One of the lesser-known provisions of the Affordable Care Act (ACA) is an Annual Special Open Enrollment Window that gives you and your business the opportunity to get health coverage for your employees, even if you were turned down in the past.
An Amazing Opportunity
You can enroll in CaliforniaChoice with fewer requirements from 11/15/17 to 12/15/17. You do not have to meet the standard 70% employee participation requirement, nor do you have to contribute the usual 50% of premium for your employees’ health coverage.
This special enrollment period is an excellent way for your employees to get the coverage they want – and need – without increasing the costs to your business.
No Minimum Enrollment, No Minimum Premium Contribution
If you apply during the 11/15/2017 to 12/15/2017 enrollment Window, your employees’ coverage will begin on January 1, 2018.
There’s no minimum enrollment for your group and there’s no minimum contribution required from you for your employees’ premium. If you don’t want to contribute, then you will collect the full premium from each of your participating employees each month and pass it along to CaliforniaChoice.
If you want to contribute, you are able to pay any amount toward their coverage premium; the usual 50% employer contribution does not apply. It’s your choice; you can contribute 5%, 10%, 25%, or more – or you can make zero contribution to your employees’ premium.
There’s no minimum group participation either. (The usual requirement that 70% of your employees enroll does not apply.) So, if you have 10 employees and just two want to enroll, that’s fine. All we ask for is a minimum of one enrolled employee and that CaliforniaChoice be the only health plan offered.
Great Options for Employees
CaliforniaChoice offers your employees a variety of plans from seven different health insurance carriers, so each one is sure to find coverage to match his or her individual or family health care needs. They can select from HMOs, PPOs, HSAs, and other plans from Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage.
It doesn’t matter how many employees you have, or how many choose to sign up for coverage through CaliforniaChoice during this special enrollment window. This is your once-a-year opportunity to offer health coverage to your employees without worrying about participation guidelines or premium contribution requirements.
Keep in mind, though, if you employ 50 or more full-time and/or full-time equivalent employees, your business is considered an Applicable Large Employer and you required to offer “affordable” health coverage to full-time employees. (Click here for guidance from the Society for Human Resource Management.) As such, your business is likely not eligible for the ACA Special Open Enrollment Window.
Continuation of Coverage
If you sign up during this ACA Special Open Enrollment Window, your employees’ coverage will begin January 1 and continue for up to 12 months as long as the premiums are paid. At the end of that time, if you want to keep your CaliforniaChoice coverage, you will need to meet the usual participation and premium contribution requirements at renewal.
This is a limited opportunity for businesses like yours to get coverage without meeting the usual participation or premium contribution requirements. If you’re interested, act now and contact your broker so you can take advantage of the ACA Special Open Enrollment Window, November 15-December 15. If you don’t already have a broker, we help you find a CaliforniaChoice broker to speak with about health coverage for your employees.
Health insurance is important when it comes to protecting your employees’ future financial security and ensuring they have access to health care when they need it. But how can you and your employees be sure you’re making the right choices when it comes to selecting your health insurance plan? CaliforniaChoice makes it easier to find the right plan at the right price, based on your individual or family health care needs and your anticipated plan usage.
CaliforniaChoice offers a range of publicly available tools on its website (www.calchoice.com) to help you and your employees:
1. Automated Choice Profiler: compare plans based on your health care needs
2. Online Provider Search: find the doctors you want
3. Online Rx Search: ensure the prescriptions you take are covered
4. Affordable Care Act (ACA) Calculators: determine how the ACA impacts your business
5. HR Calculators: calculate the cost of new hires, turnover, and overtime for your business
Let’s take a look at each of these tools separately:
1. Automated Choice Profiler
Using the Automated Choice Profiler, you have the power to compare coverage from seven different health plans (Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage). Your comparison is not based just on your premium but also on:
- the availability of your preferred doctors, medical group/IPA, and hospitals
- quality and affordability (like your deductible and co-pays)
- how you use your health insurance (or how you expect to in the future)
A great resource to help you or your employees when shopping and comparing plans, the Automated Choice Profiler takes into consideration:
- how often you visit the doctor
- out-of-pocket costs (like your deductible, plan co-pays, and co-insurance)
- your projected costs (based on what you can and can’t predict)
- your preferred doctors – and whether they’re “in network” for the plans you’re considering
- the overall quality of your health plan options (including feedback from plan members)
2. Online Provider Search
This tool can help you and your employees ensure your potential new health plan includes the doctors, medical groups, and hospitals you want after you enroll. It’s easy to use – just enter your home or work ZIP Code and the carriers you’re considering. You can then narrow your search by the doctor’s first and/or last name, distance from the ZIP Code you’ve entered, medical specialty, languages spoken, ACA metal tier (Bronze, Silver, Gold, or Platinum), medical group/IPA and hospital affiliation, and the type of coverage (e.g., EPO, HMO, PPO).
3. Online Rx Search
This tools lets you search for prescription drugs by name, treatment, or the medical condition with which they are most-often prescribed. You can search by brand name or generic class and by condition. You’ll get an easy-to-understand display of how the Rx is covered (or not covered) for each plan you’re considering.
4. ACA Calculators
The ACA’s reporting requirements and employer mandate apply only to employers with 50 or more full-time equivalent employees. The CaliforniaChoice ACA Full-Time Equivalent Calculator helps you determine whether that includes your business. The ACA Penalties Calculator helps you determine your possible penalties if you’re required to offer ACA-compliant coverage and you don’t. The ACA Safe Harbor Calculator helps you determine your plan “affordability” under one or more “safe harbors” of the ACA.
5. HR Calculators
CaliforniaChoice also offers HR Calculators to help you determine how much it costs to recruit and hire a new employee – and how employee turnover and overtime affect your business.
All of these tools are available in the CaliforniaChoice website. No registration or login is required. Use them before you talk with your broker. They can really help you when it comes to searching and comparing plans – and making the right choice for your employees and your business.
If you don’t already have an employee benefits broker, we can help you find a CaliforniaChoice broker to speak with about a health insurance quote for your employees.
As discussions continue in Washington, DC, about the potential repeal, replacement, or “repair” of the Affordable Care Act (ACA), it’s a good time to look at how small businesses can offer health insurance to their employees, the tax benefits available to businesses, and what insurers look at when it comes to eligibility and the review of applications for employee benefits.
Let’s look at five of the questions small businesses like yours are asking?
Are all small businesses required to offer health insurance benefits to employees?
No. The ACA only requires certain employers with 50 or more full-time and full-time equivalent employees to offer health insurance. However, many businesses with less than 50 employees choose to offer health insurance as part of their broader employee benefits and retention program – and because of the available tax benefits.
What are the tax advantages of offering employee benefits?
The premiums you pay toward employees’ health insurance benefits are exempt you’re your company’s federal income tax and payroll taxes. Plus, the Tax Policy Center at the Urban Institute and Brookings Institute says the portion of premium paid by employees (if any) is typically excluded from their taxable income.
Employee Savings Example: The Tax Policy Center has calculated savings for employees in the 15 and 25 percent tax brackets based on a reduced taxable income and lower payroll tax (7.65 percent of which is paid by the employee), as shown below.
|Tax Savings for Employees
(Based on $1,000 Health Premium)
|25% Tax Bracket||$374|
Other advantages include additional savings on employees’ state and local taxes, access to benefits at a cost that could be less than comparable coverage through the individual marketplace, and reduced employee turnover and absence due to illness.
Is my business eligible to offer health insurance benefits?
The CaliforniaChoice multi-carrier, employee-choice health insurance program offers medical coverage from seven insurers to small businesses with as few as 1-2 employees. (All firms must include at least one employee enrolled in medical who is not a business owner or spouse/domestic partner of the business owner.) Employees must be permanent and actively working an average of 30+ hours per week.
Employees not eligible include those who are: 1099; commissioned; permanent employees eligible for medical health care coverage offered by or through a labor union; part-time, seasonal, temporary, or substitute workers; and employees on a leave of absence not categorized as FLMA, Workers’ Compensation, or Military.
You can learn more about CaliforniaChoice underwriting guidelines by linking to this pdf, or a broker. He or she will gladly set up a time when you can discuss the options available to businesses like yours.
How much should I expect to pay for my employees’ health insurance?
Working with your broker, you have the ability to set the amount you want to spend monthly on your employees’ benefits using Defined Contribution. You can choose to contribute a fixed dollar amount or a fixed percentage of the costs for your employees’ benefits.
Budget Example: You may choose 50% of the lowest-cost health plan. If the least expensive option available to your employees has a $100 per month premium, you could contribute $50 per employee per month.
Flexible Budget Options: At CaliforniaChoice, we offer you up to 12 different ways to define your employee benefits budget. Whatever amount you select, you can take comfort in knowing your premium is locked in for 12 months. And, at renewal, you can adjust your premium contribution – up or down – so you continue to have full control over your benefits budget for another 12 months.
The Right Plan: One of the best things about CaliforniaChoice is that it gives each of your employees the ability to choose coverage to match his or her individual or family health care needs. One might pick a PPO because it includes his or her preferred doctor or hospital in the health insurance carrier’s provider network. Another employee, who rarely visits the doctor, might choose an HMO from a different carrier. A third employee might choose an HSA-compatible plan from a third carrier because of the plan cost and tax advantages. Your Defined Contribution is like a health insurance gift card that your employees use toward the premium for their preferred health plan. If their cost exceeds your contribution, they simply pay the difference.
Are there other benefits I should consider for my employees?
Yes, beyond medical benefits, you and your broker may want to discuss options like Dental, Vision, Life, and Chiropractic & Acupuncture.
Plus, when you select CaliforniaChoice for your employees’ benefits, you and they get access to no-cost extras through our Business Solutions Suite. It includes discounted hearing and other services plus employee entertainment and other discounts, HR support, HSA resources, a free Flexible Spending Account, COBRA administration, and more.
CaliforniaChoice gives employers like you the ability to enhance your employee benefits program, while still controlling your costs. It offers coverage through seven leading health insurers: Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage. And it makes administration easy, too.
To learn more, contact your broker. Or, if you don’t already have a broker, we help you find a CaliforniaChoice broker to speak with about a quote for your employee benefits.
Employee-benefits made simple without eliminating the power of choice.
Most of us would agree that simpler is usually better. No one – or very few of us – wants to make life more complicated than necessary. That’s the principle behind “aggregators” when it comes to websites or products that bundle what you may need and offer you a single place to find what you want.
Take Expedia, for example. A lot of us use Expedia and Priceline to search airline flights, hotel rooms, car rentals, and even things to do when arriving at our destination city. These sites make your search easier because they do a lot of the work for you and you can get everything you’ll need in one location without having to manage all of your travel arrangements separately.
It’s this concept – choice and simplicity – that you take advantage of in other areas of your life and business that you can also use when putting together an employee health benefits program. It’s called CaliforniaChoice and if you haven’t heard of it or your broker hasn’t mentioned it, you’re missing out.
The CaliforniaChoice Philosophy
We believe every one of your employees is different.
You and your employees are not the same. You have different family make-ups, are probably different ages, and we’re willing to guess you live in different parts of your community. You probably also have different health care needs. What does this amount to? Each of you is uniquely different, and it’s those differences that make the power of choice so important.
With CaliforniaChoice you give yourself AND your employees the power to select the health insurance option that meets your individual needs. Our program offers seven different health insurance carriers and dozens of plan options including HMOs, PPOs, HSAs, and more – in a single program. Employees can each choose what they like best – it doesn’t matter to us and doesn’t affect your business – but it matters to your staff. You simply decide what you can afford to contribute to their health insurance benefits, and employees can use your contribution to select the insurance they like best – paying the difference if they want an option that is more than your contribution – it’s like a gift card for health insurance.
And what’s the alternative?
The alternative to offering multiple health insurance carriers in one program is that you’d have to find a single health insurance carrier that everyone likes, but why would you and how could you? One size no longer fits all. Why not offer your employees more options without increasing your costs? That way, each of them can find the coverage that’s right for their individual or family health care needs.
We believe your health insurance bill shouldn’t be surprising.
When it’s time to pay any bill, seeing a number that is different than you expected is the last thing you want to deal with. You have to start crunching numbers, look to see if something changed when you weren’t looking, or, of course, figure out if there’s a mistake that you have to get fixed. Who has time for that? When you offer benefits through CaliforniaChoice, your broker will work with you to set an amount you feel comfortable contributing to your employees’ benefits each month. There are no surprises because the amount you agree upon together is locked in and won’t change for 12 months.
We believe managing your employees’ benefits should NOT be complicated.
If you select CaliforniaChoice for your employees’ benefits, regardless of what your employees select, whether all seven insurance carriers are selected or just three, you get one monthly invoice with everything consolidated and every employee listed with his or her selection. That’s the beauty of CaliforniaChoice. We understand that managing employee benefits can be complicated, so we try and reduce the burden where we can.
Medical, Dental, Vision, and More Available
Similar to having the option to add a flight, hotel, and car to your shopping cart, you have the option to add to your employee benefits program without having to leave the CaliforniaChoice program.
Here are the different types of insurance you can offer:
- Medical (required if you offer CaliforniaChoice to your employees)
We also offer no-cost extras to you and your employees just for being customers of CaliforniaChoice. It’s our way of showing you we appreciate your business. This value-added benefits include:
- Online HR support from HRAnswerLink
- Access to a discounts program for your employees (movies, theme parks, hotels, and more)
- Flexible Spending Account administration (so employees can set aside a portion of their salary on a pre-tax basis for eligible medical expenses)
- No-cost COBRA administration for businesses with 20+ employees
- And much more
Take the Next Step
If you want to learn more, do what you would with Expedia – check out your options. All it takes is a call or email to your broker. He or she will ask for an employee census that includes the names and birth dates for each person to be included in your plan quote. (Premiums are based on actual age, so the more information you can give your broker, the more accurate your quote.)
If you don’t have a current broker, we can help you find a CaliforniaChoice broker.
If you’re considering health insurance benefits for your employees, you may be wondering about your options and whether you can offer employees a choice of different plans. One option is a single health insurance carrier for all of your employees. Everyone get the same carrier and the same plans to choose from. Another option – and one that offers more choices for your employees – is a multi-carrier, employee-choice health insurance exchange. What’s that? Let us tell you.
A multi-carrier employee benefits exchange is, literally, a program that offers you and your employees access to multiple health insurance carriers. And while having access to “multiple anything” these days is fairly common, when it comes to offering health insurance benefits, more isn’t always simpler . . . except when comes to CaliforniaChoice.
In fact, with CaliforniaChoice, you get multiple everything. Check it out.
MULTIPLE HEALTH INSURANCE CARRIERS
The CaliforniaChoice multi-carrier, employee-choice health insurance exchange is sort of like a health insurance shopping mall – or an online website like Expedia or Amazon, where you and your employees can shop different vendors and then choose what you want to buy. CaliforniaChoice offers a variety of Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Health Savings Account (HSA) qualified plans, and other plan choices. Coverage is available from seven different carriers: Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage.
One of your employees might pick a PPO because it includes his or her preferred doctor or hospital in the health insurance carrier’s provider network. Another employee, who rarely visits the doctor, might choose an HMO from a different carrier. A third employee might choose an HSA-compatible plan from a third carrier because of the plan cost and tax advantages. Whatever your employees’ needs may be, they can shop, compare, and purchase the coverage that best meets their individual or family health care needs. It’s their choice!
MULTIPLE WAYS FOR YOU TO CONTROL YOUR COSTS
Working with your broker, with CaliforniaChoice you have the ability to set the amount you want to spend on employee benefits using a concept called Defined Contribution. You can choose a fixed dollar amount or a fixed percentage of the costs for your employees’ coverage.
For example, you may choose 50% of the lowest-cost health plan. If you offer multiple health plan options for employees to choose from and the least expensive has a $100 monthly premium, you must contribute $50 per employee per month.
Your Defined Contribution is like a gift card that you give to employees to use toward the premium for their preferred health plan. If their cost exceeds your contribution, they simply pay the difference.
Whatever amount you select, you can take comfort in knowing your premium is locked in for 12 months. And, at renewal, you can adjust your premium contribution – up or down – so you continue to have control over your benefits budget for another 12 months.
MULTIPLE WAYS TO FIND THE RIGHT PLAN
CaliforniaChoice makes finding and enrolling in the right health insurance plan easy – for you and your employees. Our technology suite includes an Automated Choice Profiler, which lets employees compare plans not just based on premium, but also on doctor availability, affordability, and how you use your health plan. There are also Online Provider Search and Online Rx Search tools, so you can be sure any plan you’re considering will include the doctors, hospitals, and other providers you want, as well as the prescription drugs you need. We also offer online enrollment to help streamline the process for your employees – and to help you keep track of who has completed their sign-up and whose enrollment is still pending.
MULTIPLE OPTIONS TO BUILD YOUR BENEFITS PACKAGE
The Business Solutions Suite from CaliforniaChoice includes valuable free extras for you and your employees. These include discounted Dental, Vision, and Hearing services plus employee entertainment and other discounts, HR support, HSA resources, a free Flexible Spending Account, COBRA administration, and more.
We also offer voluntary and employer-sponsored options for Dental, Vision, Chiropractic & Acupuncture, and Life Insurance.
MULTIPLE WAYS TO STREAMLINE YOUR ADMIN
Another advantage of the CaliforniaChoice multi-carrier, employee-choice exchange is easy administration. When you hire a new employee, he or she can be quickly on-boarded and offered benefits based on your company’s designated waiting period. If an employee leaves, we make it easy to offer them COBRA coverage.
Plus, you get just one bill each month for all of your employees’ coverage. It doesn’t matter how many different health plans they enroll in, your single monthly invoice shows all coverage, your contribution, and each employee’s contribution to the cost. You can even pay your invoice online, if you wish.
At renewal, it’s easy to changes to your employees’ coverage, while still staying with the CaliforniaChoice program.
Get started right now
If you want to learn more about how CaliforniaChoice can provide your employees with more choice, while helping you control your employee benefits costs, ask your broker about America’s only multi-carrier, employee-choice health exchange for small business. If you don’t already have a broker, we can help you find a CaliforniaChoice broker.