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Group Medical Insurance is an important part of employee benefits offered by an employer. Businesses that provide benefits package is capable of retaining high-value employees.
What is Self-Funded Group Medical Insurance?
Employers often struggle to find healthcare benefits options that give you the control, flexibility, and value you need until now. With Self-funded benefits plan, you get better control over your health care benefits, the flexibility to tailor your self-funded plan design to your budget, and the opportunity to receive a refund if the group claim experience is lower than yearly projected claim. Advantages of Self-Funded Group Health Insurance are:
- Predictable Monthly Payment – premium is the same amount each month.
- Attract and retain employees – Self-funded plan design gives you the feel of a traditional health insurance plan while allowing the flexibility to tailor the plan to meet the budget of your company.
- Transparency of healthcare dollars – You will receive monthly reports showing how your healthcare dollars are spent.
- Opportunity for future savings – if there is a surplus in the aggregate claim liability account at the end of the 12 months agreement, a portion of that money is credited to your account, or return as cash to you.
- Stop-loss Protection – if medical claims paid by your self-funded plan are higher than the amount of money funded by the claim pre-fund account, you are protected with stop-loss insurance.
A.C.A. Compliance for Group of 50 + Employees
Effective 01/01/2016, all businesses with 50 or more full-time equivalent employees (FTE) provide health insurance to at least 95% of their full-time employees and dependents up to age 26 or pay a penalty fee of $3,000 per employees by 2016.
ObamaCare Employer Mandate for groups over 50 employees Are:
- The employer mandate is calculated on full-time equivalent employees, not just full-time employees.
- Affordable Health Insurance for your employees that provide minimum value, simple calculation is 60% coverage
- Employers must offer coverage to all 95% of their full-time employees.
- Coverage must be offered to dependents up to age 26.
- Spouses do not count as dependents, only kids under 26 years old.
- If Employers offer coverage, employees don’t have to take it. However, employees cannot get marketplace subsidies if coverage meets affordability and minimum value guidelines of 60%. Since the employee was offered qualifying coverage, the employer doesn’t pay any penalties.
- Employees who work at least 30 hours per week are considered full-time.
- Coverage offered to employees must be regarded as affordable (can’t cost more than 9.56% of employee household income) and must provide minimum value (60%). If coverage is not affordable, employees can use the Marketplace; then the employer can be fined of $3,000 per employees.
- For employers who don’t provide coverage, the fee is $2,000 per full-time employee (minus first 30 full-time employees).
- For employers who do provide coverage but don’t provide coverage meeting minimum value and affordability requirements, the fee is the lesser of $3,000 per full-time employees.
- For plan years beginning in 2016 and beyond, employers can exclude the first 30 full-time employees from the penalty calculation.
- The fee is only “triggered” if at least one employee shops in the marketplace, and is eligible for a federal premium subsidy.
- As long as an employer has a waiting period of 90 days or less they are abiding by the law and don’t have to pay the penalty.
- Employers must offer at least a 30 day Special Enrollment Period for employees or qualify employee family members losing coverage from another source.
- The penalty fee is a pro-rated per month fee.
Need a group quotes from Health Insurance Companies?
We are committed to providing a satisfactory plan that is right for your company along with affordable premium and helps you administer the program. If you are shopping today for a Group Medical Insurance Quotes from Florida Health Insurance Companies, please Call Us Now at (954) 454-9599 or (866) 454-9555, we will be happy to answer your questions and guide you through setting up an affordable plan that is right for your business.