In these challenging times, we have some good news.
Congress approved, and President Trump has signed, a $2 trillion Coronavirus stimulus bill to help small businesses and others coping with the COVID-19 pandemic.
The new legislation includes the “Keeping American Workers Paid and Employed Act,” which provides $350 billion in Small Business Administration (SBA) loans to assist employers who keep employees on payroll and pay rent and insurance premiums.
For more information, or to apply for a loan, please visit the SBA website.
If you decide to pursue an SBA loan, we encourage you to speak with a tax professional to better understand the implications for your business. Be well and stay safe.
The U.S. Senate passed a $2 trillion Coronavirus stimulus bill last night designed to provide economic relief to all Americans.
The bill is with the U.S. House of Representatives and will route to President Trump for his signature; the bill is expected to get approved tomorrow.
Included in the bill is the “Keeping American Workers Paid and Employed Act,” which provides $350 billion in loans for small businesses to cover salary, wages, and benefits worth 250% of an employer’s monthly payroll, with a maximum loan of $10 million.
Businesses with fewer than 500 employees will be able to work with the Small Business Administration to get more information and apply for a loan. Loans will be forgiven for qualifying groups who use their loan to keep employees on payroll, pay rent and insurance premiums, and other guidelines in the law. Please consult your tax professional with questions.
For a copy of the details before the House of Representatives, click here. We encourage you to review the information on the Small Business Administration website and we will share more information as it becomes available.
As concern grows regarding the Coronavirus (COVID-19), please know the team at CHOICE Administrators is committed to providing a safe environment for our employees and visitors to our office, and ensuring business continues as usual.
However, in the event of a serious disruption to the market, we have a Business Continuity Plan in place. Our business operations supporting CaliforniaChoice and ChoiceBuilder will continue and your employees will have access to the health care they need.
For details on what our health plan partners are sharing with members, please see below:
- Anthem Blue Cross
- Health Net
- Kaiser Permanente
- Oscar Health
- Sharp Health Plan
- Sutter Health Plus
- Western Health Advantage
Stay safe – steps to protect you and your employees
Keeping your business healthy is key. In alignment with the Centers for Disease Control and Prevention, be sure to remind your employees to:
- Wash their hands
- Avoid touching their eyes, nose, and mouth
- Avoid close contact
- Stay home if they are sick
We wish you good health and thank you for placing your business with us.
- Review the details of your account
- Make a payment
- Add an employee to coverage
- And more
An Exclusive Provider Organization (EPO) may not be as well-known as a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO); however, with a bit of research, you might find an EPO is the perfect health insurance plan option for you and your employees.
What’s an EPO?
An EPO is a type of health plan that offers a full-network of doctors and hospitals from which to choose.
Like a HMO, an EPO gives your employees access to a select network of medical providers. If they go to a provider in-network, they have limited out-of-pocket costs. If they go outside of the network, the plan offers limited, if any, benefits and your employees’ costs are higher.
Like a PPO, your employees with EPO coverage don’t need to get a referral from a Primary Care Physician to visit a specialist, so long as the doctor is part of the EPO network.
An EPO in Action
Benefits of an EPO
The most well-known benefit of an EPO is its ability to apply the strengths of both an HMO and a PPO in a single option. An EPO offers more flexibility than an HMO because you don’t need a referral from your primary care physician (PCP) to receive specialist care. An EPO is also priced competitively, frequently offered at more affordable premiums than a PPO. For many, it’s a happy medium between an HMO and a PPO.
EPO Plans Available through CaliforniaChoice
The Anthem Blue Cross EPO coverage through CaliforniaChoice includes member access to the Anthem Prudent Buyer Network, which offers 90% of doctors and hospitals in the United States through the national BlueCard® Program. Some of the in-network premier California facilities include:
- Cedars-Sinai Medical Center
- John Muir Health
- Loma Linda University Medical Center
- Mercy General Sacramento
- Methodist Hospital of Sacramento
- Scripps Memorial
- UCSF Medical Center
Oscar Health offers EPO plans in all four metal tiers through CaliforniaChoice. Oscar’s EPO network in Southern California includes top hospitals and providers in Los Angeles and Orange counties, including:
- Good Samaritan Hospital (Los Angeles)
- USC Norris Comprehensive Cancer Hospital and Keck Hospital of USC (Los Angeles)
- Children’s Hospital Los Angeles
- Huntington Memorial Hospital (Pasadena)
- Providence St. Joseph Medical Center (Burbank)
- UCLA Medical Center
- Providence Saint John’s Health Center (Santa Monica)
- Hoag Memorial Hospital (Newport Beach)
- Mission Hospital (Mission Viejo and Laguna Beach)
Talk With an Agent to Learn More
You can get details on the EPO, HMO, PPO, and other options available to you and your business from an employee benefits agent. If you don’t already have an agent, you can look for one here.
The unemployment rate is the lowest it’s been in 50 years. Offering competitive compensation and employee benefits packages is key to recruiting and retaining top talent. Knowing what benefits other companies offer their employees is important when defining your budget and the benefits options for your business.
Health insurance is among the most-popular employee benefits offered today. The Bureau of Labor Statistics at the U.S. Department of Labor said in September 2019 that the national access rate to medical care benefits for full-time workers was 87 percent and the take-up rate was 74 percent.
The 2019 Kaiser Family Foundation (KFF) Employer Health Benefits Survey also found 82 percent of workers with a medical plan have a deductible – similar to a 2018 survey and up from 63 percent a decade ago. More than one-quarter (28%) of workers – including nearly half (45%) of those at firms with fewer than 200 workers – are in plans with a deductible of at least $2,000, up nearly four times the number from 10 years ago.
According to the Employee Benefits 2019 study by the Society of Human Resource Management (SHRM), 70 percent of organizations maintained health care benefits at existing levels in 2019, while 20 percent increased them and three percent decreased them. Eighty-five percent of organizations offered a Preferred Provider Organization (PPO) health insurance plan. High Deductible Health Plans (HDHPs) paired with a Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA) were offered by 59 percent of organizations taking part in the SHRM study.
Dental and Vision Insurance
KFF’s 2019 survey found 60 percent of firms (including 92 percent of large firms) offer separate dental coverage, while 46 percent (including 83 percent of large firms) offer separate vision insurance. Employers sometimes contribute to the cost of this coverage, but it is often voluntary – with employees paying the full cost of insurance.
SHRM found the vast majority (83%) of employers taking part in their 2019 study offer Accidental Death & Dismemberment (AD&D) insurance, 71 percent offer long-term disability, 61 percent offer short-term disability (STD), and 27 percent offer accident insurance. Accident insurance was down by nearly half from 2015, when 51 percent of employers offered coverage.
Benefits Bundle Options
With a multi-carrier, private exchange like CaliforniaChoice, your employees can choose from eight different health plans for the medical coverage that best meets their unique needs. One employee might choose a PPO or Exclusive Provider Organization (EPO) plan from Anthem Blue Cross because of a particular doctor or hospital in their network. Another employee who rarely visits the doctor might choose an HMO from Kaiser Permanente. A third employee might choose an HSA-compatible plan from UnitedHealthcare because of cost and tax considerations. An added plus, all of these different health plans — and others — available through CaliforniaChoice are billed together, and you have just one monthly bill for all of your employees’ coverage.
In addition, CaliforniaChoice offers you and your employees access to value-added extras through the Member Value Suite at no cost. That includes discount dental services, savings on vision care, employee discounts on entertainment (like movies, theme parks, sporting events, travel, and more), hearing services savings, and a prescription drug card that can reduce your cost to less than your Rx co-pay with insurance.
You can learn more from your employee benefits agent. If you don’t have an agent, you can find one here.
According to the federal National Health Interview Survey and the Kaiser Family Foundation (KFF), nearly 60 percent of America’s non-elderly population have health insurance through their employers. There’s no doubt, health insurance is highly sought after by employees. However, many employers are still unclear as to how group health plans provide distinct advantages to their business.
Here are 5 reasons why businesses choose Group Health Insurance for employees:
1. Employee benefits help in recruiting new employees.
A survey by the Harvard Business Review found that 88% of respondents would choose a job that offers a lower salary with better health, dental, and vision insurance over an opportunity with a higher salary but lesser benefits. Providing employee benefits sends an implicit message to job candidates that your business is competitive and financially stable – and it also shows you care about your employees, which can further set you apart in your recruitment efforts.
2. Benefits affect current employee retention.
Fifty-six percent of U.S. adults taking part in a 2018 SHRM survey said that a favorable opinion of their health coverage is a key factor in deciding whether to stay in their current job. Forty-six percent said health insurance was either the deciding factor or a positive influence in choosing their current job. Clearly, health benefits are among the most critical components of job satisfaction – second only to compensation.
3. Group Health Insurance helps reduce stress in the workforce and improve morale.
The Affordable Care Act (ACA) mandates that 10 essential health benefits be included in ACA-qualified health coverage:
- Ambulatory patient services
- Emergency services
- Pregnancy/maternity/newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Lab services
- Preventive and wellness services and chronic disease management
- Pediatric services (including oral and vision care)
Having comprehensive health care services can make a huge difference in the lives of your employees. The Annual U.S. Employee Benefit Trends Study by Metlife found that 74% of employees agree that having insurance provides peace of mind for the unexpected. It has been well-documented that happy employees are more productive and use less sick time, in addition to staying with a company longer.
4. Group Health Insurance offers tax benefits for employers.
Generally speaking, your expenses related to providing health insurance for your employees and their dependents are 100% tax deductible as an ordinary business expenses on your state and federal income taxes. Ask your employee benefits agent about the added benefits of a Premium Only Plan, which can reduce your payroll taxes and give employees the ability to pay their share of premiums with pre-tax dollars.
5. Group Health beats Blanket Health and Individual Health Insurance.
Group Health Insurance is, often, a better choice for your business and your employees than so-called Blanket Health policies because Group Health offers protection that is more comprehensive. As mentioned above, ACA-qualified plans include coverage for essential health benefits that are not part of Blanket Health plans. Typically, a Blanket Health policy offers coverage in connection with accidental injury. If it does cover broader health benefits, a Blanket Health policy may limit the amount it pays toward treatment or services – perhaps limiting coverage to $5,000, $10,000, or $50,000 for the life of the plan. The ACA prohibits health insurers from limiting coverage annually in qualified Group Health plans.
Group coverage may also beat individual insurance for two of the same reasons: no maximum benefits and continuous protection. Once you sign up, coverage will continue for one year as long as you pay the premium.
Finding What’s Right for Your Business
To learn more about the advantages of Group Health, talk with your insurance agent.
Decoding the Affordable Care Act (ACA) employer mandate can be difficult for the average small business owner. For some businesses, offering health insurance coverage is required. For others, it’s a choice. We’re breaking it down and shedding light on what you need to know to ensure your business is ACA compliant.
Do employers have to offer benefits to full time employees?
Applicable Large Employers with 50 Employees or More
The Tax Cuts and Jobs Act of 2017, signed by President Trump on December 22, 2017, eliminated the ACA individual mandate penalty (for not having health insurance). However, it did not affect the employer mandate, which applies to Applicable Large Employers (ALEs) with 50 or more full-time employees and/or full-time equivalent (FTE) employees. The ACA employer mandate remains in force. If your business employs 50 or more full time employees, offering health insurance is required.
Depending on how you staff your organization, calculating the number of full-time employees (including FTEs) can be complex. If you’re unsure of your group size, visit the Healthcare.gov website to use a group size calculator. When considering your group size, employees working 30 or more hours per week are considered full-time.
Employers that qualify as ALEs are subject to the ACA’s shared responsibility provisions and the reporting requirements concerning minimum essential coverage. ALEs must offer health insurance that is “affordable” and provides “minimum value” to 95% of full-time employees and their eligible children up to age 26. If you are an ALE and do not offer ACA-compliant coverage, you are subject to penalties. For 2019 employer penalty information, consider reading this article by the Society for Human Resource Management.
If your business had, on average last year, fewer than 50 full-time employees (including FTEs), you are not an ALE for the current calendar year. Still, it’s important that you evaluate your potential ALE status annually.
While non-ALEs are not required to offer health coverage to employees, you can voluntarily do so. In fact, many employers not subject to the employer mandate offer health insurance and other employee benefits because it helps them compete in an increasingly competitive talent market.
Qualifying for Group Health Insurance
If you offer full-time employees health coverage, you must make it available to all employees, regardless of any pre-existing medical conditions. Health insurers will write groups with as few as two insured persons (the business owner and an employee). However, many carriers will not write a policy for a husband and wife group if both are owners of the business, or if it is a sole proprietorship. LLC, S-Corp, C-Corp, and Partnerships where a spouse is a W-2 employee are acceptable to most insurers. Ask your employee benefits agent for more information on qualifying for group health insurance.
Cost of Coverage
If you choose to purchase health insurance for your employees, the next step is determining how much you want to contribute toward the premium. With Defined Contribution, available from the CaliforniaChoice multi-carrier private exchange, you can choose a Fixed Percentage Amount (from 50% to 100% of the cost of a selected coverage level) or a Fixed Dollar Amount. Whatever amount you choose applies to each employee, and your cost is locked-in for a full year. At renewal, you can adjust your contribution up or down and lock it in for another 12 months.
Finding a Plan
You can choose to purchase coverage directly from an insurance company, or you can use an independent agent to help you shop multiple plans. A multi-carrier exchange like CaliforniaChoice or the state’s ACA exchange, Covered California, can expand your employees’ options without increasing your costs.
CaliforniaChoice also allows you to choose one or more ACA metal tiers for your employees. This gives you and your staff greater access to doctors, hospitals, and other providers offered by the eight health plans available across the state from CaliforniaChoice. The networks for CaliforniaChoice include 84,355 individual health care providers and 389 hospitals (as of August 2019).
To learn more about the health plan options available for your group, contact your employee benefits agent. If you don’t already have one, we can help you find an agent.
Health Care Benefits Don’t Have to Be One Size Fits All
Each of your employees is different, and those differences extend to their health care needs. Traditional “one size fits all” health plans can prove limiting. As an employer, you may have wondered whether you can offer different health care benefits to your employees. You can, with CaliforniaChoice. Our multi-carrier private health insurance exchange includes eight different health plans across California.
Coverage Choice Wherever You Are
With CaliforniaChoice, you and your employees have access to Anthem Blue Cross, Health Net, Kaiser Permanente, and UnitedHealthcare statewide. If you are located in Northern California, you also can choose coverage from Sutter Health Plus and Western Health Advantage. Southern California businesses have added health plan options from Oscar Health in Los Angeles and Orange counties and Sharp Health Plan in the San Diego area. Combined, there are nearly 90 options available, so you and each of your employees can easily find coverage that’s right for their individual or family health care needs.
The provider network for CaliforniaChoice is unparalleled. Each health plan offers a diverse roster of physicians, medical groups, and hospitals. In total, there are 84,355 unique individual health care providers and 389 unique hospitals across the state.
CaliforniaChoice gives your employees the freedom to choose the health plan that’s right for them. One of your employees might select a PPO from Anthem Blue Cross because it includes a favorite doctor or hospital in its network. A second employee might choose coverage from Health Net. Another employee who is looking for a lower copay might select an HMO from Kaiser Permanente or UnitedHealthcare. A fourth employee might prefer a regional plan like Sutter Health Plus, Western Health Advantage, Oscar, or Sharp Health Plan. With CaliforniaChoice, it’s their choice. As an added perk for you, the coverage selected by all of your employees is included in a single bill each month.
Tools to Find the Right Plan
CaliforniaChoice offers several tools to help match your needs to the health plans available through our multi-carrier exchange.
- Automated Choice Profiler: Thisonline assistant give users the ability to review premiums, deductibles, and other out-of-pocket costs (like copays and co-insurance) to get a total estimated cost of coverage. Employees can view side-by-side plan comparisons based on costs, risk, and quality.
- Online Provider Search: This tool takes the guesswork out of finding the right doctor by helping employees find out in advance whether a preferred doctor is part of any of the health plans offered through CaliforniaChoice. It’s easy to search by city or ZIP Code, doctor’s name or gender, health plan, hospital affiliation, language(s) spoken, and distance from a targeted city or ZIP Code (like home or office).
- Online Rx Search: You and your employees can use this tool to match your prescription drug needs to available plans. It’s easy to look up medications alphabetically, by brand or generic drug name, therapeutic class (prescriptions for pain, infection, or treatment of the heart), or health condition.
Employer Cost Control
Beyond giving your employees more options from which to choose, CaliforniaChoice helps you control your employee benefits expenses, too. With Defined Contribution, you choose how much you want to contribute to your employees’ health insurance premium. It’s up to you if you want to choose a Fixed Dollar Amount or a Fixed Percentage Amount (50% to 100%) toward a specific benefit. The contribution for each employee does need to be the same.
Your employees then use your contribution toward the cost of coverage for the plans they like best. It’s like a health care voucher. If employees choose coverage that costs more than you’re contributing, the employees simply pay the difference. The amount you choose is locked-in for the plan year, and you can change it at renewal if you choose.
Get Help from an Agent
A health insurance agent can help you set your contribution amount and discuss available options. Best of all, there’s no cost for an agent’s service. If you do not already have an agent, you can search for one here. You can find additional information on this subject in our prior post, 6 Things to Consider When Choosing an Insurance Agent for Your Business.
If you’re a small business owner, spending time building your company brand may not be at the top of your priority list. In reality, though, businesses of every size need to think about how they can brand themselves to gain an edge in today’s competitive market.
Brand Building Tips1. Determine Your Voice
The first step in creating your brand is selecting your voice. Think about who you are as a company and what you are known for. If you were meeting someone for the first time, how would you describe what your organization does?
If you already have a mission statement and core values, you’re off to a good start. If not, it may take a little more thought, but it’s well worth the effort. Your approach – and how you “sound” – play an important role in your branding.
You want to be able to develop a tone and message that will help create a connection with your prospects and customers, while also helping differentiate you in your local market and business space.2. Add Some Visual Flair
If you are just starting your business, and you don’t already have a name and logo, you may want to engage help in selecting one or both. You can talk with friends or other small business owners about their recommendations or look online for a naming or logo design resource.
A good name and visual identity are important to creating a strong brand. Think about the logos of the organizations you know, locally, regionally, and nationally. Some organizations, like McDonalds or Nike, can be identified by a logo alone.3. Go Your Own Way
You may be tempted to borrow from what you think is working for a competitor, or a large, regional or national brand. Don’t do it. Think about what makes your organization different, and why a prospect should choose your company over another. Your independence may be a differentiator that helps you attract and retain customers.4. Consistency Is Key
Some businesses – large and small – make a mistake in branding and use a different approach depending on who they are communicating with and what vehicle they’re using (say, for example, an ad versus social media). That can undermine your efforts, because your prospects and customers can be confused by your mixed messages. It’s more effective to be consistent in your approach. Familiarity is important, and it can help you build trust.5. Deliver on Your Promise
You can create long-term relationships with your prospects – and turn more of them into customers – by delivering on your promises. Be clear about what you do, and what your customers can expect from you. Then make sure you work to follow through. You can earn their trust and generate positive word of mouth. Customer service is vital.
It can be helpful to learn from others’ brand-building missteps. Click here to read Five Branding Mistakes That Could Put Your Small Business Out of Business, published by Crowdspring, or check out this article, You May Be a Small Business, But You Can Still Focus on Building a Big Brand Image!, from Espresso.
The Affordable Care Act (ACA) has a long list of requirements for small businesses. To help you keep track, we created an ACA Compliance Checklist.
- Use a Group Size Calculator to determine whether your business had an average of 50+ full-time (FT) plus full-time equivalent (FTE) employees in the prior year. If so, your business is an Applicable Large Employer (ALE) subject to the ACA Employer Mandate during the next business year. An FTE Calculator is available from your agent or on the Healthcare.gov website.
- If your business is an ALE, you can use an Affordability Calculator to determine whether your health coverage meets one of the ACA Affordability Safe Harbor guidelines. If it does not, your business is subject to an ACA penalty. More information on the ACA’s Affordability Safe Harbors is available here.
- Collect accurate Dates of Birth for dependents under age 21. Effective 1/1/2018, insurance carriers can charge one single rate for dependent children ages 0 to 14 years old and unique rates for dependents ages 15-20. Carriers may only charge for the three oldest dependent children under age 21.
- If your business just reached the 50+ FT plus FTE threshold for the first time, ask about eligibility for transition relief from the employer penalty, if you offer Minimum Essential Coverage with Minimum Value to your employees.
- Confirm you are not paying directly or reimbursing employees for individual health plans, unless you sponsor a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA).
- Review the impact of upcoming minimum wage increases on your employees’ affordability of coverage calculations and your overall company budget.
Health Plan Administration
- Verify your waiting period does not exceed the 90-day limitation.
- If you have an orientation period prior to your waiting period, confirm it is no longer than one month.
- If you have 50+ FTEs with variable hours who may or may not work full-time, it is important to consider the lookback measurement method as well as administrative and stability periods. Click here for guidance on the IRS website.
- Review Health Flexible Spending Account (FSA) documents to make sure they reflect the current limit ($2,700 in 2019) and include any grace period/carryover provision.
- If your business has difficulty meeting carrier participation guidelines, you may want to talk with your agent about the ACA’s annual one-month Special Open Enrollment Window (SEOW), when eligible small groups can enroll in coverage without having to meet standard employer-contribution and/or employee-participation ratios. The SEOW occurs November 15-December 15 each year, allowing groups to enroll for coverage effective January 1.
- Confirm you are applying a 30-hour full-time definition to determine employee eligibility for coverage.
- Confirm you have not changed employees to 1099 status to avoid the ACA employer mandate.
- Determine if use of Professional Employer Organization (PEO) or staffing agency personnel increases your group size to 50+ FTEs due to IRS common law employee rules.
- Deliver Department of Labor Mandated Notice (New Health Marketplace Coverage Options and Your Health Coverage) to new employees within 14 days of hire.
- Deliver Summary of Benefits and Coverage (SBC) and Uniform Glossary to employees at enrollment, renewal, and to new hires.
- Deliver 60-day notices of modification, if you make plan changes outside of renewal.
- If you had average of 50+ FT plus FTE employees in 2018, prepare to give copy of IRS Form 1095-C (for 2019) to FT employees by 1/31/2020.
While not all of the items apply to every small business, this Checklist may be useful in determining how you can stay in compliance with the ACA.
More Help Available
If you have additional ACA compliance-related questions, talk with your employee benefits agent.