Choice Stories

June 22, 2022

Tips for Getting Health Insurance for a Small Business

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:

  • Eight health plans – and dozens of options – through a single health program
  • Cost control with Defined Contribution – you choose the amount you want to put toward your employees’ health care
  • Greater access to doctors, specialists, and hospitals
  • Options for Dental, Vision, Chiropractic, and Life Insurance
  • Consolidated billing – one bill for all coverage (even if employees enroll in multiple health plans)
  • Smart Decision Technology: an online plan comparison tool, online enrollment, doctor and hospital search tools, and a prescription drug search

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:

  • HMO (Health Maintenance Organization) plans: Each insured must choose a Primary Care Physician (PCP) to manage their care. Patients are required to get approval from the PCP to visit a specialist. Treatment is generally not available outside of the HMO network, except in case of an emergency.
  • PPO (Preferred Provider Organization) plans: A PPO offers more flexibility, although at a higher premium than an HMO or EPO. A patient can go directly to an in-network doctor, specialist, or hospital without a referral. In-network care is offered at pre-negotiated, discount rates. PPO members can go outside of the PPO network, although they will pay higher out-of-pocket costs.
  • EPO (Exclusive Provider Organization) plans: An EPO is often described as a sort of a hybrid plan that offers both HMO and PPO benefits. Like an HMO, patients need to get health care through a doctor, specialist, or hospital that is part of the EPO network. Like with a PPO, members are able to go to a specialist without a referral, as long as the provider is in-network.

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:

  • Online HR support from Mineral: Get best practices, customizable handbooks, job descriptions, and more
  • Premium Only Plan (POP): Reduce your payroll taxes and give employees the ability to pay insurance premiums with pre-tax dollars
  • Flexible Spending Account (FSA): Employees can put away money to pay for eligible out-of-pocket health care (Available to groups of 15 or more employees)
  • COBRA or Cal-COBRA Billing: Take advantage of participant invoicing, premium collection and remittance, payment tracking, and processing of eligibility changes for non-payment

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

  • Discounts of up to 57% on Garmin, Vitamix, and Fitbit products
  • Fitness memberships at just $25 per month
  • Reduced fees on hundreds of Dental procedures at participating Dentegra® Smile Club dentists
  • Discounts on frames, lenses, and eye exams at locations from coast to coast
  • Up to 50% savings on brand-name hearing aids – plus discounts on testing, batteries, and more
  • Rx savings on brand-name and generic prescription drugs – you can even reduce your cost to less than your co-pay with insurance
  • Discounts on shopping, home services, education, travel, entertainment, and more

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.

Your Beginner's Guide to Choosing a Small Business Employee Benefits Program

Do you need help choosing the right health benefits for your employees?
This guide can help!