hand with building and person inside the bubble.

Employee Benefits that Have Your Back

The employee-paid benefits are not part of your health insurance. These benefits can be used to pay for things your health insurance does not cover. You may be able, during enrollment, to select benefits that will provide extra coverage to help you protect your future. And knowing how these benefits work will help you make informed decisions about what is best for you, now and in the long term.

Are you legal to provide employees health insurance?

You are required by law to offer group health insurance to employees if you have more than 50 employees. You must ensure coverage for at least 95% of your full-time employees and dependents. Full-time employees work for more than 30 hours per week.

You are not required to offer these benefits if you have less than 50 employees. Yet, we recommend you at least consider it. Robust benefits packages can make a big difference in attracting and keeping talent. The government offers many incentives to make it easier. We recommend SHOP, which is more detailed below.

How Does Employees’ Health Insurance Work?

Group insurance plans are often used to refer to employee health insurance. A group plan provides coverage for all employees. The monthly premiums for plans are usually paid monthly. This is dependent upon the location of the employees, their ages, and the number of employees.

There are also different types of insurance plans. These are the four most popular types of insurance plans:

Preferred Provider Organizations (PPO): PPOs can be considered the most flexible type of plan. Referrals are not required and the plan will, at most, partially cover out-of-network services. However, they tend to have the highest premiums. It is also the most popular group insurance plan.

Health Maintenance Organizations (HMOs): HMOs have lower monthly premiums, but employees will still need to be referred by a primary care physician (PCP) to receive any special services.

Exclusive Provider Organization: EPO plans pay only for services from a limited number of providers.

Point-of-Service (POS): HMOs are similar in that you need to refer certain services to a POS, but a PO will still pay for out-of-network services.

There are many ways to save money on employees health insurance.

It can be overwhelming to pay for group insurance. However, there are ways that you can reduce your costs creatively.

Sharing costs with employees: Offering health insurance benefits to your employees is not an all-or-nothing effort. Many employers share the premium prices with their employees. There are two options: have your employees pay higher premiums or shift your employee costs to the copay level to negotiate lower premiums from your insurance provider.

Group for health insurance: If your employees are very risk-averse and well, you might consider making your group for health insurance. Instead of signing up for insurance, you can set aside a portion of your budget for emergency care. Employers are responsible for paying the high cost of health care. While this may be short-term savings, it can cost the employer a lot of money.

Employee Coverage Options:

Many employers offer benefits to employees that will improve their health and well-being. Some examples of these benefits are:

Medical

The details of the employee benefits package, including health insurance, will depend on which plan you select. You may have the option to get it through different types of health insurance plans, such as an HMO or preferred provider organization (PPO). Both plans are connected to a provider network.

Vision

If you are interested in adding vision insurance to your benefits, find out which types of exams are covered. You should be aware of the out-of-pocket expenses and which type of contact lenses or eyeglasses are covered. Some plans only allow you to purchase one pair of prescription glasses each year. Many employers offer vision insurance but a vision discount plan. You can pay for vision care at a reduced price with a discount plan.

Dental

A healthy mouth is an integral part of good health, which is why many employers offer dental insurance for employees. There are many types of dental plans.

An employee pays for the services and is reimbursed directly by the insurance company. While most DR plans allow you access to the dentist of choice, benefits may be reduced if you choose a dentist from a preferred provider network.

An indemnity plan pays a predetermined amount for certain services such as crowns, fillings, and extractions. This is independent of the actual cost. Some programs may cover preventive care and cleanings at no cost. 

Life

Some employers offer life insurance to employees. It is usually for a benefit equal to one to three times your annual salary. If you feel you need more, you can buy a supplemental insurance policy to supplement your employer policy.

Employer life insurance may be an option if you cannot find life insurance due to a severe medical condition. You can often get life insurance with guaranteed acceptance through open enrollment or your first hiring. There may be limits on the amount you can get in life insurance if you are not accepted.

Disability

Most employers offer some disability insurance. This helps to make up lost income if you cannot work because of a non-work-related condition. Your employer may provide short-term coverage for up to six months or long-term coverage for up to five years.

How is the employer contribution split?

The two main factors that determine the breakdown of employer contributions are :

  • Healthcare premium cost
  • Contributions from employees

With the assistance of our professional healthcare agent, let’s discuss the employer’s contribution.

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