Small group health insurance can be confusing, and the health insurance marketplace can be an asset for small businesses. However, even the marketplace can be a bit overwhelming for business owners, especially if they are tackling this project for the first time.
Like any other asset or business investment, owners want to ensure to the extent that they can that their purchase of a small group health insurance plan is the best one.
But how can you know? And how do you best navigate the small business health insurance marketplace?
THE HEALTH INSURANCE MARKETPLACE EXPLAINED
Like many other government-related programs and services, acronyms and differing terms for the same thing are common. For example, you may have heard or used the terms “marketplace” or “exchange” or even “Obamacare” when referencing the government-run healthcare plan offerings.
But what is it actually?
The government website at Healthcare.gov offers this explanation of the Health Insurance Marketplace®,
“A service that helps people shop for and enroll in health insurance. The federal government operates the Health Insurance Marketplace®, available at HealthCare.gov, for most states. Some states run their own Marketplaces. The Health Insurance Marketplace® (also known as the “Marketplace” or “exchange”) provides health plan shopping and enrollment services through websites, call centers, and in-person help.”
The health site also points out that small businesses can use the Small Business Health Options Program (SHOP) Marketplace to provide health insurance for their employees.
Simply put, individuals and families can make use of the federal or state health exchange, while small businesses – defined as those with between 1 and 50 full-time employees – must make use of the Small Business Health Options Program Marketplace, or SHOP.
A Look at the SHOP Marketplace
Of course, as a small business owner, you are also free to shop for company health plans on your own, directly with insurance companies, or with the help of a broker or licensed insurance agent.
For many owners, taking advantage of the Marketplace is a relatively easy route to take and easily navigated. The first hurdle, of course, is determining your company’s eligibility for SHOP. As the CMS.gov site explains,
“To be eligible to enroll in health insurance through the Small Business Health Options Program (SHOP), your small business or non-profit organization must:
Have a primary business address in the state where you’re buying coverage.
Have at least one employee enrolling in coverage who isn’t the owner, business partner, or spouse of the owner or business partner.
Have from 1 to 50 full-time equivalent (FTE) employees.
Offer SHOP coverage to all full-time employees.”
By completing the form found here you can quickly navigate the first step towards gaining access to the SHOP Marketplace offerings.
POINTS TO CONSIDER WITH HEALTH INSURANCE MARKETPLACE PLANS
Many state health exchanges offer programs for small businesses, including California, for example. What this means is that certain aspects of the eligibility and other factors can differ from that of the SHOP Marketplace.
An example of this is that, in California, eligible businesses must have at least one but no more than 100 eligible employees (as opposed to only 50) and meet certain contribution and participation requirements. In addition, a business must have at least one employee who receives a W-2, and the majority of eligible employees must live in California.
Known as Covered California for Small Business (CCSB), the state exchange program helps owners find health insurance for their employees to fit employee budgets.
In addition, using the CCSB portal allows owners to compare and choose health insurance plans, costs, doctors, and hospitals, as well as have a direct hand in controlling costs by choosing a plan that fits their employees’ needs and the company’s budget.
Using the state’s health insurance marketplace lets owners choose from HMO, and PPO plans with the following providers:
- Blue Shield of California
- Health Net
- Kaiser Permanente
- Sharp Health Plan
As a blog article at Health for California points out, partnering with an agency can make the process more streamlined. Experienced agents can answer your questions regarding the insurance exchange and the best plans for your small business.
LET J.C. LEWIS INSURANCE SERVICES HELP YOU MAKE THE RIGHT HEALTH COVERAGE CHOICE
J.C. Lewis Insurance Services wants to be your preferred small group health insurance partner.
With more than five decades of experience and the ability to offer only quality health insurance plans, we are more than capable of helping your navigate the health insurance waters. In addition, J.C. Lewis Insurance Services only works with the leading health insurance carriers licensed to do business in the states that we operate in.
As a family-owned and operated health insurance agency located in Santa Rosa, California, we, too, are a small business, and we understand the particular needs and challenges business owners face. In addition to being specialists in finding and managing medical insurance plans for small businesses, we are also licensed and certified by each insurance carrier we represent.
So, whether you’re considering small group health insurance for you and your employees or you’re simply looking to make changes to your existing plan, we understand that you’ll likely have questions and concerns.
We always welcome your questions about health coverage insurance, and you can be confident that J.C. Lewis Insurance Services will help you find the right solution for your needs.
J.C. Lewis – make us your preferred partner to help you make the right decision for your health coverage needs.