Group Health Insurance Plans

Employee benefits help employers attract and keep key employees, and are a valuable form of compensation. Knowing your benefit objectives and budget will help us recommend the best value in plans for your group. To receive a proposal, please fill out our quote request form and we will provide detailed plan descriptions and rates for your group.

Following are brief descriptions of types of group plans. Please click below on those that interest you.

Small Group Health Plans

Employers with two to 50 eligible employees can be issued health plans on a guaranteed basis, that is, regardless of medical conditions in the group. Carriers set a standard rate for each of their plans and cannot vary your rates more than plus or minus 10% from the standard. To qualify for guaranteed issue, employers must offer the plan to all eligible employees and meet basic contribution and participation guidelines.

Employers may offer one plan or a choice of plans, may contribute a percentage of premiums or a flat dollar amount (subject to minimum requirements), and may require enrolling employees to share in the plan costs. The employer also selects the new-hire waiting period and whether part-time employees are eligible.

Your rates will depend on the plan you select and the location of your business, the ages of your employees, your industry and your group size. Groups in good health may pay less than groups with medical conditions or histories.

PPO

PPO plans utilize large networks of physicians and hospitals. These plans generally have a flat co-payment for office visits and certain out-patient services, and a calendar year deductible must be met before the carrier begins to pay its share of hospital charges and other out-patient expenses. The patient's liability is limited by the out-of-pocket maximum, which applies to most covered expenses. PPO providers will not bill for more than the carrier allows. Out of network providers are reimbursed at lower levels and may bill excess charges.

HMO

HMOs typically keep out-of-pocket costs low and require physician-directed care. Services out of the physician network are only covered if the HMO authorizes the care.

Consumer Directed Plans

Consumer Directed Plans give employers a low-cost plan option and give employees immediate benefits by providing limited first dollar coverage at 100%, then applying a deductible or shared costs before high-level catastrophic benefits begin. Unused first dollar benefits can roll over to the following year(s), depending on the plan, enabling the employee to save 100% coverage for future use.

High Deductible HSA-Compatible Plans*

High Deductible HSA-Compatible Plans* can be combined with health savings accounts (HSAs) or used to insure only large healthcare expenditures. Except for preventive care, all covered healthcare expenses apply to the calendar year deductible, and the deductible applies to the annual out-of-pocket maximum.

Plans pay 100% of covered charges for the remainder of that year once this maximum is met. The family deductible can be satisfied by any or all family members and must be met before benefits are payable on behalf of any family member. Therefore, dependent premiums tend to be lower than traditional plans that use per member deductibles and maximums.

Health Savings Accounts* (HSAs)

Health Savings Accounts* enable people to save money for qualified healthcare services on a tax-free basis. An HSA can be funded by an individual or by an employer or by both. An HSA-account holder receives a tax deduction for deposits and disbursements are not taxed if spent for healthcare, dental care, vision care, and other allowable expenses (according to IRS guidelines). An HSA has three parts: a qualified underlying high-deductible health plan, a plan administrator, and an investment or bank account. Several insurance carriers have partnered with financial institutions to package qualifying plans and Health Savings Accounts. Contributions to an HSA are limited to the lower of the insurance plan or the current legal maximum. Persons over age 55 are also allowed a catch up contribution. HSAs are owned by individuals (employees) and are completely portable.

Health Reimbursement Arrangements

Health Reimbursement Arrangements are employer-funded plans that add benefits to an Employee Benefit Plan or replace insurance coverage in full or part. Here, the employer is at risk only for the amounts and services that the HRA covers. These plans provide great flexibility to employers and may be written to pay only actual claims expenses or funded as a fixed expense. The employer has considerable control over the plan scope and funding mechanics.

Group Dental Plans

Group Dental Plans range from low-cost Preventive and Basic Restorative coverage to full-coverage plans. Generally plans limit total benefits to under $2500/year, often $1000. Network plans (Dental PPO, Dental HMO) are lower cost, but provider networks may be sparse in certain areas.

Group Vision plans

Group Vision plans generally provide payment for vision exams, lenses and frames, or contacts at certain intervals. Payments are based on allowances or schedules that cover a minimum or standard product and can be applied towards more expensive items. These plans help employees obtain regular routine eye exams and pay for necessary eyewear, while health plans cover treatments for eye disease or injury. Many health plans include free vision discount programs.

Long Term Disability

Long Term Disability plans replace a percentage of an employee's income lost due to disability. Employers can generally purchase group disability policies for considerably less than the expense of individual plans. We can help you determine the most cost-effective plan or package of plans for protecting your employee's earnings.

Complementary Care Plans

Complementary plans provide an inexpensive supplement to traditional medical plans which limit or exclude non-medical services. Complementary plans cover alternative medicine such as wellness services, chiropractic, acupuncture, massage, nutrition counseling, naturopathy, and other care to help employees stay healthy. These services may be very effective and less costly for certain health conditions.

Latest Insurance News

New Voluntary Benefit for Employer Group

- February 23, 2016

Read More

Contact Us

Chico Office:
Toll Free: (888) 780-3285
Phone: (530) 895-3285
Fax: (530) 895-4292
Address:
70 Declaration Drive, Ste. 201
Chico, CA 95973

Pasadena Office:
Toll Free: (888) 780-3285
Address:
225 S. Lake Avenue, Ste. 300
Pasadena, CA 91101

License #: 0D52868