Effective July 1, 2017, AB 72 protects individuals from receiving unexpected ‘surprise’ medical bills from an out-of-network doctor when receiving inpatient and outpatient care at an in-network healthcare facility such as a hospital, clinic, imaging center or other healthcare facility.
If an out-of-network physician treats a patient at an in-network facility and does not obtain the patient’s consent to be treated by an out-of-network physician, then the physician will not be paid the full amount for his or her services from either the patient or the insurer.
Group health continues to be high on the list of what job seekers are looking for in a compensation package. Almost without exception, group products offers better coverage than plans bought in the individual market. This reality makes an employer’s benefit program extremely important to those considering employment as well as those currently employed. In many cases, an employer’s health plan, or lack thereof, is decisive.
Most people get their health insurance through work. That’s where they expect to get it. For businesses that want to grow and encourage employee loyalty and productivity, employee benefits are not a cost- they are an investment in the future of the company and the admission price to be in the game.
To attract the talent and skill sets your business needs to flourish, offer your employees and colleagues something they can’t get on their own or through another employer. Group coverage and benefits can make all the difference.
Why Some Employees Consider Benefits More Important than Salary
Unlike the 28% increase hitting individual health insurance plans (led by Covered California) in Monterey California in 2017, employer group plans will be surprisingly stable. The renewal premiums from some carriers are actually lower than they were in 2016!
Small businesses who jumped out of the group market a couple of years ago thinking Obamacare would be more competitive will find better overall options in the group market come January 2017.
Contact us for additional information. Open Enrollment starts soon!
Health Savings Accounts have quickly become the smartest option for healthcare. Not only can you set aside pretax contributions that lower your taxes, you can then turn around and use HSA funds to pay your deductible, co-payments and other expenses not covered by your health plan. Even dental and vision expenses can be paid for and it will have all been 100% tax deductible!
While other medical expense plans make you ‘use or lose’ the funds within 12 months, a HSA account can be invested and rolled over every year. It is the silver lining in Obamacare. Check it out!
When Obamacare passed in 2010 there was some speculation that small businesses would eventually drop their group coverage and let employees buy their own coverage in the exchanges. Though the jury may still be out, the most recent survey released by the Urban Institute found that 82% of employees are continuing to get their health insurance through their employer. Some of the primary reasons employers are sticking with group;
- Competition for Skilled Employees; Businesses use benefits attract and retain the best employees. Medical insurance is one of the most considered benefits in any compensation package.
- Tax Advantages; Group benefits provide significant tax benefits to both employers AND employees. Employers get a tax deduction for offering coverage and employees don’t have to pay taxes on the contributions employers make on their behalf.
- Superior benefits; When compared to skimmed-down individual plans offered through exchanges like Covered California, group plans offer larger PPO Networks and more comprehensive drug formularies. As an added incentive, insurers like Anthem and Blue Shield include the Blue Card Program in their group plans which give employees the freedom to seek out the best providers and hospitals around the country. Individual plans do not have this ‘out of state coverage’ except for life-threatening emergencies.
While most small employers will continue group in 2015, not every company will. Those not offering medical will still want to provide some benefits to remain competitive in the marketplace. Dental, Vision and Long-Term Disability insurance are very popular benefits that can be very affordable. Ask us for some quotes!
If your company took advantage of the grandmother option in 2014, your plan will not be available for renewal in 2015. All ‘grandmothered’ plans in California are being canceled at their renewal and employers will have to renew into plans that are ACA compliant.”
While many employers have resisted changing to the Obamacare plans due to the higher cost, the silver lining is that benefits will actually be BETTER under the ACA; plan limitations on a number of services such as physical therapy, speech therapy, and mental health have been eliminated.
The new group plans fall into four categories or Metal Levels:
- Bronze: Health plan pays 60% of expenses on average
- Silver: Health plan pays 70% of expenses on average
- Gold: Health plan pays 80% of expenses on average
- Platinum: Health plan pays 90% of expenses on average
Though plans will be pricier, benefits are still going to be key to attracting top-notch employees. With the job market improving, there are certain benefits that good employees feel they must have and medical insurance is generally at the top of the list. Given the tax advantages of group insurance, most companies will opt into the ACA at renewal and continue offering robust coverage to their valued employees.
Have a question ?
At JGA, we’re here to help you think through the employee benefit needs of your company. With creative solutions, hands-on help and employee education we can help you reimagine your benefits and successfully transition to the ACA.