Group Health Insurance
At Twin City Underwriters, we help small to midsize business owners design an employee benefit program at the lowest possible cost while providing the best benefits in the market.
Benefits of Offering Group Health Insurance:
- Implementing an employee benefit program helps attract and retain employees.
- Employer contributions to employee health, life and pension programs are tax deductible.
- Employee premiums are deducted on a pre-tax basis reducing the employee’s taxable income.
- Since employee premiums are deducted on a pre-tax basis, each dollar reduces the employer’s FICA taxes by 7.65%.
- Offering a benefits program boosts employee morale, loyalty, and job satisfaction.
- Employers with 50 or more full-time employees are required by law to offer affordable minimum essential coverage that meets minimum value or face the possibility of incurring an Employer Shared Responsibility Payment (ESRP).
- Employers can deduct their HSA contributions to employees from their small business taxes.
- Employees with group health insurance gain greater access to medical care, creating healthier, more productive employees.
Glossary of Terms:
Deductible – The amount you pay for covered healthcare services before your insurance plan starts to pay. For example, if you have a $3000 deductible, you would pay the first $3000 before the insurance plan pays out.
Copayment – A fixed amount you pay for covered healthcare services after you have paid your deductible. For example, after you meet your deductible, you would pay a copay such as $20 for a doctor’s office visit until you meet your maximum out-of-pocket.
Coinsurance – The percentage of costs of covered health services you pay after you’ve paid your deductible. For example, you have a $3000 deductible with 20% coinsurance and a $7000 maximum out-of-pocket. Once you meet your deductible, you will pay 20% of all charges (Carrier pays 80%) up to your maximum out-of-pocket or $7000.
Formulary – A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.
HDHP – High Deductible Health Plan – a policy with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more out of pocket (deductible) before the health plan begins to pay its share. HDHP’s can be paired with HSA’s.
HMO – A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the Health Maintenance Organization (HMO).
HSA – Health Savings Account – Type of benefit account that allows you to set money aside on a pre-tax basis to pay for qualified medical expenses. Expenses include deductibles, copay, coinsurance, and other out-of-pocket medical expenses. You can only contribute to an HSA if you have a compliant High Deductible Health Plan (HDHP).
In-Patient – Serious illnesses or services that require a patient to be monitored overnight in a hospital. Examples like surgeries, childbirth, or rehabilitation services.
Maximum out of Pocket – The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.
Out-Patient – Treatment for routine conditions and services that do not require a stay in a hospital. Examples like bloodwork, lab tests, MRI’s, X-rays, mammograms and specialist consultations.
PPO – Preferred Provider Organization – a type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You usually pay less if you use providers that belong to the plan’s network.
Preventive Care – Most health plans must cover preventive services like shots and screening tests at no cost to you.
Employers offering group health insurance provide their employees with an affordable healthcare coverage option. Employers can often obtain group health insurance at lower rates with more comprehensive coverage compared to individual insurance available on the market. By providing your current staff and prospective employees a benefits package, including health insurance, you can attract and retain quality talent and boost employee satisfaction.
