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The Importance of Having Group Health Insurance for Your Business

San Jose, CA

When you are running a business and people work for you, it is very important that you are providing protection for your people to avoid any types of risks. In a business operation, people might get injured while they are performing their tasks that is why it is very essential to protect them as you are protecting your business as well at the same time. One of the best options that you can provide to them is a group insurance. In this article, what a small group health insurance is and why it is important to get one for your business and how to get it.

Business Group Health Insurance

A business group insurance is a type of insurance provided by employers to their employees. It is commonly known as employer-sponsored or job-based health insurance. This type of health insurance is not only beneficial for the employees but can also be extended to their family member. This is being paid by the employer and the employee into two equal parts. Included in this type of policy is a percentage rate that the company must pay, for the premium. After careful evaluation of the previous healthcare cost for the group, premium cost can increase. Since it comes in bulk, company insurance offer the insurance at a discount rate and allows for the risk to be spread among the members equally.

The Importance of Having Group Health Insurance

The first thing that you have to do in getting a group health insurance is to find a good insurer or insurance company. You will know that they are a good company if they take time to work on understanding your business needs for them to provide the best policy that is perfect for your business. They carefully study your business operations and its risks and they learn what would be the best policy coverage that protects your employees and your business as a whole. Kaiser Permanente is one of the best companies that works with you to get the protection you need. They are known to provide an affordable and affordable healthcare to different types of businesses.


One of the biggest factor that affects your business success is your people and their health. When they are healthy, they are always present to run your business operation and work efficiently. Healthy employees means good productivity and leads to your business’ success. Now, if you think that group health insurance is very essential to your business, you can start to talk to some insurance agent or a broker to get some assistance from them.

San Jose, California
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Health Insurance Brokers and Agents

San Jose Group

If you are a business owner who needs assistance in looking for the best insurance provider and on how to choose the right plan for your company and for your own family as well, then an insurance agent or a broker would be very helpful to you. Searching for the right insurance provider and to know what plan to choose is would time consuming and you might not even know if you can save money or will be spending too much for its cost.

A good insurance agent or broker is well-trained and knowledgeable that can provide you all the best options for your company. They are able to learn your business needs and its operation to achieve what should be the best insurance policy that fits with your employees’ needs. This is how important a good health insurance agent or broker to employers in choosing the right coverage.

A Broker will help you understand your insurance needs

“Producer” is the common name for licensed agent or broker. They understand the complexity of the American Health Care System and know how to explain it. As an employer who needs explanation about the American health care System, you may need an assistance from them to avoid any confusion when you are choosing the right plan. You’ll know if an agent is good if he or she is able to explain and will let you understand the plan options easily. They are also be able to provide you insights of your insurance needs and will also provide assurance or guarantee that you are making a good decision in choosing the best plan.

What are the different types of Producers?

The two common types of producers are the “captive” and “independent”. The one who are working under an insurance company are captive producers while the independent producers work on their and not for specific insurance provider. Both types of producers are getting almost the same percentage of the plan amount or flat fee as a commission.

Why should you go with an agent or a broker?

As mentioned, getting some assistance from a broker or an insurance agent is one of the best ways in getting the best insurance coverage for your employees. Why? Aside from being knowledgeable when it comes to insurance policy, they also know different types businesses and its needs that is why they can easily learned what would be the best options they should offer to each and every company depending on the type of the business. Apart from our own knowledge, as a business owner who is very busy in managing our own business, we also need people that can provide different insights and these insight will help us to pick the best insurance provider and the right policy or coverage for our employees that fits with the cost that we can afford and that can offer the best health coverage at the same time.

In addition, our law that governs the different businesses when it comes to health insurance policy are being updated. Brokers and insurance agents are the one who are being updated immediately since it is their part to be always on the right track in providing information about the health care system of our country.

There’s a lot of insurance agents or brokers available out there to provide you the best options for your business. These options are based on their knowledge on insurance policies and their understanding about your business. Finally, since the final decisions is up to you as the business owner, meeting some of them would be a good idea but you have to remember that that working with multiple agents may not be a good idea, as it would be pretty much the same as working with a broker, but with limited advantages.

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Understanding Requirements and Premium Rates for Small Group Health Insurance

San Jose TRA business having number of employees equivalent or less than 50 full-time employees is considered as a small business legally in the US while a company that has more than 50 full-time employees is a large one. Having this business classification, the laws that governs the group insurance policies also differ. What will be discussed in this article is only about small group health insurance which is very important to both employers and employees of a small business.

Coverage Requirements

Legally speaking, small businesses in the United States are not required to provide small group health insurance coverage to their employees. However, there are some business aspects that persuades employers to provide insurances to their employees such as employee’s retention and how to attract new talents. However, when the Affordable Care Act (ACA) has enacted in 2010, it requires that the small group health insurance plans meet certain requirements. Different benchmarks has set to ensure that employees has certain level of benefit. Below are the different levels or metal tiers of benefits that are based on what the plan pays off the average total medical expenses.

  • Platinum plans: These are the best ones, but also the most expensive. They usually cover as much as around 90% of medical expenses
  • Gold plans: These plans cover 80% of medical expenses
  • Silver plans: A silver plan would usually cover around 70% of medical expenses
  • Bronze plans: These are the most affordable ones and offer the least benefits, paying just around 60% of medical expenses

These different metal tiers reflect the average medical expenses they may cover. Coinsurance is not the same with these metal tiers since coinsurance requires an individual to pay a certain percentage of the overall medical expenses.

How to Determine Premium Rates

Since ACA has been enacted, premium rates has also been determined in different way. They are now based on the updated community rating which takes limited factors into consideration to come up premium rates. These factors include age, residential location and if an employee is a smoker or a non-smoker. Let’s say for example, the premium rate of a 50-year old regular smoker male employee that has an existing cancer which is a major health condition has a higher premium rate that regular type employees. On the other hand, the rates of a 30-year old healthy employee and a 30-year old employee with diabetes would be the same. In addition, depending on the state where they belong, an employer may allow their employees to choose the insurance company and the metal tier they want for themselves.San Jose, CA

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The Small Group Benefit Administration

Insurance AdministrationThe Small Group Benefit Administration

Administrative works such as managing the group insurance of employees is a quite difficult task to do but a very important matter to both employees and employers. As being said, a small group benefit administration service can be a solution for managers or employers that are responsible to this task and don’t want to deal with all the hassle involved but want to complete this responsibility as possible as it they can to make sure they are providing all the benefits of small group insurance.

The purpose of this article is to give us an overview on how an insurance provider can help employers in completing the small group insurance processes. Let’s go through the things involved that need to obtain by the insurance benefit administration service.

Educating the Employees about the Group Plan Details

This first part of the process is sharing the group details with the employees. This is the basic and very important procedure since this is when the employees understand the insurance plan details. Employees will be able to get clarifications about the things they don’t understand and to avoid making the wrong decisions.

The group insurance provider are great in explaining all the important details and knows how to makes it easier for the employees to understand about the plan. They are the best in position to handle the administration of the plan because aside from the plan details they share, they are also be able to make changes to employees’ contract immediately if needed. This will avoid any confusion in the future and makes the process faster.

The Enrollment Process

Enrollment process is one of the services that an insurance benefit administrators can offer. Aside from the initial enrollment, they also can also handle enrollment changes in the event of marriage, divorce, death of dependent, new child, etc. These processes can be done electronically and would avoid the inconvenience in submitting documents manually through their employer.

In addition, the termination of enrollments, special provisions and all other inquiries of the employees are being answered by the provider such as details about the plan, benefits and eligibility criteria.

Handling Claims

When it comes to POP and other claims, the insurance benefit administrators can handle this for employees directly. However, sometime provider are unable to do so due to cases like when an employee seeks for professional services that is not part of their network.

Managing Billing

Managing billing and payments is a continuous tasks and would be much easier to attain with the help of administrator. Invoices generated online and hard copies can be provided by the insurance provider who’s handling the administration and would make these documents available at different intervals depending on the plan. Special billing arrangements that an enrollee may require can also be assisted by the provider. And finally, various payment methods would be available in paying bills through insurance provider.

Again this is just an overview of what are the benefits of having an insurance provider administrators. There are more to discuss about the services that insurance provider administrator can offer. Always keep in mind that a good administrator achieves high level of efficiency and keeps smooth claims management procedure. La Fayette, CA

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Requirements and Premium Rates for Small Group Health Insurance

health-insuranceAccording to the law, a business having less than 50 full time employees is considered as a small company. On the other hand, businesses with more than 50 full time employees would be considered a large employers in accordance to law. Being said, the laws governing health insurance policies on these two different businesses level have quite differences. In this article, we will be discussing topics regarding small group health insurance that is very important to both employees and small business employers. This will guide us how to understand insurance policies and its premium rates.

Understanding the Coverage Requirements

Generally, if we are talking about the benefits required by the law either state or federal law, small businesses are not obliged to provide health insurance coverage to their employees. However, there are some factors that may affect the implementation of the law depending on the number of employees, the nature of the business and whether the coverage is being provided through an insurance company. In spite of these facts, many small business employers nowadays sees how important this benefit to them and to their employees and the major reasons of acquiring insurance policies is to attract new talents and to retain their best employees in their company.

Another factor that may affect in implementing laws on employees’ benefits in a company particularly regarding health insurance policy is the Affordable Care Act (ACA). Affordable Care Act requires that the small group health insurance policies must meet certain requirements. This act set a different benchmark to ensure that the employees get certain level of benefit.

The different levels or “metal tiers” of benefits are simply based on what the plan pays of the average total medical expenses.

  • Platinum plans: These are the best ones, but also the most expensive. They usually cover as much as around 90% of medical expenses
  • Gold plans: These plans cover 80% of medical expenses
  • Silver plans: A silver plan would usually cover around 70% of medical expenses
  • Bronze plans: These are the most affordable ones and offer the least benefits, paying just around 60% of medical expenses

Take note that different tiers reflect the average expenses they may cover. This means that insurances require individual to pay a certain percentage of the overall medical expenses.

Determination of the Premium Rates

Employees’ premium rates vary in different ways when the Affordable Care Act was introduced. Rates are defined depending on modified community rating which takes limited factors into consideration to come up with premium rates. However, rates for a 30-year old healthy male employee and a 30-year old male employee with a pre-existing disease such as diabetes would be the same.

After all the factors that affects the premium rates for employees of their health insurance, employee nevertheless can choose the insurance company that they think would provide the best coverage and rate. They may also be able to choose the type of tier they will provide to their employees since options would be always available to offer by the insurance provider.

San Jose, CA