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The National Research Business Institute says that more than three-quarters of large employers (79%) have an employee wellness program of some type. Across the broader workplace, the percentage of employers offering a wellness program is close to half, according to the 2018 Aflac WorkForces Report, as reported by Small Business Trends in January 2019.

So, what steps should you consider if you want to implement a wellness program for your organization? Here are our five suggestions.

  1. Ask Your Employees

Employee feedback is critical to establishing a successful wellness program. Survey your employees to get their perspective. You’ll discover what they consider most valuable. As a starting point, wellness programs could include onsite classes, discounted gym memberships, and discounts on fitness gear such as Fitbits®.

  1. Start Slow

While you may have big ideas about what you want your program to do, it is best to start small. You want a program that is inviting for all employees and easy to understand. Make sure you consider everyone in your workforce when developing your program. That may include specific features designed to appeal to different segments of your employee population: women, men, younger and older workers, etc.

  1. Education is Important

Providing useful wellness information to your employees can help them take charge of their health. Talk with your health insurance agent to find out what information might be available from your health plan(s) that you can post onsite or include in regular staff communications. Consider a lunch-and-learn or health fair to share information or introduce employees to stress reduction techniques, health screening resources, fitness classes, or other opportunities available in your area. 

  1. Healthier Food Choices

If you have onsite restaurants, cafés, or food trucks, talk with the operators about adding a “healthy choice” to their daily menus. If you have vending machines managed by an outside firm, talk with the vendor about replacing some of the sugary drinks and empty-calorie foods with healthier options.

  1. Consider Walk-and-Talk Meetings or a Rewards Program

There are several out-of-the-box ideas you can implement in your workplace. “Standing desks” are increasingly popular. Having walking meetings can work for some managers and employees. You might also consider a rewards program or a prize drawing for employees who take part in charity walks or weight-loss clinics.

Health Plan Wellness Options

Supporting healthier employees can reduce workplace illness and absences, boost morale, and increase productivity. Many health plans offer wellness activities, education, and resources to help employees get and stay healthy. Talk to your employee benefits agent to find out what’s available to you. If you are not currently working with an agent, you can search for one here.

Unless you’re an insurance industry veteran or a health insurance agent, you might be wondering, What exactly is a defined contribution employee benefit plan?! More than just a mouthful to say, a defined contribution employee benefit plan allows companies to offer employees a full spectrum of insurance coverage that includes health , dental, vision, life, chiropractic and in some cases even more benefit options.

The defined contribution aspect of the plan gives business owners and managers the ability to choose how much they contribute toward the costs of their employees’ coverage. Groups typically like defined contribution because they can choose a fixed dollar amount or a fixed percentage (like 50%) of the cost for the lowest-priced plan. Plus, the amount they contribute is tax deductible for their business.

In order to help groups select the right defined contribution plan we created a guide ( available for download below) that includes some helpful tips to consider when searching for an employee benefit plan. The guide highlights some key factors to consider when plan shopping, including:

Download your copy today!

The Affordable Care Act (ACA) took effect in March 2010. Still, many employers – particularly small businesses – remain unclear of its requirements. We’re untangling critical details about ACA coverage and the associated penalties.

ACA-Compliant Coverage

If you employ 50 or more full-time or full-time equivalent (FTE) employees, you are an Applicable Large Employer (ALE) under the ACA and, therefore, subject to the ACA employer mandate. Under the mandate and the ACA employer share-responsibility provision, ALEs must offer minimum essential coverage that is “affordable” and provides “minimum value” to full-time employees and dependents.

All ACA-compliant plans for individuals and small groups must include these Essential Health Benefits:

The ACA divides health plans into four metal tiers: Bronze, Silver, Gold, and Platinum. Each tier offers a different level of support for covered services, with Bronze plans covering about 60% of health care costs. Silver plans cover 70%, Gold plans cover 80%, and Platinum plans cover 90% of costs for covered services.

Penalties for Non-Compliance

If you’re an ALE and do not offer health coverage, when an employee receives a federal subsidy to help pay for coverage through the Covered California exchange, that triggers a non-compliance penalty. The penalty is assessed monthly and is equal to the number of FTE employees (minus the first 30), multiplied by one-twelfth of $2,500 (the 2019 penalty amount). There is no penalty for not offering health insurance to part-time employees.

A greater penalty of $3,750 applies if you offer employee coverage that is not affordable or does not provide minimum value. Affordable means the cost does not exceed 9.86% of an employee’s household income for the lowest-cost, self-only coverage option. A health plan meets the ACA minimum value test if it includes substantial coverage of physician and inpatient hospital services and pays at least 60% of the total cost of medical services covered by a plan.

If you have seasonal or part-time workers and you are unsure if your business is an ALE, visit the IRS website to help determine your status.

Employer Cost Control

Cost is a huge consideration for employers when it comes to providing health benefits for employees, whether you’re required to provide coverage or not. However, the ACA does not require ALEs or non-ALEs to pay 100% of the costs of employee coverage. Businesses can share the costs with workers.

If you are not an ALE, what you contribute to employee coverage is entirely up to you. However, most employers who offer coverage, regardless of their workforce size, do pay at least half the cost. The Kaiser Family Foundation says in its 2018 Health Benefits Survey report that on average, covered workers make an 18-30% contribution to the cost of health insurance, depending on their plan type.

If you choose employee benefits through CaliforniaChoice, with Defined Contribution, you contribute a Fixed Percentage (50% to 100%) of a specific plan type, OR you can choose to contribute a Fixed Dollar Amount. If employees select a plan that costs more than your contribution, they simply pay the difference. At renewal, you can adjust your company’s Defined Contribution – up or down – to help you manage your costs for another year.

Non-Compliant Plans

There are several non-Major Medical plans that are not regulated by the ACA, and therefore, non-compliant. Among them are short-term health insurance plans (already limited in California), accident-only plans, limited-benefit policies (such as Long Term Care plans and indemnity coverage), and plans offering medical discounts that are not actually insurance programs. None of these meet the ACA employer shared responsibility requirements.

How to Learn More

The best way to learn more about required ACA benefits and the potential costs for your business is to talk with a licensed health insurance agent. If you are not working with an agent, click here to find one in your area.

CaliforniaChoice has always placed the highest priority on giving its members more choices when it comes to something as important as health care.

Now, as part of our continuing commitment to deliver more, we’re excited to introduce the Member Value Suite. It gives your employees and their loved ones access to outstanding savings on a range of products, services, and activities. Plus, it’s available to your employees at no added cost to you or your business.

Here’s a snapshot of all of the available discounts through the Member Value Suite:

 

Entertainment

Your employees’ free Cal Perks® program membership offers savings on movies, theme parks, water parks, sporting events, travel, tax prep, retailers, and more.

 

Wellness Products

The ChooseHealthyTM program offers discounts of up to 57% on Garmin®, Vitamix®, and Fitbit® products, fitness memberships for $25/month, and 25% savings on specialty health care practitioners in acupuncture, chiropractic, and therapeutic massage.

 

Dental Care

Employees enjoy reduced fees on hundreds of procedures at participating Dentegra® dentists across California and nationwide. Dentegra offers instant savings to your employees with no Dental claim forms or waiting periods.

 

Vision Care

The EyeMed® Vision One Eyecare program offers discounts on frames, lenses, and exams at participating JCPenney, LensCrafters, Pearl Vision, Sears, and Target locations in California and nationwide.

 

Hearing Services

Your employees can save up to 50% on brand-name hearing aids, and take advantage of additional discounts on testing, batteries, and other devices through the EPIC® Hearing Service Plan.

 

Prescription Drugs

The California Rx Card saves your employees up to 75% on brand name and generic prescription drugs – often reducing their cost to less than their Rx co-pay with insurance.

 

Talk with an Agent to Learn More

If you are interested in finding out more about the CaliforniaChoice Member Value Suite – and all of the benefits offered to your business and your employees through CaliforniaChoice – talk with your employee benefits agent.

 
NEED AN AGENT?
 

Winter is finally on its way out and the sun is shining. It’s time celebrate and CaliforniaChoice can help. Check out the special offers and discounts you can take advantage of through Cal Perks, thanks to your CaliforniaChoice membership.

Save on Family Fun

Cal Perks offers savings of up to 40% on admission to some of California’s most-popular destinations for family fun. You can purchase discounted tickets to these attractions:

Movie Ticket Discounts

With Blockbuster season in full swing, you can save up to 35% on movie tickets for the whole family. Take advantage of discounts at six prominent theatre chains across the state, including:

A Relaxing Getaway for Less

Cal Perks can help you and your employees save on trips with discounts of up to 60% on hotel rates. Whether you want to escape to San Diego, Anaheim, San Francisco, or Las Vegas, you can find rates starting at well under $100 per night. Visit the Cal Perks website and check out the “Hotel Discounts” category.

Cruise the San Diego Harbor

Flagship Cruises & Events offers harbor tours, ferry and water taxi transportation, whale watching excursions, gourmet-prepared dinner and brunch cruises, yacht and boat charters, and fairy tale weddings.

Enjoy 25% off Dinner & Dance Cruises or Sunday Champagne Brunch Cruises on Flagship. You can also get one adult ticket free, when you buy one ticket, on seasonal Whale Watching Cruises or Harbor Tours on San Diego Bay.

Jump Start Your Beach Body

You can join LA Fitness online through until 3/28/2020, and take advantage of a low $25 initiation fee and pay just $34.99 per month per person for membership.

LA Fitness membership includes:

Visit www.calperks.com and choose the “Fitness/Wellness” category for details.

Note: Amenities and classes may vary from club to club; an extra charge applies for some amenities.

Enjoy More Activities

Cal Perks partner vendors include theme parks, amusement parks, home services and products, hotels, recreation venues, sporting events, entertainment venues, fitness centers, and much more. There is something for everyone at Cal Perks.

If you are already a CaliforniaChoice customer, login at calchoice.com to access your Entertainment Discounts in the Member Value Suite.

NEED AN AGENT?

Get Free HR Support Services from CaliforniaChoice

CaliforniaChoice offers small businesses access to an online HR Support Center at absolutely no cost! We’ve partnered with Mammoth HR, a national human resources services leader, to help you stay on top of changing regulations affecting your business and your employees.

When you offer CaliforniaChoice health insurance benefits to your workers, you can take advantage of everything the HR Support Center has to offer, including:

  • Employee Handbooks, company policies, job descriptions, and HR forms
  • Alerts for regulatory changes affecting your business and employees
  • A database of thousands of questions and answers on subjects ranging from benefits and compensation to labor relations and recruitment
  • Tips, information, and best practices to help you better manage your business and employees
  • Tools and information on leave of absence, hiring, performance management, and termination
  • Great pricing on HR posters, books, and training videos
  • A subscription to the monthly HR Advisor e-newsletter designed to keep you aware of the most current HR best practices and legal changes
  • CaliforniaChoice is more than great health benefits. The HR Support Center is one of many valued-added benefits that are part of the Business Solution Suite. Other benefits include discount Dental, Vision, and Hearing services, a Premium Only Plan (POP), prescription drug discounts, HSA Resource Center, and Cal Perks discounts on travel, entertainment, and sporting events.

    Talk with an Agent to Learn More

    If you are interested in finding out more about the CaliforniaChoice HR Support Center, or any of the other advantages offered in the Business Solutions Suite, contact your employee benefits agent. If you do not already have an agent, we can help you find one.

    If you’ve been researching health insurance options for your small business, you’ve likely encountered the term “Exclusive Provider Organization” or EPO. This lesser known plan has its advantages, and it’s important to know all of your options before you make a decision. So, we’re breaking it down for you, including how an EPO differs from other health plan types, like a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO).

    Here are answers to five frequently asked questions about EPOs.

     

    1. What is an EPO?

    An EPO is a health plan that combines the traditional features of an HMO with the flexibility of a PPO. Like an HMO, an EPO offers members access to a network of doctors and hospitals from which to choose. Also, like an HMO, it offers a budget-friendly premium. However, an EPO may limit or not pay for services outside of your EPO plan network (except in case of an emergency).

     

    2. Where can I buy EPO coverage?

    Roughly half of California is served by one or more EPO plans. CaliforniaChoice offers multiple EPO options among its carriers. Oscar Health offers 11 EPO plan options in Los Angeles County and Orange County, including two Bronze tier plans, three Silver plans, four Gold plans, and two Platinum plans. Anthem Blue Cross offers two Silver tier EPO plans and one Bronze tier EPO plan through CaliforniaChoice.

     

    3. Does an EPO require me to have a Primary Care Physician, who will refer me to other specialists when I need care?

    With an EPO, you typically do have a Primary Care Physician (PCP) who will help you manage your health care. However, not all EPOs require your PCP to make referrals. Some plans, like the Anthem Blue Cross EPO and Oscar Health EPO, allow you to self-refer as long as your specialist is part of your plan’s EPO network.

     

    4. What if I need emergency care and have to go to the hospital?

    If you have an unexpected emergency need for medical care, an EPO will generally cover your treatment at least for some part of your stay in the hospital. However, you must get a pre-certification for non-emergency hospital care. Special rules typically apply for maternity stays of less than 48 hours. Ask your broker or review your health plan enrollment materials for details.

     

    5. How do I know if my preferred doctor is part of an EPO’s network?

    Insurers in the state that offer EPO health plans have provider lists available on their websites. If you offer CaliforniaChoice to your employees, it’s easy to look up doctors and specialists using the Provider Search tool at calchoice.com. You can search for a doctor by name, gender, city or ZIP Code, distance from home or work, affiliated health plan(s), hospital, or medical group, and language(s) spoken.

     

    Get Your Own Custom Quote

    If you want to learn more about EPOs, your employee benefits agent can help.

     
    NEED AN AGENT?
     

    California employers who want to provide health insurance benefits to employees have several considerations:

    Before we tackle these questions, it is important to first look at where your business stands under the Affordable Care Act (ACA).

     

    Current ACA Regulations

    Providing health insurance to employees is required under the ACA for some businesses. The ACA’s Shared Responsibility Provision (sometimes called the employer mandate) says Applicable Large Employers (ALEs) must offer minimum essential coverage that is “affordable” and provides “minimum value” to full-time employees and their dependents. Otherwise, the employer is subject to ACA penalties.

    An ALE is an employer with an average of at least 50 full-time employees or full-time-equivalent (FTE) employees working at least 30 hours weekly. For more information on determining your ALE status, visit the HealthCare.gov website.

    If you do not have 50 full-time or FTE employees, you are not required to provide health insurance coverage to your workers. However, you may still choose to do so to compete more effectively with other employers in your area. Click here to download the 2018 Employee Benefits: The Evolution of Benefits report released by the Society of Human Resource Management (SHRM).

    After determining if your business is subject to ACA requirements, the question lingers on what you can expect to pay for your employees’ health insurance benefits. Many factors influence costs, including the number of people you employ, their ages, and employees’ home ZIP Codes.

     

    Employee Health Insurance Costs

    According to an analysis by the Kaiser Family Foundation (KFF), the annual family premium average last year for all employer-sponsored health insurance plans was $19,616 ($1,635 per month) according to the benchmark KFF Employer Health Benefits Survey. Of that total, the average employer cost was about $14,069 ($1,172.42 per month) or 72%, with employees paying the rest. These amounts were up about five percent from the prior year.

    Keep in mind, you are not required to pay such a large share of the costs for your employees. The KFF numbers are based on a national comparison. California’s health care market is very competitive, and you have the ability to pay less.

     

    You Decide What You’ll Pay

    If you choose coverage from CaliforniaChoice, you control the amount you want to spend on employees’ health benefits.

    You can choose a Fixed Percentage of 50% to 100% of the cost for a specific plan and/or benefit, or you can choose a Fixed Dollar Amount for each employee. Your employees then apply your contribution toward the cost of whichever health plan they prefer. If an employee selects a plan that costs more than your contribution, he or she pays the difference.

    Using the annual family premium average mentioned above, if you chose a 50% contribution to coverage, your cost could be $9,808 ($817.33 per employee per month). This is 30% less than the national employer contribution average. At renewal, you have the option to adjust your contribution up or down – giving you complete control over your benefits cost for another year.

     

    Deciding Who to Cover

    If yours is a small business with fewer than 50 employees, you may offer coverage only to your full-time employees, or extend it to both full- and part-time workers. If it’s in your budget, you also have the opportunity to cover other family members, such as a spouse and dependent children. It’s your choice.

    If you’re an ALE (with 50+ employees), you must include dependent child coverage (through age 25) for children of full-time or full-time equivalent employees. Under the ACA, a dependent does not include a stepchild, foster child, or a child who is not a U.S. citizen, nor does it include a spouse. (For more information, refer to the Q&A on the Healthcare.gov website.)

     

    Single Health Plan vs. Multiple Options

    When deciding on whether to offer your employees a single health plan or one with multiple options, it’s important to recognize that each of your employees is different and so are their health care needs.

    One employee may rarely visit the doctor and want a lower cost Exclusive Provider Organization (EPO) plan. Another may have a chronic health condition and want to continue to see a specialist who is part of a Preferred Provider Organization (PPO) plan. A third employee who selects a High Deductible Health Plan (HDHP) may want to choose a HSA-qualified plan, which offers tax-advantaged medical savings for qualifying expenses before reaching the plan deductible. CaliforniaChoice gives them the ability to match their needs and preferences to the right health plan.

     

    Changes Coming to California

    On his first day in office, California Governor Gavin Newsom announced he would like to see California adopt an individual health insurance mandate. The ACA individual mandate penalty was reduced to zero in 2018, so individuals are no longer required to have health insurance or face a financial penalty in connection with their federal tax return. The effective date for any new state mandate is not known at this time, although it’s likely the state legislature would support such an idea. This is something to consider as you contemplate sponsoring health coverage for your employees.

     

    Get Your Own Custom Quote

    While it’s beneficial to know the average cost of small business health insurance, a detailed quote with numbers specific to your business will provide you with further insight into the plan that’s right for you. Your employee benefits agent can walk you through your options and provide you with a custom quote based on your budget and employee needs. If you are not currently working with an agent, you can search here for one in your area.

     

    Whether you are considering health insurance for your employees for the first time, or planning to renew, rates are an important factor in the decision-making process. Here’s a look at what industry experts are forecasting for Small Group health insurance rates in 2019.

     

     

    Annual Premiums on the Rise

    In the fourth quarter of last year, CBS MoneyWatch reported employees should expect to see more of the same when it comes to health insurance in 2019 – more cost sharing in the form of increased premiums and higher deductibles. The Kaiser Family Foundation said in its 2018 Health Benefits Survey that annual family premiums rose for the eighth straight year. Since 2008, average family premiums have jumped 55 percent. That’s twice as fast as employees’ earnings and three times the rate of inflation.

     

    More than a quarter of employees with employer-sponsored coverage have a plan with a deductible of $2,000 or more, up from 22 percent in 2017 and 15 percent in 2013. For companies with fewer than 200 employees, 42 percent have a $2,000 (or higher) annual plan deductible.

     

    California Rates Also Increasing

    California’s public health insurance exchange, Covered California, announced in the run-up to the individual 2019 Affordable Care Act (ACA) enrollment period that rates for 2019 increased an average of 8.7 percent statewide. In most parts of Southern California, the increase is nine percent, although Monterey, San Benito, and Santa Cruz counties face the highest increases: 16 percent on average. That compares to a 12.5 average increase statewide in 2018 and greater increases in other parts of the country – both for 2018 and this year.

     

    What Does This Mean for You?

    Your employees’ health insurance costs are influenced by a variety of factors:

     

    The best way to control your costs is by choosing coverage that offers Defined Contribution, which allows you to choose the amount you want to contribute to your employees’ health insurance costs. 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. Each employee must receive the same amount.

     

    From there, your employees apply your 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.

     

    Other Money-Saving Tips

    In the past, employers looking to reduce costs could raise employee deductibles or offer less-generous plans. However, for 2019, less than half are planning to make similar changes. In today’s talent marketplace, businesses need to offer competitive benefits packages in order to attract and keep their best employees.

     

    As reported by the Society for Human Resources Management (SHRM), a Mercer study found more organizations are open to adopting new technology to manage medical expenses. One common strategy includes targeting specific health problems like diabetes with coaching and interactive glucose monitoring devices that transmit health data directly to a health care provider. Other strategies include tools to help employees match their health plan to their specific health needs, and using predictive analysis to identify opportunities to improve health plan performance.

     

    A Health Savings Account (HSA) can also help employees with a High Deductible Health Plan. Funds in the HSA can go toward co-pays, co-insurance, and other out-of-pocket amounts. In 2019, the HSA limit is $3,500 for an individual and $7,000 for a family with a qualifying health plan (with a deductible of at least $1,350 for an individual or $2,700 for a family). There is no time limit on the use of HSA funds and they grow tax-free until withdrawn for eligible expenses, even if that’s during retirement.

     

    More employers with fewer than 50 employees are now offering a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), which was created by Congress in 2016 as part of the 21st Century Cures Act. A QSEHRA allows employers to offer a monthly tax-free allowance to employees to purchase individual health insurance or use for qualified medical expenses. Go here to read an Accounting Today article concerning QSEHRAs.

     

    Get Help from an Expert

    As you navigate the complexities of your employees’ health insurance, it helps to speak with an expert. An employee benefits agent can provide critical information on how to manage your expenses. Click here to connect with an agent in your area.

    CaliforniaChoice offers several distinct advantages to both employers and employees in California. When compared to health coverage from a single health insurer, CaliforniaChoice makes it easier for employers to control their costs, while still giving employees more health care choices. Add in the access to our Smart Decision Technology tools, which help employees find the right plan, discounts from Cal Perks and other programs, and the new no late fee policy, and it is easy to see why small businesses across the state are choosing CaliforniaChoice.

    Let’s look at each of these – and how they make CaliforniaChoice a good choice for you and your employees.

     

    Employer Cost Control

    With CaliforniaChoice, your insurance carrier does not dictate your cost – you do. You determine the amount you want to spend on employees’ health benefits. You can contribute a Fixed Percentage of 50% to 100% of the cost for a specific plan and/or benefit, or you can choose a Fixed Dollar Amount for each employee.

    Your contribution applies toward the cost of whichever health plan and benefits your employees prefer. If an employee selects a plan that costs more than your contribution, he or she pays the difference. When you renew your coverage, you have the option to adjust your contribution up or down – giving you complete control over your benefits cost for another year.

     

    Greater Employee Choice

    With CaliforniaChoice, you and your employees choose from eight outstanding health plans across the state:

    There are dozens of coverage choices available, including HMOs (Health Maintenance Organizations), PPOs (Preferred Provider Organizations), EPOs (Exclusive Provider Organizations), HSAs (Health Savings Account-qualified plans), and more.

    Because we deliver access to so many health plans, we offer employees more doctors, specialists, and hospitals than any health program in the state. Another advantage is the variety of price points employees have when weighing their options.

    You have the flexibility to give your employees coverage in a single metal tier, two metal tiers, or three metal tiers. The more metal tiers you select, the more price points from which your employees have to choose.

     

    Smart Decision Technology

    CaliforniaChoice makes it easier to find the right health care solution. We provide tools to help compare coverage and ensure the doctors and specialists you and your employees want are part of the plans you’re considering.

     

    Cal Perks Savings and Other Services

    Beyond great health care, CaliforniaChoice includes valuable extras for you and your employees. The Cal Perks program is free and offers savings on movies, theme parks, hotels, and more. You can save on prescriptions, too, with the California Rx Card, which delivers discounts of up to 75% at 68,000 pharmacies nationwide – often reducing your cost to less than your Rx co-pay. The Business Solutions Suite includes savings on Vision, Dental, and Hearing services as well as COBRA billing services and no-cost setup for a Premium Only Plan.

     

    Consolidated Billing – and No Late Fees

    Whether you have a single employee or 100, you get a consolidated monthly bill for all of employees, regardless of which health plan and benefit type they select. If your payment is mailed late, don’t worry. CaliforniaChoice no longer charges a late fee. However, the company does give you the ability to manage your account easily online, including the option to sign up for Auto Pay.

     

    Consult an Agent to Learn More

    If you are interested in learning more about the advantages of CaliforniaChoice, or if you want to get a quote for your business, contact your employee benefits agent. If you do not already have an agent, we can help you find one.