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If you own or run a small business, you have a lot on your plate. Taking on the added responsibility of shopping for health insurance for employees may seem intimidating. But, it doesn’t have to be if you’re working with the right health insurance partner.

CaliforniaChoice puts you in control by offering everything you and your employees want:

CaliforniaChoice meets the diverse needs of you and your employees at a price you can afford.

The Benefits of Using a Broker

A great place to begin your comparison of health insurance programs for your employees is by talking with an employee benefits broker. At CaliforniaChoice, we work exclusively through brokers, who can counsel you about the options in your area. A broker helps you find the right coverage for your business based on your unique needs and budget.

A broker will also share information about the Metal Tier and provider network options. You can choose from medical plans in all four Affordable Care Act (ACA) Metal Tiers: Bronze, Silver, Gold, and Platinum.

ACA Metal Tiers

Each tier offers a different percentage of shared health care costs for the employee. They range from 10% to 40%. The health plan pays the other 90% to 60% of covered costs when patients visit an in-network provider.

You can offer your employees access to one, two, three, or all four metal tiers. With Defined Contribution through CaliforniaChoice, your costs could even remain the same.

Each employees receives a personalized enrollment worksheet that spells out their options, your contribution amount, and how it reduces the cost of coverage. It also shows how much they will have to pay if they select a plan that costs more than your contribution.

Coverage Considerations

If you are not required to offer health insurance, it’s up to you whether you want employee-only coverage or employee and dependent coverage. If you are not sure if you’re an Applicable Large Employer, visit the CaliforniaChoice website. It has ACA Calculators to determine your group size.

You may want to make health insurance available to your full-time employees and dependents anyway. Employee benefits can help you attract and retain workers in today’s competitive market – and boost employee satisfaction, too. Read our post, 11 Reasons Why You Should Offer Group Health to Employees, which we published earlier this year for details.

Plan Options

Here’s a look at plan options and how they differ:

A High Deductible Health Plan (HDHP), which can be an HMO, EPO, or PPO, may offer a lower monthly premium. But, the insured has to pay more health care costs upfront before an HDHP begins to pay its share. Combined with a Health Savings Account (HSA), insured persons can pay for qualified medical expenses with funds free of federal taxes.

A Program with No-cost Extras

CaliforniaChoice doesn’t just offer you and your employees outstanding health insurance options. You also get value-added benefits at no extra charge through two exclusive programs.

The Business Solutions Suite saves you money and delivers valuable benefits for your business:

The Member Value Suite offers CaliforniaChoice members outstanding savings, including:

Taking the Next Step

If you’re ready to learn more, ask your broker about everything available through CaliforniaChoice. You can request a custom quote for the options in your area. If you do not have a broker, search for one here.

Making changes to your health insurance coverage isn’t limited to your annual open enrollment. If you experience what the Affordable Care Act (ACA) calls a “life event,” you and your employees can also make changes to your coverage.

What Is a Life Event?

There are several different “triggers” that could make your employees eligible to change their coverage, including:

When Can I Make Changes to my Group Health Plan?

Making Coverage Changes

Employees have a limited window – 60 days from a qualifying/triggering event – to make changes.

At CaliforniaChoice, we want to make these changes easy for members. If an employee wants to add coverage for a newborn or newly adopted child or remove a dependent from coverage, they simply take the following steps:

Effective Date of Changes

Changes requested will be effective on the first day of the month following receipt of a completed request. For example, if an employee submits a request/application on May 10, the change would be effective on the first of June. (If the employee submits a request through you, it’s important you forward it to CaliforniaChoice as soon as possible, so as not to delay the effective date.)

If new ID Cards are issued in connection with the request, they will be sent within 7-10 business days after the processing is complete.

Help When You or Your Employees Need It

While there are many actions you and your employees can take online concerning your bill, account changes, coverage, and benefits, the CaliforniaChoice team is available to offer support by email or phone. Our Customer Service team is available Monday through Friday, 8:00 a.m. to 5:00 p.m., Pacific Time.

Today’s workforce is vastly different from environments of the past. It’s more diverse than ever before, which means broader perspectives, increasingly varied opinions, and more inclusion of previously underrepresented groups.

Bringing a diverse group of people together has a wealth of benefits, but it can pose challenges for business owners trying to meet a variety of employee needs, especially when it comes to health care.

The Expectations of Today’s Employee

The challenge for employers is offering an employee benefits program that can address the needs of a varied group. The 20th Annual MetLife Employee Benefits Trends Study released this year finds workers today expect their employers to recognize the importance of their lives – on the job and away from work.

As MetLife notes, “Forward-thinking HR leaders are looking at benefits and beyond to adopt a more holistic view of employee needs.” That’s because it is what’s needed to serve today’s broad employee population.

Changing “Must-Haves”

The pandemic of the past two years has prompted employees to rethink their priorities, and reconsider their “must have” benefits when it comes to making a job change. Here’s a comparison of views pre-pandemic (in 2020) and today (in 2022).

The priorities of employees when it comes to benefits stayed the same from 2021 to 2022, but are a bit different from 2019. The top insurance-related “must have” or “nice to have” benefits during this period are as follows, according to MetLife’s studies in the three-year period:

2019

2021 and 2022

An enduring trend – year after year — is that Health Insurance is among the most desired employee benefits. And, thanks to the Affordable Care Act (ACA), Health Insurance coverage offered through ACA-compliant plans offers a comprehensive range of care.

What Is Group Health Insurance?

Group Health Insurance most often refers to an employer-sponsored, Affordable Care Act (ACA) compliant health insurance plan that provides benefits for employees’ and dependents’ care. To qualify as ACA compliant, plans have to include 10 Essential Health Benefits (EHBs), including:

Plans must also include birth control coverage and breastfeeding coverage.

More information is available at the healthinsurance.org website, and at the HealthCare.gov website.

Frequently Asked Questions

Often employers have questions about Group Health Insurance, and we’ve answered some of the most frequently asked questions below.

Coverage and Eligibility

The employer mandate in the ACA requires Applicable Large Employers (ALEs) to offer Minimum Essential Coverage (MEC) to full-time employees and eligible dependents. An ALE is a business with at least 50 full-time employees, including full-time equivalent employees, on average during the prior calendar year.

If your business is an ALE, and you fail to offer your eligible employees “affordable” coverage that provides minimum value to 95% of your full-time employees and their children (up to the end of eligibility when they turn age 26), you are subject to ACA penalties.

If you are not subject to the employer mandate, you can choose to cover full-time employees only, full-time employees and eligible dependents, or full-time and part-time employees (with or without dependents). Depending on your selected carrier and plan, there may be eligibility guidelines for participants. Ask your broker for details.

Selecting Your Contribution Amount

If you select coverage from the CaliforniaChoice multi-carrier, private exchange, you decide what you want to contribute to your employees’ health insurance costs. It’s called Defined Contribution. You can select a Fixed Percentage (50% to 100%) of a specific plan and/or benefit. Or, you can choose a Fixed Dollar Amount for each employee. (The amount has to be the same for all employees.)

Your employees then apply your generous contribution to whichever health plan and benefits they prefer. If an employee selects a plan that costs more than your contribution, he or she simply pays the difference.

When you renew your CaliforniaChoice coverage, you have the option to adjust your contribution – up or down – giving you complete control over what you spend on employee benefits.

Finding the Right Coverage

If you’re shopping for Group Health Insurance for your employees, what can you do to offer more to your employees? How can you give them the ability to personalize their benefits? Depending on the options available from your broker, you might be able to package together a program involving multiple insurers and benefits administrators. Or, you might consider the multi-carrier CaliforniaChoice exchange.

Your employees can choose from eight different health plans: Anthem Blue Cross, Cigna + Oscar, Kaiser Permanente, Health Net, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage.

There are plans available at different price points, too. Health Maintenance Organization (HMO) plans are generally the least expensive, followed by Exclusive Provider Organization (EPO) plans and Preferred Provider Organization (PPO) plans. There are multiple Health Savings Account (HSA) qualified plans among the offerings.

CaliforniaChoice also offers added benefits like Dental, Vision, Chiropractic (with or without Acupuncture), and Life Insurance. Plus, you and your employees have access to fitness and wellness products and services, discounts through the Cal Perks program, and more.

Greater Access to Doctors

One of the reasons so many small businesses in California prefer CaliforniaChoice is that it offers a choice of full and limited provider networks. That gives you and your employees access to more doctors, specialists, and hospitals than any single health plan in California.

You can offer plans in a single Affordable Care Act (ACA) metal tier, multiple tiers, or all four ACA tiers (Bronze, Silver, Gold, or Platinum). Each tier offers a different percentage of shared health costs for employees. They range from 10% to 40% (with the health plan paying the other 90% to 60%). This can significantly increase the number of plans, doctors, and specialists available to your employees.

Talk With a Broker

To get more information – or a custom quote for your group – talk with an employee benefits broker. Your broker can share details about the plans in your area, as well as options to help you address the diverse needs of your employees. If you don’t already have an employee benefits broker, you can search for one here.