Group Insurance

Group insurance is complex. The first thing to know as you consider offering group health benefits to your employees is that you will want the assistance of a knowledgeable and competent health insurance agent. The agent will be able to inform you of employer mandates under the current healthcare reform law, and give you an idea of the types of the group health plans available to you. He or she will also have knowledge of what other businesses in your area are doing for their employees.

  • As of 2015, businesses with 100 or more full-time equivalent employees must offer employer health benefits to at least 75% of their workforce, or else incur a penalty.
  • As of 2016, a penalty will be incurred by all businesses with 50 or more full-time equivalent employees that do not offer group insurance.

If you run a small business with fewer than 50 full-time equivalent employees, and choose not to offer coverage, you will NOT be penalized but may lose out on strong candidates for employment – candidates who may look elsewhere for a job with a company that offers group insurance.

If you have 50 or more full-time equivalent employees, do not offer Affordable Care Act compliant employer health plans to at least 95% of your full-time employees, and just one of your employees qualifies for subsidized health insurance through a private plan under The Affordable Care Act, then in 2016 you will be penalized $2,000 for each full-time employee employed for the year (minus the first 30 employees). As long as you are offering Affordable Care Act compliant group health benefits to your employees, you will NOT be penalized in the event one of your employees opts to purchase private health insurance through The Affordable Care Act instead of using your employer health plan.

In addition to determining whether you want to offer group insurance at all, you also need to consider the benefits and liabilities of being fully insured, self-funded, or partially self-funded. Will you want your employer health plans to include ancillary benefits like dental and vision coverage? Would it be helpful to enroll in group insurance through the Federal Marketplace? Will tax laws allow you to acquire a refund of some percentage of the premiums you pay each year? What benefits do you have to offer employees for your healthcare coverage to be considered compliant under The Affordable Care Act? Will you be required to provide COBRA coverage to employees after termination?

With so many questions to answer, it behooves you to take advantage of the knowledgeable agents at WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store. Our personal reform advisors are fully trained to clarify laws, communicate options, and connect you to the best group insurance for building prosperity into your business and protecting the health of your employees.