

Does Your Small Business Qualify for Group Health Insurance?

Let’s start with the basics. If you’re new to offering group health insurance to your employees, you might be wondering how you qualify to offer it. Well, it’s actually pretty simple, and more likely than not, your business will qualify! You need to:

• Have at least one full-time employee who is not the business owner, or the spouse of the business owner
• Be legally registered as a business entity in your state (regulation for this varies from state to state)
• Contribute at least 50% to your employees’ monthly premiums

Why Take Advantage of Open Enrollment?

Ok, so your business qualifies to offer group health insurance, but should you? And if you’ve already got a plan in place, why review it during Open Enrollment? Well, there are a few very good reasons to do both:

• You and your employees can save money – Enrolling in a group health insurance plan is often cheaper than enrolling in an individual plan. Not only that, but the more employees you can get to sign up, the cheaper the plan could be.

• Changes in life circumstances mean changes in insurance needs – If you do already offer group health, you definitely need to take advantage of Open Enrollment and use this time to reassess your and your employees’ needs. Has anything major changed, like births, deaths, or marriages? If so, you might be able to find a plan that offers better or more tailored coverage for a better price.

• Group health can mean tax advantages – Who doesn’t love to save on their taxes? Take this time to look into ways you could be saving, like checking if you qualify for the small business health care tax credit, or by choosing to offer tax-advantaged healthcare options, like HSAs, FSAs, or HRAs. 

What Should You Be Thinking About When Choosing a Plan?

Another important basic step in the process: knowing what you should be thinking about when exploring your options. Here are 4 essential factors that should go into your decision-making process:

• Costs associated with the plan – You’ll want to consider how much employees want to pay in premiums, while also remembering that you have to contribute at least 50% of the amount each month. Also keep in mind things like deductibles, copays, and coinsurance that can all add up, depending on how often your employees access medical services. 
• The metal tiers of available plans – Familiarize yourself with the so-called metal tiers of plans: Platinum, Gold, Silver, and Bronze. These terms have nothing to do with quality of care, rather they indicate what percentage of costs a plan will pay for covered benefits. For example, popular Silver plans will usually cover around 70% of costs, with the insured paying the remaining 30%. 

• The type of plan you want – In addition to choosing a metal tier, you’ll also have to consider what type of plan you want to offer to your employees. For example, you can choose from HMO, PPO, POS, and EPO plans; each of these types of plan will offer different price points, since some are more flexible about things like network coverage.

• Insurance companies – Check out which insurance companies offer plans in your area, and what their networks look like; you want to be sure that they offer affordable care in locations that are convenient for your employees.

What Should Employees Consider?

So you know what you need to be thinking about, but are you ready to answer your employees’ questions, or take on their concerns? You can help guide them in choosing or changing their plan by telling them to take the following factors into consideration:

• The price of the plan – Let your employees know exactly how much the plan will cost them per paycheck.

• Their dependents – Your employees should think about who they will need to have covered by their plan, especially if they plan on adding on family members in the coming year, or if they have added any new household members since last year. You’ll also need to make clear your policy on contributing to dependent coverage.

• Any changes in coverage – Make sure your employees know what is covered under the plan, especially if there is anything new being added, like dental or vision coverage. 

• Any added benefits – In addition, if your plan is going to have any new benefits, like telemedicine or wellness programs, let your employees know.

Top Tips for Employers

Group health insurance can seem a bit overwhelming, especially since studies show that 35% of employees have little to no understanding of their healthcare coverage! Not only that, but  22% of employees are confused during open enrollment, 20% are anxious, and 21% are stressed, so it can be tough to know how to approach this subject. But there are some ways to make the process go a little more smoothly. For example, you can:

• Go digital – You don’t have to print out reams of paper, or have endless meetings with employees about benefits (which might be tough with all of the work-from-home going on right now)! Save paper, toner, and your and your employees’ sanity by offering everything in PDF form, and by considering holding a virtual benefits fair, which employees will be able to access when it works for them from the comfort of their home. 

• Keep it simple – When emailing employees about their benefits, be as concise as possible, with price per paycheck and benefits clearly laid out, using language that is easy to understand. You can also include any FAQ sheets you get from your insurer or agent, as well as a glossary of terms and acronyms. 

• Send out a survey – While you do have to be careful about privacy when it comes to employees’ health, there is no reason why you can’t send out an anonymous survey to find out what your employees are most interested in when it comes to their insurance plan, so you can either make a choice to change the plan you’re offering, or can recommend the right plan to them.

• Be creative with your communication – Email is great, but you have tons of options when it comes to follow-up communication and reminders about enrollment, including:

• • Text messages
  • Posters
  • A dedicated intranet webpage
  • Videos on screens in common spaces
  • Notices on paychecks (both hard checks and online)
  • A chat channel, through a platform like Slack
  • A Twitter chat, complete with hashtags that other employees can search

Yes, it’s Open Enrollment time again, what some might consider the most confusing time of the year. But you know? You got this, and we’ve got your back if you need help choosing, reviewing, or changing your employees’ healthcare plan. Come to EZ.Insure for a dedicated agent who can answer all of your questions, every step of the way, as well as find you fast, accurate quotes and sign you up for a great plan – all for free! No hassle, no obligation. To get started with us today, simply enter your zip code in the bar above or to speak to an agent, call 855-677-0157

ICHRA Pros

ICHRAs are a type of health reimbursement arrangement, a health benefit that differs from an HSA in that it is an arrangement, as opposed to an account. Employees don’t put money aside for their healthcare expenses; rather, you reimburse them for their medical expenses. You provide a set monthly allowance for employees’ premiums and medical expenses. ICHRAs have a lot of advantages for both you and your employees, including: 

• You can choose how much you want to contribute every month, and there is no minimum or maximum. Once set, you will give that amount to employees monthly; they cannot exceed that amount, which will help you budget accordingly.
• Reimbursements are tax-free.
• You can offer different monthly allowances to different groups of employees based on the type of job they do, how many hours they work, and even family status.
• Employees use the money you offer them to find an individual healthcare plan that suits their needs. This is empowering to them, and will allow you to focus on your business instead of trying to find a group health insurance plan that fits all of your employees’ needs. 
• Employees need to have an individual insurance policy to participate in an ICHRA, so if you enroll and start reimbursing employees mid-year, employees will become eligible for a Special Enrollment Period to choose a major medical health insurance plan. This means that they will not have to wait until the Open Enrollment Period, November 1- December 15, to buy a health insurance plan.

ICHRA Cons

There are many positives to offering an ICHRA, but sometimes with the good comes some bad. The disadvantages of ICHRAs include:

• This type of arrangement prevents employees from being eligible for advanced premium tax credits on ACA Marketplace plans. So if an employee decides not to take part in an ICHRA that is considered “affordable,” they will not be able to receive tax credits with an ACA plan. 
• Employees who are on their spouse’s health insurance plan cannot participate. The only way to participate is if they purchase their own individual health insurance and get reimbursed for it through the HRA. 

Need Help?

For many employers, ICHRA pros outweigh the cons and can seem like a no brainer, which is why they are growing in popularity. You get to help your employees purchase health insurance plans that meet their specific needs, and you also get to save money in the process. Reimbursements are tax-free for both employees and employers, meaning that they are tax-deductible for employers, and income tax-free for employees, which will save you on employer payroll taxes. It’s a win-win situation.

If you are interested in an ICHRA, or want to explore your options for a group health insurance plan, reach out to an EZ agent in your area. Our agents are highly trained and work with the top-rated insurance companies in the country. We can assess your needs and compare plans instantly, for free. To get started simply enter your zip code in the bar above, or to speak directly with a local licensed agent, call 888-998-2027.

Furloughed Vs. Laid Off

Health coverage for an employee is determined by the employer’s (your) health plan. The plan indicates how many hours an active employee has to work to be eligible for health insurance. There are also rules surrounding what happens to their health insurance when they are no longer an active employee. When an employee is :

• Laid off, their employment is terminated, even if you are considering the lay off temporary. After an employee is laid off, their health insurance plan ends on the last day of the month they were laid off.
• Furloughed, their hours are reduced, or they might not be working at all. The difference is that they can expect to return to work again when the furlough is over, so they can continue to get health insurance coverage during the furlough period. If this is the case, the employee will either be responsible for their share of the plan’s premiums, or you, the employer, can temporarily waive employee contributions and pay all of their premium.

ERISA & Federal Income Tax Rules

In general, nothing actually prevents you from paying monthly premiums on behalf of furloughed or laid-off employees. You have the option to choose to pay monthly premiums as long as you are able to. The premium will continue to be excludable from the gross income of the employees. Be aware, though, that if the plan rules do not permit an employee to be covered, then you are in danger of:

• Potential loss of tax-exempt status of the plan, which means both you and your employees might owe back taxes, since pre-tax qualification would be lost.
• Your insurance company denying claims for any employees that they determine are not eligible to participate in the plan. 
• A possible fiduciary breach under the Employee Retirement Income Security Act (ERISA) if plan assets were used to pay for benefits of non-eligible employees.

  

COBRA Insurance

Another option to continue coverage for your employees is the COBRA program. Both laid-off and furloughed employees qualify for a Consolidated Omnibus Budget Reconciliation Act (COBRA) plan if their group plan is terminated and you can no longer pay their premiums. COBRA can be expensive for your former employees, because if you do not contribute to their premiums, they will have to pay the full amount. 

ACA Marketplace

Last but not least, losing a job is considered a qualifying life event, so a Special Enrollment Period will open up for your former or furloughed employees after they lose their job and their coverage. This means that they will have 60 days to get a health insurance plan on the ACA Marketplace. This could be a cheaper option for your employees than COBRA.

EZ Can Help

The pandemic has actually caused some changes in the way that group health insurance works. For example, some states have issued orders requiring or encouraging insurance companies to allow employers to make changes to their eligibility requirements so they can continue to offer group insurance to furloughed or laid off employees. Some states are even allowing a grace period for premium payments. To find out if your state is one of them, speak to an EZ agent, who can help find out the information for you. If you are interested in continuing to offer a group insurance plan, we can help you find a reasonable way to provide insurance to the employees that you had to let go. The times we are living in are not normal by any means, and we know it is not an easy decision to let go of your valued employees. EZ can help by offering our services for free, which includes checking all possible options, answering any questions, and comparing quotes.

To get started, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-998-2027.

Reporting QSEHRA Benefits On the W-2

If you have an employee who is participating in your offered QSEHRA, you must report the total amount of the employee’s permitted benefit on Form W-2 in Box 12, using Code “FF.” The IRS description for this code is: “Permitted benefits under a qualified small employer health reimbursement arrangement.” This benefit is not counted as taxable income for the employee. 

It is important to note that over-the-counter medications used to require a prescription for reimbursement. However, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) signed in March 2020, has made over-the-counter medications eligible for reimbursement without a letter from a doctor or prescription. The medications should be reported on the W-2 Form as income in box 1 as well as in box 3, Social Security wages, and box 5.

Calculating The Benefits

When reporting on your W-2s, the permitted benefit amount should include only newly available QSEHRA funds. Any carryover amounts from previous years should not be included. However, if you use a non calendar-year QSEHRA, you will need to report a prorated amount.

Take the following example of a QSEHRA with a plan year that runs from August 1 to July 31:

• For the plan year beginning August 1, 2020, a QSEHRA benefit of $3,000 was available to every employee for August 1, 2020 through July 31, 2021. The amount reported on the employee’s 2020 Form W-2, box 12, code FF is $1,500 (for August-December 2020).
• In the new plan year (2021), the QSEHRA provides $3,500 to every employee for August 1, 2021 through July 31, 2022. The amount reported on the employee’s 2021 Form W-2, box 12, code FF is $3,250 ($1,500 for January-July 2021, and $1,750 for August-December 2021).

What About Carryovers?

When a QSEHRA has a carryover provision, only the newly available amounts are reported. If the QSEHRA allows for the use of carryover amounts from prior years, those amounts are not included in the amount reported for the current year. For example, if your employee has a remaining allowance of $1,000 in their QSEHRA allowance for 2020 and they receive $3,000 for the following year, only the $3,000 in new funds will be reported on their 2021 Form W-2 in box 12, Code FF.

What If An Employee Didn’t Participate?

Even if an employee did not participate in your QSEHRA, the benefits must still be reported on the employee’s W-2. You will report the amount of benefit that they were entitled to receive.

What About Employees With No MEC?

Employees who do not have the required minimum essential coverage (MEC) can still receive reimbursement through the QSEHRA, but will have to pay income tax on it. Specifically, any taxable reimbursements should be included as other compensation in box 1: Wages, tips, and other compensation.

If you issue a QSEHRA reimbursement and then later learn that the employee did not have MEC for the period in which the reimbursement occurred, the employee must repay the reimbursement as soon as possible.

However, if W-2 reporting is required before the employee has repaid the amount, that amount is taxable to the employee:

• The amount must be included in the employee’s gross income on Form W-2, box 1.
• The amount is not subject to FICA tax and should not be included in box 3, Social Security wages, or box 5, Medicare wages.

Have Questions?

If you choose to provide a QSEHRA to your employees, great! They are an excellent way to help your employees get the healthcare they need. But know that you will have to report these reimbursements on your W-2s, and it is important that you do it correctly in order to abide by the QSEHRA’s guidelines. If you need help exploring different types of small business HRAs, or have questions about offering healthcare in general, EZ can help. We will compare quotes, answer any questions and even sign you up for a plan at no cost to you. To get started, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-998-2027.

What Is An Employee Assistance Program?

EAPs are voluntary benefits that employers can choose to offer. You are not required to provide them, but they can be useful. Not all Employee Assistance Programs offer the same services, but services offered can include:

• Counseling for personal and work-related issues, including anger management, anxiety, depression, substance abuse, psychological problems, psychiatric disorders, chronic disease, stress management, and grief. 
• Training and development for things like communication skills, conflict resolution,  team-building, leadership coaching, and more.
• Resources and referrals for childcare, and other forms of care.
• Financial or legal resources for planning, retirement, divorce, custody cases, debt, and more.
• Access to wellness programs such as those for weight management and substance abuse, as well as gym memberships.

Services provided are free to employees, and sometimes for their families, as well. 

Why Offer an EAP?

According to the Journal of the American Medical Association, in 2003, U.S. companies lost more than $44 billion due to low productivity related to employee depression. Companies also lost $100 billion annually, or $3,000 per employee, because of substance abuse and mental illness. If you can help your employees manage their stress, you can help avoid this decrease in productivity.

Employee Assistance Programs provide emotional support and help employees maintain a healthier lifestyle. Employees can meet with EAP consultants by telephone or in person for assistance with problems that keep them from doing their best. Offering an EAP can increase employee satisfaction and productivity, while decreasing:

• The cost to your business of employee stress 
• The risk of workplace violence
• Turnover
• The risk of litigation
• Absenteeism

Determine What To Offer

Your employees have different needs, so it can be difficult to determine which benefits to provide. In order to determine which services to offer, you should conduct a healthcare survey. Ask your employees what matters most to them, but remember to keep it confidential. 

The well-being of your employees matters. There are a variety of Employee Assistance Programs to choose from, and even some comprehensive group health insurance plans that offer some of these services. EZ can help sort through all of your options. Our highly-trained agents can assess your business and what your employees need. We will provide you with guidance to find a great plan that works for everyone and will save you money. To compare quotes instantly, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-998-2027.

The Difference Between HSAs & HRAs

HSAs are savings accounts that work alongside your employees’ health insurance plan. Employees are only eligible for a HSA if they are enrolled in a qualified high-deductible health plan. Your employees can contribute money to the account, which then acts like a bank account for medical expenses; you can also contribute to their HSAs, and receive some of the tax benefits. The money that you both contribute is pre-tax, earns tax-free interest, and will not be taxed when employees withdraw it to use for qualified medical expenses.

HRAs are not savings accounts like HSAs, they are arrangements that allow employers to reimburse employees for medical expenses. They are intended to help employees pay for out-of-pocket health-related expenses, and are often used in place of a traditional group health insurance plan. Depending on the type of HRA you offer, there may or may not be a limit on the amount that you can reimburse your employees in a given year.

The Different Types of HRAs

First, let’s take a look at the different types of HRAs you can offer your employees. There are integrated HRAs, which are offered alongside traditional group health insurance, including:

• ICHRAs (Individual Coverage Health Reimbursement Arrangements), which allow tax-free reimbursement of benefits for any size business, and for any amount. 
• EBHRAs (Excepted Benefit HRAs), which are limited to paying for excepted benefits, such as premiums for vision and/or dental coverage and premiums for plans that are exempt from ACA rules (short-term plans).

Standalone HRAs do not have to be tied to a group plan. These include:

• QSEHRAs (Qualified Small Employer HRAs) – These are meant for businesses with less than 50 employees that do not offer a group insurance plan. Business owners can set up a QSEHRA for their employees to help pay for benefits tax-free.
• Spousal HRAs– These are for employees who are covered by a spouse’s group plan. They cannot be used to reimburse employees for their premium payments.

• Retiree HRA–  These are for former employees. They allow you, the employer, to help pay for any retired members’ insurance premiums and medical expenses.

When Offering Both HSAs & HRAs

In order for your employees to be eligible for a HSA, they must have a high-deductible health insurance plan (HDHP) that is HSA-qualified. If you choose to offer a HRA and a HSA, then the HRA has to follow the same rules as a HDHP, and cannot begin paying out until your employee’s minimum “deductible” amount is met. 

Another way to offer a HRA that is HSA-qualified is by offering a limited-purpose HRA that only reimburses employees for expenses that are exempt from the HSA deductible requirement. Expenses exempt from the HSA deductible are:

• Health insurance premiums
• Dental 
• Vision 
• Long-term care premiums
• Wellness and preventive care such as check-ups and quitting smoking or weight loss programs

You want to help your employees with their healthcare costs, but there is nothing wrong with also wanting to offset the costs of group health insurance. One way to do this is by offering both a HRA and a HSA. It can be done! As long as you follow the guidelines, then everyone can benefit from these arrangements. If you are unsure or need some help, then we can assist you. To compare plans, and to find a plan with the most coverage and savings, enter your zip code in the bar above. Or to speak directly to one of our licensed agents, call 888-998-2027.

Get More Employees to Participate in Your Plan

In order to get a good price on group health insurance, make sure that as many of your employees are participating in your plan as possible. If you’re in the financial position to do so, you can even consider hiring more employees – the more employees that you cover, the lower your premiums will be. How will your premiums be lower? Well, insurance companies face large risks for every employee that they have to cover, so having a smaller pool of employees paying into the plan means that  they are taking on more risk. However if you have a larger amount of employees paying into the plan, then there will be less risk for the insurance company, and they will be able to offer you a better deal.  

Reduce Coverage: Exclude Dental & Vision

Reducing the amount of coverage that you offer is a simple way to keep your insurance costs low. You can do so by cutting dental and vision from your plan and having  your employees decide whether they would like to purchase their own dental and vision coverage. These costs will come out of your employees pockets, but eliminating these plans will help to lower your premium costs and save you money.

Consider Switching Plans

The most common way to control the costs of your group insurance plan is by switching plans. Consider switching to a high-deductible health plan (HDHP). Doing so will increase your employees’ deductibles, but it will also reduce the cost of their premiums, and your premium contributions. Another route you can take is switching to a more cost effective plan with a smaller network, such as an HMO. 

Take Control of Prescription Drug Costs

Medications are necessary, but they can be expensive. There are ways, though, to save on  prescription drug costs in your plan by:

• Having a plan that mandates a generic substitution for any medication that has one.
• Having a limit on coverage, which will allow you to save on dispensing fees. 
• Encouraging your employees to shop at less expensive pharmacies, use money-saving apps, or request 90-day supplies of their medications.
• Checking your plan’s drug formulary, and making sure that it includes a large range of drugs in the lowest tier. These generic, lower cost drugs will most likely be covered 100%.

Keep Your Employees Healthy

The healthier your employees are, the lower your insurance costs will be. Offer a wellness program, which could include perks like fitness membership stipends, free flu shots, help quitting smoking, and cancer screenings. This is a cheap and easy way to not only make your own employees happier and more productive, but also a great way to save money in the long run.

Provide An HSA

If you decide to switch to a high-deductible health plan (HDHP), consider offering a health savings account (HSA) alongside it. HSAs are only available with a qualified high-deductible health plan, and will allow your employees to contribute tax-exempt dollars to a fund that can only be used for medical expenses. These funds also accrue tax-free interest and roll over each year, so employees will have money for healthcare when they really need it. The benefits for you? Tax breaks for you if you choose to contribute to your employees’ HSAs, and a healthcare plan that is more attractive to your employees. 

Find A Good Agent

Health insurance is complex. But if you have a good insurance agent, they can help you shop around for plans from different providers and help you to reduce your health insurance costs. Many insurance agents charge a fee for their services, but not EZ. We will provide you with one dedicated agent who will navigate through all available plans and provide you with instant, accurate quotes. All of our services are free – our mission is to help you find an affordable plan that provides great coverage. To compare group insurance quotes in minutes, simply enter your zip code in the bar above, or to speak to one of our agents, call 888-998-2027.

Tax Credits & Deductions

Contributing to your employees’ premiums can be expensive, but you can get some of that money back through tax credits and deductions. If you run a small business, you might qualify for the small business health care tax credit if you offer your employees a plan through the Small Business Health Options Program, or SHOP. To qualify for the minimum credit, you must have fewer than 25 full-time or full-time equivalent employees earning an average of $50,000 or less per year; to qualify for the maximum credit, you must have fewer than 10 employees earning an average of $25,000 or less per year. 

If you decide to offer a HRA or HSA, your employees will get tax advantages (all of their  contributions and reimbursements are pre-tax), and so will you. Contributions to your employees’ HSAs and HRA reimbursements are tax-deductible. 

Lower Payroll Taxes

Another tax benefit of offering group insurance is the ability to lower your payroll tax. When employees pay for health insurance, the cost of their premiums is typically excluded from their taxable income. This lowers most workers’ tax bills, and in turn reduces their after-tax cost of coverage. Lower taxable income for your employees means lower business payroll taxes for you. In addition, if you contribute to your employees’ HSAs, you can also save on payroll taxes because HSA contributions are deducted from your payroll on a pre-tax basis.

You Can Participate In The Plan

Offering health insurance to your employees means that you and your family can also participate in the plan. Compared to individual plans, group policies offer more pre-deductible benefits such as preventative care and primary doctor visit coverage. They also offer lower copays for prescription drugs and routine care.

Lower Costs Due To Larger Risk Pool

The higher the number of employees that participate in your group plan, the lower the cost of  health insurance. When more people are included in your plan, you have a larger risk pool, and everyone will have more options at a lower price. 

Attract & Retain Employees

Do you want healthy, productive employees who show up to work and boost your bottom line? Then provide them with group health insurance! If you want  employees who come to work and work hard for you, there’s no better way to ensure you’ll get that than by offering health insurance. They’ll be able to receive care when they need it, and they will feel like you have invested in them, so they will invest in you. This will lower your hiring costs, improve morale, and reduce absenteeism and risks associated with poor health. 

Health insurance can help you keep your current employees happy and healthy, and it can also help you to attract the best employees when it comes time to hire. Job seekers expect employers to offer health insurance and partially pay for their premiums, so you risk missing out on great candidates and potential employees if you’re not offering some sort of plan. You don’t want to be disappointed if a candidate rocks the interview, you offer them the job, and they turn it down because you’re not offering the benefits they’re looking for!

You Can Save Money

When searching for a group health insurance plan, you have to look beyond the premium. The costs associated with group health insurance plans include premiums, which you contribute to, but also co-payments, deductibles, and coinsurance, which your employees are responsible for. If you are looking for a way to lower your premium costs, consider offering a high deductible health plan. The higher the deductible a plan has, the lower the premium costs will be, so you can save on contributions. You can also offer a HSA with qualified high deductible health plans, so your employees will be able to put money aside to help with the cost of the higher deductible. 

Affordable group health insurance plans are out there, and you can find the right one for your business as long as you use a licensed, trained agent to help you. There are ways to offer everyone the most coverage while saving the most money. The best way? Start by talking to an EZ agent! All of our services are completely free, and there’s never any hassle or obligation. To instantly compare plans in minutes from top rated carriers around the country, enter your zip code in the bar above, or to speak directly to one of our agents, call 888-998-2027.

As you review your options, you also have to be aware of any legal changes affecting the design and administration of your current plan or any other plan you choose. Go through the following checklist, share it with your employees, and use it to help you choose your plan for the coming year.

Plan Design Changes

Healthcare plans and the rules surrounding them change every year. The cost of your plan may go up, so you need to be aware of changes to your costs. But you also need to be aware of changes to certain limits in your plan. Some changes to know for 2021 include:

• Affordable Care Act (ACA) affordability standard– The affordability percentage for 2021 is 9.83%. Employer-sponsored coverage for next year’s plan will be considered affordable under the employer shared responsibility rule if the employee’s required contribution for self-only coverage does not exceed 9.83% of the employee’s household income for the tax year.
• Out-of-pocket maximum– The annual out-of-pocket maximum limit for 2021 is $8,550 for self-only coverage and $17,100 for family coverage.
• FSA contribution limit: This has not been announced yet, so watch for IRS guidance on the FSA contribution limit for the 2021 plan year.
• High deductible health plan (HDHP) and health savings account (HSA) rules for 2021:
  • HSA contribution limits: $3,600 for individuals and $7,200 for families
  • HDHP minimum deductible: $1,400 for individuals and $2,800 for families
  • HDHP out-of-pocket-maximum: $7,000 for individuals and $14,000 for families

Make sure to confirm that your plan’s out-of-pocket maximum complies with the ACA’s limits for next year. If you offer a HDHP, make sure that the plan’s deductible and out-of-pocket maximum are also in compliance with next year’s rules. Remember  to communicate these changes to your employees. 

Notices To Pass On To Employees

You should provide certain benefits notices to your employees during the Open Enrollment Period. Benefit notices that you should review and provide to your employees include:

• Summary of Benefits and Coverage– The ACA requires healthcare plans and health insurance issuers to provide a summary of benefits and coverage to enrollees. This has to be given to your employees who enroll or re-enroll during Open Enrollment.
• Summary Plan Description (SPD)– Plan administrators have to provide a SPD to new participants within 90 days after plan coverage begins. In addition, any changes that are made to the plan should be communicated to employees in an updated SPD booklet.
• COBRA General Notice– Group health plan administrators have to provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. It can be included in the SPD.
• Grandfathered Plan Notice– If you have a grandfathered plan, then make sure that you provide any information about the plan’s status and any changes to the plan. 
• Children’s Health Insurance Program (CHIP) Notice– Group health plans that cover residents in a state that provides assistance subsidies under a Medicaid plan or CHIP have to send an annual notice about the available assistance to all employees residing in that state.
• Notice of Patient Protections– This notice needs to be provided if you are offering non-grandfathered group health plans that require designation of a participating primary care provider. If a non-grandfathered plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice.
• Individual coverage HRA (ICHRA)– This applies to employers who sponsor ICHRAs for specific classes of employees, or all employees. You must provide the written notice to each participant at least 90 days before the beginning of each plan year.
• HIPAA Privacy Notice– Employers with self-insured health plans are required to maintain and provide their own Privacy Notices. Special rules apply for fully insured plans. Under these rules, the health insurance issuer, and not the health plan itself, is primarily responsible for the Privacy Notice.
• Wellness Program Notices- There are 2 notices that you will need to provide employees if you offer a workplace wellness program:
  • HIPAA Wellness Program Notice– HIPAA imposes a notice requirement on health-contingent wellness programs that are offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (for example, not smoking) in order to obtain rewards.
  • Americans with Disabilities Act (ADA) Wellness Program Notice– Employers with 15 or more employees are subject to the ADA. Wellness programs that include health-related questions or medical exams must comply with the ADA’s requirements, including an employee notice requirement.

Finding An Affordable Plan

Whether you are considering renewing your current group plan, or finding a new plan or insurance company to work with, you will have to do some researching and comparing. There are hundreds of group insurance plans to compare in order to find the one that best suits you and your employees. By combing through these plans, you will be able to save hundreds, and maybe even thousands of dollars a year! The first step in figuring out what kind of plan to look for is to conduct an employee health survey.

Next, you should speak to an EZ agent. It can be time consuming to sit down and compare plans, and with Open Enrollment coming to an end soon, the whole process can become overwhelming. Running a business means that you have a lot on your plate, so let EZ.Insure do all the work for you. You can speak to one of our agents free of charge. They will ask you questions regarding your budget and employees, and will then begin comparing quotes. EZ will present you with the best option that will offer the most benefits and savings. To get instant quotes, simply enter your zip code in the bar above, or to speak directly to a licensed agent, call 888-998-2027.