How Your Group Health Premiums Are Calculated

How Your Group Health Premiums Are Calculated text overlaying image of a ben and calculator on a white table 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.

Compare Group Health Insurance Plans

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.”


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.

Compare Group Health Insurance Plans

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.

Compare Group Health Insurance Plans

How To Insure Your Small Business

how to insure your small business text overlaying image of a business man working Your company will be better protected from potential losses and liabilities if it has small business insurance. Business insurance can assist in covering claims resulting from professional errors and natural disasters. As well as bodily injuries and property damage. If you do not have this coverage for your company, you will have to to pay the cost of any claims out of your own personal assets. This forces the owners of many small businesses to make the difficult decision to permanently close their businesses. Continue reading this article if you want to learn how to obtain insurance for your small business.

Compare Commercial Insurance Plans

  • Compare The Best Commercial Plans For Your Business!

Get Started

Looking for business insurance and making sure you’re getting all the coverage you need can get complicated. So, let’s break down what you need to do to start.

1.Collect information

Obtaining business insurance is as complicated as any other aspect of managing a company. In order to provide you with an insurance policy, insurance companies require a substantial amount of information about your needs, risks, coverages, and costs. 


You might be familiar with some of it or have it handy. While other details might be trickier to track down. EZ can help in that regard. We have helped thousands of other customers through the commercial insurance application process. So, we know what is required of you and how to get it. Let’s go over the requirements so the application process goes as quickly and easily as possible.

Business Operation Information

Your insurance agent or company will need a thorough understanding of your company’s operations in order to provide you with an accurate quote. If you’re in the contracting business, for instance, it’s not enough to know that you’re an electrician. The percentage of commercial versus residential work you do, whether or not you use subcontractors, do you use ladders or scaffolding, do you install alarms, etc., are all relevant details. 


The types of questions you’ll be asked vary widely by profession. It’s fine if you don’t know the answers right away. But you’ll save time and energy if you have a solid grasp of your operations before beginning the application process. In order to receive quotes from insurance companies based solely on operational exposures, you must be as specific as possible with your agent. 

Ownership and Experience

Questions about yourself, such as how long you’ve been in business and how much experience you have, will be asked. As well as questions about your company’s operations. Your quote will be based on the information you provide to the insurance company regarding the business’s owners and, in some cases, employees. If your resume is strong, you may be able to negotiate a lower price. 

Financial Data

Get some numbers ready. Your insurance agent or provider will inquire about projected earnings, employee headcount, outside vendors, and stock on hand. These estimates are predicated on the length of your policy, which may or may not align with your fiscal year. If your policy is audited at the end of the policy term and you were wrong in your projection, you could be penalized. However, you are not required to provide any confidential reports.


If you use contracts with customers, your insurer will probably want to see a sample to make sure you’ve included all the necessary safeguards to protect your business from claims and lawsuits. If you offer professional or other services but don’t have a contract, you may be required to draft one before receiving an estimate. 

Claims History

You will also need copies of your “loss runs,”. Which are the insurance term for the report that details all insurance claims made on behalf of your company. A three to five year claims history across all of your policies is typically required by insurance companies. If you are unable to obtain these reports from your current insurance agent, the quoting process will be significantly slowed down. Your insurance agent will be able to assist you in writing a letter to request these reports. 

Any Current Policies

Although it’s not required for a quote, having copies of your current policies on hand can help the insurance agent review your coverage and identify any potential gaps. The truth is that a lot can change in a year. It is possible that a policy review will serve as a prompt to either add or remove pieces of machinery, vehicles, etc.

2. Research

When was the last time you purchased something that needed to be assembled, but you chose to ignore the instructions? How did you determine that it was constructed properly? Unless you follow the steps, it is difficult to know for sure what the outcome will be. Obtaining the appropriate insurance for a small business is no different.


Reading the instructions isn’t nearly as interesting as learning about the different types of business insurance. Even though you might want to skip this step, spending as little as twenty to thirty minutes doing research could end up saving you a lot of time and money. You don’t need to become an expert. But having a fundamental understanding of the coverage options will help you make better decisions. Regardless of how long you’ve been in business, whether or not you seek the assistance of a professional. The first part of your research should be knowing the types of insurance available.

Compare Commercial Insurance Plans

  • Find The Right Commercial Plan For Your Business Needs!

Types Of Business Insurance

  • General Liability For a smaller company, this can be a lifesaver in the event that you are sued for damages or injuries caused by a third party.
  • Errors and Omissions or Professional Liability These policies can help a small company defend itself against claims of negligence or bad advice.
  • Group Insurance Group insurance is a great way for small businesses to provide health care coverage and other medical benefits to your staff.
  • Workers’ Compensation In the event of a workplace injury or illness, these policies will pay for the employee’s medical care, ensuring their safety.
  • Property Insurance – Coverage is good in the event that a company’s inventory or technological equipment are damaged or destroyed as a result of a natural disaster.
  • Commercial Auto This covers any vehicles that your company uses for work.
  • Business Owner’s Policy Small business insurance is a type of business insurance package that protects businesses from a variety of risks, including those associated with property and liability.

Every business has its own set of needs. Once you know the basics of business insurance, you should look into which ones are best for your business. For instance, an accountant who works from home might have a basic general liability policy. But an accountant who owns a building that customers come to would be better off with a business owners policy, or BOP, that covers more. Even though both accountants do the same job. There are differences in how they do it that affect their insurance needs.

3. Contact a Business Insurance Agent

You can work with an EZ agent who specializes in small business insurance to get the coverages you need. To work with our experts, you can get a free quote online. Talking to your insurance agent about your business can help you figure out what you need and how much coverage you need. They can help you figure out what kinds of coverage you can get and how much it will cost.

How To Determine The Business Insurance You Need

What kind of insurance is best for your business depends on your specific needs and the laws in your state and industry. You’ll need to carefully look at your business to figure out what kinds of insurance you need. Talking to an insurance expert is always a good idea if you want to find the right mix of coverage to make sure your business is legal and financially safe.

1. Analyze your legal responsibilities and business assets.

First, you should take a close look at your business and assets to figure out what you want to insure. What kinds of insurance are required by law, and where do your other responsibilities lie? For example, a machine shop might want to make sure its workers are covered in case they get hurt, while a jeweler might want to make sure they aren’t robbed. As required by law, the owners of a large distribution company would insure both their goods and their employees. Each state has its own rules, so make sure to talk to your agent to figure out what you need to insure.

2. Analyze Your Risk

Look at your new risks and responsibilities. This will help you figure out what kind of insurance will protect your business the best. For example, if your business is on the bottom floor of an office building in a flood-prone area. You’ll probably want comprehensive flood insurance. A business in a dangerous industry will probably want insurance to cover the risk of its employees getting hurt.

3. Decide How Comprehensive Your Coverage Needs To Be

Depending on what you’re insuring, you may need basic insurance or insurance that covers everything that could go wrong. Think about how much the loss would cost and how likely it is to happen. This will make it less likely that you will pay too much for coverage you don’t need or not get enough coverage for your safety.

How EZ Can Help

EZ can help whether you need group health insurance for your employees or commercial insurance to protect your business. Our agents work with the best insurance companies in the country to make sure you and your employees get the best insurance. In fact, we can find you the best coverage for your budget and save you hundreds of dollars a year. Call us at 877-670-3531 for help with group health insurance or 877-670-3538 for help with commercial insurance.

Compare Commercial Insurance Plans

  • Compare The Best Commercial Plans For Your Business!

Why Having a Multigenerational Workforce Can Benefit Your Business

There is strength in diversity. That statement holds true for all of society, and it holds true for the business world, as well. Having a workforce that is racially diverse and made up of different genders and orientations makes not only for a more socially interesting place to work, it actually also makes for a stronger business! But when we talk about diversity in the workplace, there’s one type of difference that we often overlook: age. We talk about multicultural workplaces, but we don’t often talk about multigenerational workplaces, and that could be a mistake. And not because you could be opening yourself up to an ageism lawsuit, but because limiting yourself to a younger population at work could mean missing out on the benefits of a multigenerational workforce. So how could having a range of ages working for your business benefit you?

The Benefits of a Multigenerational Workforce group of employees

We’re involved in the workforce at an interesting and unprecedented time: it’s possible to be working somewhere or running a business where up to 5 generations of employees are present! From Boomers to Gen Zers, there is a wide range of ages getting down to business these days; the problem is that we often view this diversity as a hindrance to growth. Surely older workers will slow others down, or there will be intergenerational tension, right? Wrong. 

In fact, according to a Harvard Business white paper, “Each of these five generations is vastly different, but research shows that these differences have very little impact on the way we act or what motivates us at work.” And we’ll go a step further: most research – and real world examples – show us that having a multigenerational workforce can actually lead to greater productivity and growth. How? Consider the following benefits of having an age-diverse employee population: 

Gives Businesses a Solid Pipeline of Talent

It makes sense: widen your recruitment efforts, and look at a wider range of candidates, and you’ll have a more solid pipeline of talent available to you. Reevaluating the way you recruit so you can attract employees from all generations means you’ll end up expanding the talent pool available for you to fill open positions, and tapping into unreached areas. 

Not only that, but if you make the effort to retain the older members of your workforce, you’ll be able to keep up a level of productivity and institutional knowledge that are expensive and difficult to replace. After all, how can you bring up a new generation of workers without the help and knowledge of those who have come before them? 

Increases innovation and creativity

gears with a red arrow pointing upward
Having wide range of employees can help increase innovation and company culture.

Younger workers get all the credit for having new, fresh ideas, but there’s also something else they have: less experience. So they might be able to bring the goods when it comes to new approaches and current trends, but older workers can bring a more measured approach based on strategies that have worked in the past, and the balance between these things can end up being a beautiful thing.

That’s not to say that older workers shouldn’t be given the opportunity to innovate. In fact, when everyone on a team has the freedom and support to share diverse opinions and ideas, it creates an energetic environment that utilizes the strengths of everyone at the table, whether those strengths are wisdom and experience, or a daring new approach. In one survey, 83% of workers said that they are able to come up with more innovative ideas and solutions because they work in an age-diverse team! So if you’ve got a workforce made up of all generations, you could find yourself with new products/services, improved processes, and interesting strategies that result in business growth

Enhances company culture

Did you know that 46% of job candidates believe culture is very important in the application process, with a grand total of 88% of job seekers citing it as at least of relative importance? The culture at a business is also important for retention: employees who don’t like their organization’s culture are 24% more likely to quit. Not only that but a whopping 88% of employees believe that a strong company culture is key to a business’ success. 

Employees’ opinions aside, a positive work culture is linked to higher rates of employee engagement, which has been shown to improve productivity and profitability. So what does this have to do with an age-diverse team? When companies have employees with a diverse range of ages, experience, knowledge and tenure, it can dramatically enhance the culture. After all, people with varying perspectives, backgrounds and life experiences help to create an energized workforce that builds/nurtures relationships and learns from each other.

Supports succession planning

We’ve seen a whole lot of people do a whole lot of quitting over the last few years. But the “Great Resignation” aside, losing employees is always a fact of life, and you’ve got to be ready for it! That can include leveraging the skills of the older employees that you have on your team. While some employers might see having older workers as a problem (since they are closer to retirement age), you should actually see it as a competitive advantage. You just need to properly leverage workers’ institutional knowledge, experience, skill sets, and strengths by encouraging cross-generational mentoring.

If you’ve got a multigenerational workforce, you’ll have built-in training opportunities, which will enable you to promote from within. That’s always a good thing, since employees familiar with your business and its culture will be more ready to fit right into their new roles. In addition, when employees have opportunities to advance, it leads to increased retention and less turnover, which can save you a whole lot of money.

Can affect your brand

Sometimes you want to look young and hip, and sometimes you need customers to see you as experienced, knowledgeable, and well-established. Having more seasoned workers in the mix can help you to put your best foot forward in certain situations; not only that, but being seen as an inclusive, diverse, and professional place of business could take you even further.  

How to Make It Work

Let’s go back to the benefits listed above. They are very real, and they are things that you could be easily taking advantage of – but you’ve got to get there! So the following are a few notes on creating an age-diverse workforce, and making it work for your business. 

Think about how you recruit and retain employees hiring process with a person under a light and paperwork around

If you want a more age-diverse workforce, the first thing you’ve got to do is find that more age-diverse workforce, right? That means reevaluating your recruitment efforts: you need to update your job descriptions with language that appeals to everyone, and look for different avenues of recruitment. 

Bring employees together

Like we said, watching your employees collaborate and innovate is a beautiful thing. But how can you get them to this point? One way is to try a “reverse mentoring” programming, in which younger employees pair with older employees to share their ideas. This shouldn’t simply be the younger folks schooling the older ones on tech topics and social media trends, and it certainly shouldn’t ever feel patronizing; on the contrary, it should be a two-way street, with those paired together offering both of their perspectives, making the learning a mutual experience. 

Remember, while younger employees might know more about tech and trends, “Seasoned employees have a lot more to teach junior employees about business intuition,” says Aaron Harvey, executive creative director at Ready Set Rocket. “Business is much more than trends and technology. It’s applied intuition that takes years of experience to develop.”

Work on leadership and communication

Some surveys show that employees of different ages sometimes find it difficult to communicate with coworkers outside of their age group. This should come as no surprise, but it doesn’t have to be that way. With that being said, an environment where people with a wide range of perspectives working to their mutual benefit, and the benefit of your business, doesn’t happen by accident – it begins with leadership.

According to Dennis Collins, senior director of marketing at West Unified Communications Services, you need to “Establish a solid understanding of who makes up your staff and the different dynamics at play,” and you shouldn’t be afraid to open the lines of communication in a respectful way. “Having an open and candid conversation about the benefits that come from a multigenerational workforce makes everyone feel more comfortable voicing their needs and concerns,” says Collins.

Don’t focus on one age group

It kind of feels like we’re spending all of our time focusing on the needs of one group of employees – often the younger generations. We want to make sure we’re speaking their language, and adopting the tools they prefer, but this can be a big mistake. Again according to Collins, “Ignoring the needs of any group of people in a company will result in a drop in productivity and unhappy employees.” So don’t worry about keeping up with every single latest trend; think more about looking for what works in your current culture, and make sure everyone feels spoken to and included. 

If you’ve got an age-diverse team at your business, you don’t have a problem on your hands – on the contrary, you could be sitting on a gold mine! And if you’re looking around and seeing a lot of fresh faces, but not a lot of diversity of viewpoint, you might want to reconsider your recruitment process, and add the spice of age into your workplace. But remember, to make the most out of a multigenerational workforce, and to get all of the benefits we laid out above, you need to be the right kind of leader, and work on bringing people together so the sparks of innovation can fly. Just follow our tips above, and you’ll get there in no time – and we want to hear about your experiences with an age-diverse team!

Starting a Business? Avoid These 10 Major Mistakes!

Nobody said starting your own business would be easy. There are so many moving pieces,  and you are responsible for everything. The pressure of solo entrepreneurship can lead to stress, setbacks, and tough decisions. There are no guarantees that you’ll make it: in 2019, the Bureau of Labor Statistics reported that only 20% of businesses keep their doors open past the first year, and 50% of those who do stay open close in their second year. Opening and sustaining a business requires funding, timing, and faith. While we can’t give you those three things, we can share some of the hard-won lessons from businesses that didn’t make it. Here are the top 10 common mistakes business owners make, and how to avoid them and survive your first crucial years.

man sitting in front of a laptop with his hand on his head and phone to his ear.
Don’t think you can start a business alone. You need a great staff.

  • Thinking you can do it alone.

To be an entrepreneur means being committed, dedicated, and independent. You see yourself as a jack of all trades and are often keen to do everything on your own. Waiting to hire staff or to outsource responsibilities could be catastrophic, though: as you become busier and busier, you might overlook important details, or let necessary tasks fall by the wayside. Hiring, training, and retaining quality staff before it becomes necessary is a must-do for all new business owners. 

  • Taking too much advice. 

When you announce your plan to start a business, everyone is going to have advice for you. Family, friends, neighbors, colleagues… you name it, they’re going to have something to say. Generally speaking, ignore it all. Seriously! Unless the advice is coming from someone who is financially invested in your business or who you truly consider a mentor, accept it gracefully and then disregard it. This is your business, and your life. Taking advice from someone lacking expertise could cause you to doubt yourself, or even to make a catastrophic mistake. 

  • Living outside your means.

    caucasian hand handing another hand a gold credit card
    Do not live outside your means or your business will fail.

People say that “the first year is the future year” – the foundation upon which your business can thrive, or dig itself into a hole, so don’t send your business to an early grave with overspending. Starting a business is a financial investment, but you shouldn’t feel pressured to purchase high-ticket items when there are reasonably priced alternatives. You may feel confident enough in your vision to justify it, but your best bet is to live within your means for the first few years. 

  • Cutting the wrong corners.

Frugality is important when starting a new business, but there are some things you just can’t cut corners on. Insurance is one of these things. Monthly premiums may seem like a burden, but they are significantly lower than the legal fees or repair costs that you might be hit with if you don’t have insurance. Hiring a professional bookkeeper is another necessary cost: miscalculating taxes can lead to hefty penalties and late fees, and it’s important to know how to budget for your quarterly and year-end tax bills. 

  • Selling yourself short.

Getting ahead of yourself and overspending can spell disaster, but so can not thinking big enough. You need to be prepared for success. Imagine that your business thrives and you’re asked to produce more of your product or provide more of your services. Would you be able to? Successful entrepreneurs have a strategy for scaling up when (not if!) their success demands it.

SMART goals written on a blackboard.
Set Smart goals for your business’s success.

  • Setting the wrong goals.

Goal setting is incredibly important, and the types of goals you set can make all of the difference! By following the SMART goal strategy you can formulate goals that are specific, measurable, attainable, realistic, and timely. Having organized goals can help you avoid burnout – you’ll have reasonable expectations and a clear way to meet your goals. 

  • Forgetting your role as entrepreneur and salesman.

It’s easy to dream of being the next Steve Jobs, but in the beginning stages of your new business, you must first work as a salesman. The product? Yourself. Someday you might have the same name recognition as Apple’s CEO, or Amazon’s Jeff Bezos, both of whom can walk up to any table and have a seat. You don’t automatically earn a seat at the table: you first have to successfully pitch yourself to your potential clients or collaborators. Remembering that should encourage you to bring your A-game to all meetings, business or casual.

  • Ignoring your victories.

Building a business from the ground up is hard work. It means putting in early mornings, late nights, and days away from family and friends. It can be emotionally and physically exhausting. To avoid burnout before you even get your business off the ground, it’s important to acknowledge and celebrate your victories, no matter how small they may seem.

never give up on a pink piece of paper and a red pen next to the words.
Starting a a business is not easy, but it is important to never give up.

  • Considering quitting.

I’ll say it again: entrepreneurship is no walk in the park! Selling yourself and your product, playing the role of manager, salesman, CEO, and innovator all at once, is a lot of pressure! Many businesses don’t survive – but in order to make it, you can’t even begin to entertain the idea of quitting. Steve Jobs famously said, “I’m convinced that about half of what separates the successful entrepreneurs from the non-successful ones is pure perseverance.”

  • Fearing failure.

Similarly, you can’t act out of a fear of failure. This results in guarded, hesitant actions –  and would you invest in someone who didn’t believe in themselves? Fearing failure, while completely understandable, can cause you to second guess yourself and make rash decisions, which could end up damaging your business. 

The Long Game

When you’re running your own business, you’re playing the long game. The first few years are survival mode, and unfortunately it doesn’t get much easier after that! Surviving past the first few years is a testimony to your resilience, authenticity, strategy, and skills – and the success of your business will always be worth the effort.

When Can Your Employees Make Mid-Year Changes to their Group Health Policy?

When getting a Group health insurance policy companies understand that people are going to sign up for what they need now, and employees’ needs can often change. Maybe there is a new baby on the way so they want to increase their coverage, maybe they just realize that they are covering a lot of stuff that they don’t need. This leaves many companies and employees wondering when and how they can make additional changes to their policy. 

The Standards

The standard is that each year there is one open enrollment period, and this is when people in a group insurance policy can make adjustments to their plan.. However, there are special cases that qualify your staff for a Special Enrollment Period or SEP

automotive worker fixing a car as employee
Any industry employee can opt into a SEP. It just depends on why.

Group Health SEPs are available if your employee has a qualifying event. Here are the most common qualifying events:

  • Death
  • Marriage
  • Divorce
  • A new addition (child) to the family

The qualifying period starts when the event happens and only extends 60 days. Otherwise, it will not be considered eligible for a SEP. This means if someone gets married June 1st, they have 60 days from that date to change their coverage, after that they will have to wait until that year’s open enrollment period.

Other Qualifying Events

Another qualifying event is loss of health insurance. This could happen when someone is covered under their parent’s plan and ages out if they are covered under their spouses’ plan and they lose that plan, or several other reasons. If this happens your employee has 60 days from the date that their current insurance plan ends to get new coverage or change their coverage through you.

Employee writing on a white board with a blue pen
Qualifying events are special circumstances that allow entrance to a SEP. These can be as simple as moving.

A change in residence also gives entitles an employee to a SEP. These mid-year changes are:

  • Moving to a shelter
  • Transitioning as a seasonal worker
  • Going to a new location for school
  • Entering the US
  • Moving to a new home

In this instance, the employee must have health insurance before then to qualify. Also, a small move like an extended vacation or sabbatical does not allow for a SEP.

Additional circumstances that might qualify for a SEP:

  • Starting service in an organization like Service Year or Americorps
  • Leaving incarceration
  • Becoming a member of a First Nationer tribe
  • Becoming a US citizen

The last thing to keep in mind is if any of these qualifying factors do arise, employees will need to have the correct information to verify an SEP. They all require documentation, but those papers are easily found. For example, a birth certificate for a child is mandatory, this is a valid proof of documentation for the verification process.

business owner speaking with her employees about special enrollment periods
Talk to your employees about these periods. It can be a confusing time, and they will appreciate both your knowledge and guidance.

If you find yourself looking for a new, or first group health insurance plan, EZ.Insure offers solutions. Your agent will answer any questions you have, compare the plans available to you, and even sign you up when you are ready, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing, or calling 888-998-2027. EZ.Insure makes the entire process simple, easy, and quick.




Is There Open Enrollment for Group Health Insurance?

Open enrollment is defined as a period of time when an employee join your group health plan or make changes to their existing policy. If you have a Group Health policy, which you should if your business employs over 50 workers, then any changes outside of a SEP  will need to be made during this open enrollment period. Your employees need to be notified so that they do not miss this opportunity.  

squares and finger pointing at them
Open enrollment is the standard period for insurance changes. Do you know the exact dates?

The unfortunate downside is that if the deadline is missed, then they must wait until next year. However, certain qualifying life events exempt an individual from this rule. You can learn more about that here. <link to SEP article>

For Employees

Open enrollment for the 2019 period will start Friday, November 1, and it will run until Sunday, December 15, 2019.

With your employment-based policy, your staff should receive reminders in the mail, but make sure to either talk to them one-on-one or send them an email yourself. 

Health coverage is important, and taking the time to reach out will send a positive message to your employees.  They will appreciate your knowledge, guidance, and interest in their well-being. 

For Business Owners

You do not have an “open enrollment” period to make changes to your company’s group health policy. You can make changes whenever you’d like. 

business owners in their company
Knowledge is power! Keep in mind important dates when it comes to making policy changes.

If you want to change your business’ policy, you can (usually) cancel your coverage at any time, but the insurance company prefers to be notified at least 30 days in advance. It would be courteous to let your employees know as well. 

For these changes, it’s good to review the pros and cons of joining an HRA or switching to a different policy. Both are valid options, but the choice ultimately falls on what would be best for your company’s future.

Don’t worry about big insurance decisions; EZ.Insure offers solutions. Your agent will answer any questions you have, compare the plans available to you, and even sign you up when you are ready, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing, or calling 888-998-2027. EZ.Insure makes the entire process simple, easy, and quick.