Offering your employees quality health insurance is essential for small businesses in Pennsylvania. Not only does it help you attract and retain top talent, but it also shows that you care about their well-being and productivity.
However, finding the right small business health insurance plan can be daunting, especially during open enrollment season. With so many options and regulations to consider, how do you choose the best one for your company and employees?
To help you navigate the process, we’ve answered the top 5 questions we get from small business owners about group health insurance in Pennsylvania.
1. How do I know if I qualify as a small business?
To qualify as a small business, you typically need to have at least one employee on your payroll. However, the exact definition of a small business varies by state.
For example:
- In Pennsylvania, a company is considered a small business if it has 50 or fewer full-time employees
- In New Jersey, the business must have 100 or fewer employees in full-time positions
- In Delaware, a company with 2-50 full-time employees is considered a small business
2. What are the benefits of offering group health insurance to my employees?
Offering group health insurance has many advantages for both you and your employees. Some include:
- Lower costs: Group plans are usually cheaper than individual plans because the risk is spread among more people.
- Better retention: Group plans can help you retain your employees by increasing their loyalty, satisfaction, and productivity. Employees who have access to quality health care are less likely to leave your company or miss work due to illness or injury.
- Enhanced reputation: Group plans can help you boost your reputation as a responsible and caring employer. Employees who feel valued and supported are more likely to recommend your company to others and speak positively about your brand.
3. How do I choose the best group health insurance plan for my small business?
There is no one-size-fits-all answer to this question, as different businesses have different needs and budgets. However, there are some factors that you should consider when choosing a group health insurance plan for your small business, such as:
- The size of your group: The number of employees you have will affect the type and cost of plans you can offer. Generally, the larger your group, the more options and discounts you have.
- The demographics of your group: The age, gender, health status, and location of your employees will affect the rates and benefits of plans you can offer. Generally, the younger and healthier your group, the lower the premiums and deductibles.
- The budget of your business: The amount of money you can afford to spend on health insurance will affect the quality and quantity of plans you can offer. Generally, the more generous your contribution, the better the coverage and value.
- The preferences of your employees: You should consider what kind of plan your employees want and need. For example, some may want more flexibility in choosing their providers, while others may be fine with a limited network.
To find the best group health insurance plan for your small business, you should compare different plans based on these factors and weigh the pros and cons of each option. You can also consult with our brokers who can help you find the best fit for your situation.
4. How soon should I enroll us for next year?
Open enrollment for the 2024 year runs from November 1, 2023, to December 15, 2023. This is the time when you and your employees can make changes to your current health insurance plan or enroll in a new one.
Small business owners should start planning for open enrollment early. This will give you enough time to compare plans, get quotes, and make informed decisions so your business can begin offering coverage on January 1st of the new year.
However, it’s important to note that certain life situations could make an individual eligible for coverage outside of open enrollment.
5. What is considered a Qualifying Life Event?
A Qualifying Life Event is a specific change in your living situation that can make you eligible for a Special Enrollment Period. For example:
- Getting married or divorced
- Having a baby or adopting a child
- The death of a family member who was an insurer
- Moving to a new zip code that affects your health plan
- Turning 26 and losing healthcare coverage from a parent’s job
- The termination of healthcare coverage as a result of losing a job
6. What is the difference between a PPO and an HMO?
The differences between health maintenance organization (HMO) and preferred provider organization (PPO) plans include:
- The ability to see specialists
- Out-of-network coverage
- Network size
- Costs
While PPOs tend to have more flexibility in seeing specialists and have larger networks than HMOs along with some out-of-network flexibility, they cost more than HMOs. You can easily compare different plans by getting small group health insurance quotes from various providers.
A broker who is licensed in your state can help you compare plans and find one that works for your budget. They can also help you understand the different regulations and requirements that apply to your business.
7. What happens if a business or employee misses open enrollment?
An employee who misses open enrollment may not be able to change their health insurance unless they have a qualifying life event. Most insurance providers, however, allow a 30-day grace period after open enrollment to let employees update their choices. If employees act quickly, they might be able to take advantage of this grace period.
8. What do I do once I’ve selected a plan?
Once you have reviewed your small group health insurance quotes and chosen a plan, you need to inform your employees. This notice should include the costs, eligibility requirements, enrollment period, and enrollment methods.
You will also need to collect information from your employees who want to enroll in the plan and submit it to the plan provider or broker. Once you have submitted the enrollment information, you need to confirm that your employees are enrolled in the plan and receive their ID cards, benefit summaries, and other documents.
Key Takeaways
Finding the right small business health insurance plan in Pennsylvania doesn’t have to be hard. By following these steps and tips, you can provide your employees with quality health care that meets their needs and fits your budget.
If you need help finding a plan or getting an insurance quote please contact us today. Our team is here to help you every step of the way.