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Business & Group Health Insurance FAQ
Providing a quality group health insurance plan as part of your employee benefits package can help you retain employees and attract new talent to your business. The current job market is competitive, and benefits like health insurance are extremely important when job seekers are looking at potential employers.
Group health insurance can offer access to lower premium rates for comprehensive coverage. This is because of the larger pool of individuals being insured. Depending on the size of your business, providing options for health insurance may also be a legal obligation.
As with individual plans, there are many options to choose from for group health insurance in NJ. This includes HMO, EPO, PPO, HSA, and POS plans. Like individual plans, they are grouped into tiers based on the total average costs for covered benefits. These are classified into Bronze, Silver, Gold and Platinum plans.
Group dental and vision coverage is available on a standalone basis or may be a rider to the main group health insurance plan.
According to the Affordable Care Act, both individual and group plans are required to offer a package of services known as Essential Health Benefits, even if they are not part of the Health Insurance Marketplace. Some examples of Essential Health Benefits (EHB) include:
- Pediatric Services
- Preventative and Wellness Services
- Chronic Disease Management
- Prescription Drugs
- Hospitalization
- Emergency Services
- Outpatient Services
- Mental Health and Substance Abuse Services
- Maternity Care
- Rehabilitation Services
- Laboratory Services
Employers are required to contribute to 10% of the health insurance premium as a minimum. They may opt to pay a larger percentage up to 100%.
Under the ACA, large employers are required to provide group health insurance or else be subject to penalties. An employer is considered a large employer if they have at least 50 full-time or full-time equivalent employees on average over the course of the year.
An employer is considered a small employer if they have less than 50 full-time or full-time equivalent employees. Although they are not required to offer group health insurance, many smaller companies do. Most Americans actually rely on health insurance through their employer.
To qualify as a small employer, your mix of full and part time employees must equal between 1-50 full-time equivalent employees. An employee that works at least 30 hours per week in any month is counted as a single full-time employee. For part-time employees, their hours must be calculated by combining all hours and dividing by 30. This calculation doesn’t include seasonal workers working less than 120 days a year. Individuals and spouses who own the business, partners in a partnership, sole proprietors, leased employees, independent contracts and 2% shareholders in S-corp are NOT considered employees
Finding the best group health insurance plan in NJ can be complicated. Every company is different and has different needs. As an independent business health insurance agent, TMG Insurance Services can help you find the right business health insurance plan for your needs and budget.
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Get Business or Group Health Insurance
As a licensed health insurance broker in New Jersey, TMG Insurance Services specializes in business group health insurance. Making sure your employees can access quality healthcare options as cost-effectively as possible is important for any business owner. This is why you need to have an experienced independent health insurance specialist in New Jersey on your side. At TMG Insurance, we will help you find the plan that offers the benefits you need while staying within your budget. These plans can also include health and dental coverage.