Are you searching for group health insurance for you and your employees? Are you looking for quality group health insurance that won’t break the bank? If so, then WNC Health Insurance has you and your employees covered. Contracted with all major and ancillary health insurance providers, we are committed to helping you find the plan that best fits your needs. Here’s a more detailed look into what types of group health insurance plans are available:
Group Health Insurance Plans
A group health insurance plan represents a type of health insurance coverage typically chosen by an employer for his or her employees, or by members who belong to an organization. Group health insurance plans are more easily attainable for large groups, as the monthly premiums are usually set lower than individual health insurance plans.
Usually group health insurance plans are purchased by companies or organizations, who in turn offer the plan to employees or members. These health insurance plans can vary due to several factors, including: the insurance provider, the amount of people covered, and the price of the plan.
The employer or organization chooses which type of group health insurance plan offers the most value for the majority of their employees or members, and then typically offers them plan options. If members or employees decide to enroll in their employer or organization’s health insurance plan, they can choose between a basic level or an advanced level of coverage, depending on their needs. Some group health insurance plans also allow the insured to include their family members or dependents to their plans.
Regulations previously instated that require businesses with 50 or more full time and full time equivalent employees to offer at least basic healthcare coverage will continue in 2020 and probably in future years as well. For employers, finding a group health insurance plan that satisfies regulations, keeps employees satisfied, and doesn’t cost an arm and a leg, can be challenging. Working with an experienced health insurance agent or broker ensures that employers are meeting health insurance legal requirements, while also looking out for their employees’ best interests.
Self-Funded and Partially Self-Funded Group Health Plans
The self-funded model for group health insurance plans is a health insurance option for employers with at least 50 full-time employees. With a self-funded group health plan, the employer pays a variable premium that is subject to claim utilization and retains a portion of the claim liability. These plans are administered by a third party administrator or a direct insurance carrier and are exempt from many state and federal taxes and regulations. Versions of these plans include: Captives, Administrative Services Only (ASO) Plans, Association Plans, Multiple Employer Welfare Agreement (MEWA) Plans, and Cooperatives.
With self-funded group health insurance plans, the employer pays a steady plan premium monthly and the insurance provider pays the health insurance policy benefits. These policies benefit smaller businesses with healthy employees, as the employees file fewer claims, resulting in their employer paying lower healthcare costs. The typical financial risk of a health insurance plan is removed from the employees and placed on the employer with these plans. If the employees have to file many claims throughout the covered term, their employer could face higher premium and plan administration costs.
Another option for employers with small businesses is a partially self-funded group health insurance plan. Partially self- funded group health insurance blends traditional health insurance plans with self-funded group health insurance plans, offering more healthcare coverage for employees while removing some of the financial risk from the employer. The employer pays a fixed monthly premium to cover plan administration and any health insurance claims made by employees. At the end of the year, if the employer has paid more into the plan than employees have claimed, the employer receives a refund. However, if claims go over the amount paid into the plan by the employer, stop-loss insurance protects the employer from having financial responsibility for that amount of money.
Reference-Based Pricing Group Health Plans
For employers with smaller businesses that have at least 26 employees, there is a newer model of group health insurance on the market that helps both the employer and the employee save money. These plans allow employers to work with insurance carriers, setting a claims limit on medical services and procedures that is typically just slightly higher than the Medicare-negotiated price, benefiting providers and businesses. If employees choose a provider or procedure where the costs go beyond the limit cap or network, then the employees are responsible for paying the uninsured excess. This encourages employees to be smart consumers who contribute to the local economy.
Reference-based pricing is meant for small- to medium-sized businesses that want to save money on their group health insurance plans. RBP group health insurance plans seek to help employees learn more about the costs of medical procedures and healthcare services, thus helping them make smarter financial choices in terms of their healthcare.
Reference-based pricing group health insurance is also beneficial for the communities where it is utilized, as it helps reduce the average cost of healthcare services that are provided by local providers. When shopping around to see which providers offer the same services and procedures at the best price, people choose the most cost-effective choice, thereby driving more expensive providers to lower their prices.
If you’re in the Asheville, North Carolina area and are looking for help to find the right group health insurance plan, WNC Health Insurance can help make your search easier, by finding the most competitive group health quotes offered by top insurance carriers. Our helpful, licensed agents will help you find the plan that works best for you and for your employees.
WNC Health Insurance helps take the guesswork out of choosing the best group health insurance plan for your employees or organization members. Our licensed brokers take into consideration the number of individuals opting into the plan, along with everyone’s financial and medical needs, in order to help create a group health insurance plan that works best for everyone.
If you are curious as to how exactly each of these group health insurance plans works, or if you’re wondering if they may work for your business, then visit WNC Health Insurance. Our friendly experienced health insurance experts are determined to find the group health insurance plan that works best for your needs and your cash flow.
Visit us at www.WNCHealthInsurance.com or reach us by phone at (828) 681-8223 today!