Shop around: How small-business owners can find the right health insurance fit

Regardless of a company's size or purpose, health benefits are an important component of employee compensation packages and a critical issue for employers and their workers.  

In the state of California, businesses with one to 100 full-time employees can provide competitively priced, high-quality, name-brand health insurance coverage for their workers through the state-operated exchange, Covered California for Small Business (CCSB). In addition to being one of the largest small business health options programs in the nation, Covered California for Small Businesses offers employers a chance to qualify for federal tax credits.

"There are many benefits to small business employers that offer health insurance to their employees," said Bob Manzer, deputy director of Covered California for Small Business. "Healthy and happy employees are more productive and will also provide an edge to recruiting and retaining employees."

Through health insurance exchanges like Covered California for Small Business, employers are able to offer employees a greater choice of plans and hospital/physician networks, explained Michael Wolff, president of Dickerson Employee Benefits. “In addition, an employer can offer both Kaiser and any other group insurance carrier without being subject to limits of how many employees can enroll with each. This is generally not the case in a non-exchange scenario.”

For 2017, CCSB is offering a wide variety of plans through six health insurance companies, available for year-round enrollment: Blue Shield of California, Chinese Community Health Plan, Health Net, Kaiser Permanente, Sharp Health Plan and Western Health Advantage.

These health insurance providers have tweaked some of their plans for next year. For instance, Kaiser Permanente will offer coverage in Santa Cruz County for the first time, while Blue Shield of California takes its Full PPO plan statewide across all tiers with coverage also available to employees working out-of-state.

Blue Shield of California is also offering a new plan called the Trio HMO Network, in which members choose from a set network of doctors, hospitals and pharmacies and get coordinated care and lower premiums. This is done by forming an accountable care organization, or ACO — a healthcare organization that ties payment to quality metrics and cost of care rather than number of services it delivers.

There are dozens of plans available through CCSB and its four tiers — Bronze, Silver, Gold and Platinum.

The new Dual Tier Choice program gives employers the opportunity of setting their level of contribution and their employees the ability to choose between two different adjoining tiers of coverage to better fit their individual needs. For example, employers can set a budget based on the Silver level, but employees have the choice of moving up to Gold if they think the extra level is worth an additional out-of-pocket cost.

For 2017, the statewide weighted average rate increase is 5.9 percent for employers and their employees, down from the 7.2 percent increase in 2016. The program seems to be meeting people’s needs, as CCSB reports a year-over-year retention rate of almost 90 percent.

Optional family dental plans are also available to small businesses through Access Dental, Delta Dental, Liberty Dental, Dental Health Services, Premier Access Dental and California Dental Network.

Because small business owners are often chronically short of time, around 14,000 certified insurance agents are available to help with their health insurance options. In fact, about 85 percent of employers enrolled in Covered California for Small Business worked with an agent to help them make the right decisions for their business. Claremont Insurance Services, Dickerson Employee Benefits, LISI, Warner Pacific and Rogers Benefit Group are general agents available to assist certified insurance agents with small group clients.

Wolff said that a good agent is someone who has lots of experience helping small business owners select the best benefits solution, taking into account company budget and employee needs.

“He will be up-to-date on current health insurance offerings as well as benefits enrollment platforms that are integrated with HR, payroll and compliance services," Wolff said. "The agent is like a business consultant, not only for employee benefits, but also for related areas like compliance and HR. Best of all, he is paid by the carrier and free of cost to the business owner.”

 

—Julia Clerk for Covered California

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