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Why do I need to buy insurance, anyway?
There is a requirement under the Affordable Care Act, frequently referred to as Obamacare, that all legal residents of the USA have coverage compliant with the new plan requirements. There are tax penalties for deciding not to purchase insurance. For members with coverage starting in 2015, this is 2.0% of your overall income, or $295, whichever is larger. For coverage beginning in 2016, the penalty will be 2.5% of your overall income or $695, whichever is larger.
Does it matter if I have a pre-existing health condition?
No. Under the Affordable Care Act, there are no health questions asked and no effect on rates if you have a condition.
How much do I as the employer have to pay towards the costs of the insurance premiums for my employees?
If you choose to set up a company plan, you are typically required to contribute at least 50% of the lowest-cost plan you implement. You are free to put in multiple plans (the number of plans will vary depending on the size of your company) and allow staff to customize their plan choice and pay any difference in premium as pre-tax payroll deductions.
Do you provide non-medical plans as well?
We can set up a wide variety of different types of coverage for your firm. For more information, please take a look at our Other Benefits Page.
What constitutes a group so that I can get a company plan?
A group is defined as at least 2 people, at least one of whom is paid on a W-2 basis and who is not related by marriage to any owner of the business. Partner-only businesses are no longer eligible for group plans under the Affordable Care Act.
What do I need to provide to set up a group plan?
Generally you need to provide documentation of the legitimacy of your business and sufficient payroll history to show you've been around at least a short while. The types of documents usually include a business license, proof that you are registered with the California Secretary of State's office, a Statement of Information listing business owners and address, and any DBA (Doing Business As) paperwork if applicable.
Will setting up a group plan mean my employees cannot buy private coverage if they want to?
In some instances, a group plan will not consider an individual or family plan a qualifying reason to waive coverage. We can help you sort out the factors in play and find the right solution.
Can I reimburse my employees to buy individual plans on the open market?
Except in one particular circumstance, you cannot. This is specifically prohibited under the ACA and carries stiff tax penalties of up to $36,500 per year per employee if you are shown to be reimbursing for open market plans.