In today’s talent market, job seekers expect a competitive salary and benefits package from their employer. That includes more than just Major Medical health insurance coverage, and often Dental, Vision, and more.
Employees want the ability to customize their benefits to address their individual and family needs. According to MetLife’s 19th Annual Employee Benefit Trends Study, released in 2021, employees are “placing increasing value on feeling safe, protected, and prepared across all areas of well-being – and they need employers to restore that sense of security through benefits and other support.”
COVID-19 brought with it an increased focus on health insurance and its importance. It also cast a spotlight on other coverage options. That doesn’t mean you have to overhaul your current benefits program to attract talent. CaliforniaChoice allows you to offer more without spending more.
Since 1996, CaliforniaChoice has offered small businesses a way to offer multiple health plans to their employees, while still controlling their benefits costs. CaliforniaChoice offers everything you and your employees want in a single program:
- A choice of eight health plans: Anthem Blue Cross, Cigna + Oscar, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage
- Greater access to doctors, specialists, and hospitals and a choice of full and limited networks – in plans across all four Affordable Care Act metal tiers; you can choose a single tier, two tiers, three tiers, or Total Choice with access to all available tiers
- Personalized employee choice: Your employees choose the coverage that best fits their specific health care needs and budget; one might choose a PPO, while another prefers an EPO or HMO; it’s their choice
- Increased cost control using Defined Contribution: You decide what amount you want to contribute to your employees’ health insurance: a Fixed Percentage or a Fixed Dollar Amount
- Optional benefits for Dental, Vision, Chiropractic, and Life/AD&D: You can easily expand your employees’ options with the SmileSaver Dental HMO, Ameritas PPO Dental, a choice Vision One Eyecare or Voluntary Vision from EyeMed or VSP, Life and Accidental Death & Dismemberment (AD&D) from Assurity Life, and Chiropractic (or Chiro and Acupuncture) from Landmark Healthplan
- Value-added extras for your business like an online HR Support Center, a Flexible Spending Account (FSA), a Premium Only Plan (POP) that allows employees to pay insurance premiums with pre-tax dollars, and Cal-COBRA or Federal COBRA billing services (depending on your group size)
- No-cost member benefits including hearing services, employee discounts on movies, theme and water parks, hotels, and much more, plus fitness and wellness savings through the ChooseHealthy® program
- Ease administration: Whether you have five employees or 100, with CaliforniaChoice, you get a single, consolidated monthly bill that lists all employees’ coverage, your contribution, and employee deductions – and we make it easy for you to manage your account online, too
- Smart technology: CaliforniaChoice offers a valuable plan comparison tool, online enrollment (that speeds up your group’s enrollment, reduces errors, and decreases processing time), and online provider and Rx search tools so you can be sure your preferred plans include the doctors and hospitals you want and the prescription drugs you need
Another Way to Help Control Costs
If you’re concerned about the costs associated with additional coverage like Dental, Vision, or Supplemental Health coverage (like Accident, Hospital Indemnity, Critical Illness, and Disability Insurance), you might consider offering coverage on a partially paid or voluntary basis. Again, you determine what amount – if any – you want to contribute to employees’ coverage. You can fund it all, or share the cost with employees. For voluntary coverage, all of the premium can be funded through employee payroll deductions, with no added cost for your business.
A September 2021 article by Benefits Pro cites an increased interest – among employees and employers – for voluntary benefits. Three in four employees said voluntary benefits would affect their employer’s ability to retain them – compared to 68% a year ago.
Among HR professionals, the vast majority (83%) believe offering more voluntary benefits helps them retain employees, engage employees (72%), and attract new talent (72%).
Whether you bear the cost entirely, or share costs with your employees, they are likely to appreciate the availability of more options, so they can tailor coverage to their individual and family needs. Offering more helps you differentiate yourself when it comes to recruitment and retention.
Explore Your Options with a Broker
One of the best ways to compare benefits costs and learn about options for your business – and your employees – is to talk with a broker. An employee benefits broker can help you sort out the health care alphabet (PPOs, HMOs, EPOs, HDHPs, and more), and provide a custom quote for your business. You won’t pay anything for your broker’s service either – and it could save you money because your local broker will know what’s available in your area and what health plans include your preferred doctors and hospitals. If you don’t already have a broker, we can help find one here.
If you’re shopping for a health plan for yourself and your employees, it’s important to make a selection that’s compliant with the Affordable Care Act (ACA). Here’s a look at ACA-compliant policies you should be aware of during your search.
Short-Term Health Plans
California prohibits the sale of Short Term Health Plans, which offer medical coverage for a specified, limited time. In general, these policies offer an initial coverage term of less than one year, although outside of California some states do permit multi-year renewals. Prior to 2019, for a few years, California allowed short-term health insurance coverage for up to 185 days; however, California Senate Bill 910 (passed by lawmakers in 2018) changed the law and prohibited all Short Term Health Plans in California starting January 1, 2019.
Many insurance companies market non-ACA-compliant coverage in the form of Supplemental Insurance. They are described as “supplemental” because these plans typically augment Major Medical coverage. (See below.) These policies may include benefits for hospital stays (Hospital Indemnity plans), specified disease (Cancer and Critical Illness plans), Accidents, and Healthcare Sharing Ministry (HSM) plans. Policies may offer payments for certain health conditions (and not others), accidents, or may offer payments for out-of-pocket costs not covered by a Major Medical plan. (Again, that’s where the “supplemental” label comes from.) A criticism of HSMs is they do not guarantee payment for services and often fail to include essential health benefits, such as prescriptions and birth control. While premiums for supplemental coverage are usually lower than broader medical coverage, these plans are often not obligated to cover preexisting health conditions, nor do they have to offer the same range of health treatments covered by a Major Medical plan. Some include annual limits on what they will pay, which ACA-compliant plans do not.
ACA-Compliant Group Health
When the federal health care law, often called Obamacare, became law in 2020, one of its principal goals was increasing coverage options for individuals and small groups. Before the ACA, California’s uninsured rate was 17.2% in 2013, as compared to 7.2% five years later.
A major provision of the ACA is a mandate that Applicable Large Employers (ALEs) – those with at least 50 full-time employees (FTEs), including full-time equivalent employees – offer Minimum Essential Coverage to full-time employees and eligible dependents.
If your business is not an ALE, you are not required to offer ACA-compliant health coverage; however, many employers with fewer than 50 FTEs do choose to offer health insurance for recruitment and retention purposes. (Repeated surveys by the Society of Human Resource Management (SHRM), MetLife, and others show employees value health insurance and benefits can often be a deciding factor in choosing an employer or staying on the job.)
All ACA-compliant health plans for small groups must include these Essential Health Benefits:
- Ambulatory patient services
- Emergency services
- Pregnancy, maternity, and newborn care (before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services (including chronic disease management)
- Pediatric services, including oral and vision care for children (adult dental and vision services are not essential health benefits)
ACA plans are available across four metal tiers: Bronze, Silver, Gold, and Platinum. Each tier offers a different level of support for covered services, as shown in the accompanying table.
Depending on the health plan you choose, you may be able to select from Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), and High Deductible Health Plans, some of which may be offered in combination with a Health Savings Account (HSA). An HSA is a tax-advantaged medical savings account where employees can put aside funds to use toward their High Deductibles Health Plan.
Another distinction of ACA-compliant coverage is the absence of any pre-existing condition limitations and no annual or lifetime coverage maximums.
What Are ACA Metal Tiers – and How Do They Work?
|Metal Tier||Payment Based on Actuarial Value (Within -4%/+2%)||Member Pays|
|Platinum||Insurance carrier pays 90% of the costs of covered in-network benefits||10% of costs of covered in-network benefits|
|Gold||Insurance carrier pays 80% of the costs of covered in-network benefits||20% of costs of covered in-network benefits|
|Silver||Insurance carrier pays 70% of the costs of covered in-network benefits||30% of costs of covered in-network benefits|
|Bronze||Insurance carrier pays 60% of the costs of covered in-network benefits||40% of costs of covered in-network benefits|
If you are an ALE and your business does not offer health coverage to eligible employees, you are subject to a penalty if even one of your employees receives a federal subsidy to help pay for coverage through the Covered California public health insurance exchange. The penalty is assessed monthly and is equal to the number of full-time equivalent employees (minus the first 30), multiplied by one-twelfth of $2,700 (the 2021 penalty amount). There is no penalty for not offering health insurance to part-time employees.
A larger penalty of $4,060 applies in 2021 if coverage you offer is not affordable to employees or does not provide minimum value. “Affordable” means the cost does not exceed 9.83% of an employee’s household income for the lowest-cost, self-only coverage option. A plan meets the ACA minimum value test if it includes coverage for physician and inpatient hospital services and pays at least 60% of the total cost of medical services covered by a plan (a Bronze tier plan or better as shown in the accompanying table).
Consult a Broker
One of the best ways to find out about the health plans in your area is to speak with an employee benefits broker. A broker helps you compare plans and find the one that’s right for you. If you don’t already have a broker, we can help you find one here.
It’s almost time for Halloween and it’s a good idea to start planning your workplace festivities from now.
2021 looks a little different than last year, but many offices are still not back in the office full time. That doesn’t mean you can’t celebrate. Here’s a list of ways to do so safely with employees in the office or working remotely.
Spooky Decorations: Get in the Halloween spirit with spider webs, caution tape, and other ghostly decorations. If your employees have returned to work, even part-time, you can have a decorating contest. Encourage participation by awarding a winner.
Make sure you remind employees that lighted decorations need to be turned off at the end of the day. Decorations cannot violate fire or safety codes.
Party Bags: While a party may not be the best idea during a pandemic, that doesn’t mean you have to miss out on treats. Put together a trick-or-treat bag for each employee in advance and hand them out to get everyone in the Halloween spirit.
Costume Contest: Nothing screams Halloween like a costume contest. You can create categories like “most creative,” scariest, and funniest.
Something to keep in mind – the Society for Human Resource Management (SHRM) suggests these do’s and don’ts when it comes to costumes in the workplace:
- Images of ghosts, skeletons, devils, etc. do not go over well, especially in health care settings. They can be offensive to those with a strong religious orientation.
- Costumes of religious leaders can also be perceived as offensive.
- Political costumes can be problematic, especially in today’s polarized environment.
- If in doubt, don’t!
Halloween 2021 is on a Sunday, so you may want to plan your costume contest for the Friday before or another day if you’re not in the office daily. You could also host your contest virtually.
Pumpkin Carving: This can work for employees in the office and for those working at home. For on-site staff, you can ask participants to carve their pumpkins at home and bring them to work for judging.
If you’re not concerned about a potential mess, and can still keep employees socially distant, have them carve their pumpkins at the office. Provide the tools they’ll need and choose a spot to de-seed equipped with carving tools. Aprons also help.
If you’re concerned about a mess, pumpkins decorated with a Sharpie works, too!
More ways to celebrate:
- Create a Halloween playlist
- Have a Halloween potluck
- Vote on a favorite horror movie – and play it during lunch
- Host a haunted happy hour after work – in person or online
- Create Halloween bingo cards, or play Halloween trivia, in-person or online
- Dismiss your team early on the Friday before Halloween
START PLANNING NOW!
Don’t wait to announce your activities. Get started today! That way, your employees have plenty of time to plan.