Small Business Health Insurance – An Employer’s Guide to Getting Small Business Health Insurance

Saving on your small business health insurance can be a challenge. But there are ways to overcome the financial obstacles and get the coverage necessary for your business. There are two major benefits of employer-based coverage. First these plans, although expensive, usually carry the best all around protection for you and your employees. Second, providing benefits plays a key role in attracting and retaining quality employees.

Why is coverage for small businesses so much more than for large corporations?

Health insurance for small businesses cost so much because of the high quality coverage concentrated among a small group of people. Every individual within the group represents a different level of financial risk to an insurance company, and this risk is added up and spread out among the group. Large corporations pay considerably less because the risk is spread to such a large group, where small business owners can see unreasonably high increases in premiums due to one or two members. Small businesses also have to insure their employees under state mandates, which can require the policies to cover some specific health conditions and treatments. Large corporations’ policies are under federal law, usually self-insured, and with fewer mandated benefits. The Erisa Act of 1974 officially exempted self-funded insurance policies from state mandates, lessening the financial burdens of larger firms.

Isn’t the Health Care Reform Bill going to fix this?

This remains to be seen. There will be benefits for small business owners in the form of insurance exchanges, pools, tax credits, subsidies etc. But you can’t rely on a bill that is still in the works, and you can’t wait for a bill where the policies set forth won’t take effect until about 2013. Additionally, the bill will help you with costs, but still won’t prevent those costs from continually rising. You, as a business owner, will need to be fully aware of what you can do to maintain your bottom line.

What can I do?

First you need to understand the plan options out there. So here they are.

PPO

A preferred provider option (PPO) is a plan where your insurance provider uses a network of doctors and specialists. Whoever provides your care will file the claim with your insurance provider, and you pay the co-pay.

Who am I allowed to visit?

Your provider will cover any visit to a doctor or specialist within their network. Any care you seek outside the network will not be covered. Unlike an HMO, you don’t have to get your chosen doctor registered or approved by your PPO provider. To find out which doctors are in your network, simply ask your doctor’s office or visit your insurance company’s website.

Where Can I Get it?

Most providers offer it as an option in your plan. Your employees will have the option to get it when they sign their employment paperwork. They generally decide on their elections during the open enrollment period, because altering the plan after this time period won’t be easy.

And Finally, What Does It Cover?

Any basic office visit, within the network that is, will be covered under the PPO insurance. There will be the standard co-pay, and dependent upon your particular plan, other types of care may be covered. The reimbursement for emergency room visits generally range from sixty to seventy percent of the total costs. And if it is necessary for you to be hospitalized, there could be a change in the reimbursement. Visits to specialists will be covered, but you will need a referral from your doctor, and the specialist must be within the network.

A PPO is an expensive, yet flexible option for your small business health insurance. It provides great coverage though, and you should inquire with your provider to find out how you can reduce the costs.

HMO (Health Maintenance Organization)

Health Maintenance Organizations (HMOs) are the most popular small business health insurance plans. Under an HMO plan you will have to register your primary care physician, as well as any referred specialists and physicians. Plan participants are free to choose specialists and medical groups as long as they are covered under the plan. And because HMOs are geographically driven, the options may be limited outside of a specific area.

Health maintenance organizations help to contain employer’s costs by using a wide variety of prevention methods like wellness programs, nurse hotlines, physicals, and baby-care to name a few. Placing a heavy emphasis on prevention cuts costs by stopping unnecessary visits and medical procedures.

When someone does fall ill, however, the insurance provider manages care by working with health care providers to figure out what procedures are necessary. Usually a patient will be required to have pre-certification for surgical procedures that aren’t considered essential, or that may be harmful.

HMOs are less expensive than PPOs, and this preventative approach to health care theoretically does keep costs down. The downside, however, is that employees may not pursue help when it is needed for fear of denial. That aside, it is a popular and affordable plan for your small business health insurance.

POS (Point of Service)

A Point of Service plan is a managed care insurance similar to both an HMO and a PPO. POS plans require members to pick a primary health care provider. In order to get reimbursed for out-of-network visits, you will need to have a referral from the primary provider. If you don’t, however, your reimbursement for the visit could be substantially less. Out-of-network visits will also require you to handle the paperwork, meaning submit the claim to the insurance provider.

POSs provide more freedom and flexibility than HMOs. But this increased freedom results in higher premiums. Also, this type of plan can put a strain on employee finances when non-network visits start to pile up. Assess your needs and weigh all your options before making a decision.

EPO

An Exclusive Provider Organization Plan is another network-based managed care plan. Members of this plan must choose from a health care provider within the network, but exceptions can be made due to medical emergencies. Like HMOs, EPOs focus on preventative care and healthy living. And price wise, they fall between HMOs and PPOs.

The differences between an EPO and the other two organization plans are small, but important. While certain HMO and PPO plans offer reimbursement for out-of-network usage, an EPO does not allow its members to file a claim for doctor visits out its network. EPO plans are more restrictive in this respect, but are also able to negotiate lower fees by guaranteeing health care providers that it’s members will use in-network doctors. These plans are also negotiated on a fee-for-services basis, whereas HMOs are on a per-person basis.

HSA (Health Savings Account)

An HSA is a tax-advantaged account used to pay existing and future medical expenses. HSAs are used in conjunction with high-deductible health plans (HDHP), which will make some with pre-existing conditions ineligible. Also, HSAs must be funded with cash. Communicating the terms of this account to your employees is important, as a large number of HSAs are underfunded or improperly funded. The health savings accounts were signed into the law by George Bush in 2003, and have become an affordable alternative to a group health plan.

When inquiring about an HSA, there will be a few things you will want to clarify. While HSAs generally cover routine medical expenses and copays, some can provide dental and vision care as well. And since HSAs can be combined with certain compatible plans, it is important to understand how money from the account will be allocated. And finally, you will want to know about cashing out your HSA balance. The amount is taxable and could be subject to a ten percent excise tax.

HRA (Health Reimbursement Arrangement)

An HRA is exactly what it sounds like. The employer reimburses the employee for health care. As an employer, you will usually have the option to contribute to a reimbursement fund, or to pay fees as they are incurred. These reimbursements can be deducted from your taxes, and are tax-free for your employees, saving you both money.

Some providers empower employers by giving them more options. HRAs, unlike HSAs, don’t have to be funded with cash money, placing a book keeping entry on your balance sheet is enough. You can usually control aspects of your arrangement such as reimbursement limits, whether you or your employee pays first, and if the previous year’s funds roll over.

HRAs are becoming a more popular option because of the control it has given small businesses. Combined with a high deductible health plan (HDHP), an HRA could be the most cost-effective solution to your small business health insurance problems. It’s always best to compare these plans to PPOs, HMOs, and EPOs to know what works best.

Fee for Service (FFS) or Traditional Indemnity

A fee for service plan is the most flexible small business health insurance option. You choose your doctor, and your hospital. You can see a specialist without a referral. This flexibility, however, comes with more out-of-pocket expenses and higher insurance premiums.

The typical FFS plan has a deductible ranging anywhere from five to fifteen hundred dollars. After this amount is reached, the provider will pick up eighty percent of your medical bills, and require you to pay the remaining twenty percent. Because of the rising costs of health care, and the potential for a small number of doctor’s visits to cost thousands, these plans can become incredibly expensive.

Flexible Spending Account (FSA)

A flexible spending account is a savings account to be used for medical expenses, and is funded by pre-tax dollars. Using pre-tax dollars means that your employees will actually show that they have less income, and will therefore have less taxes withheld. As an employer, you set the limit on contributions to the account per year. In addition to the employee contribution, you can also credit the account, or fund it completely from your general assets.

An FSA, especially if combined with an HDHP, can significantly reduce the costs of small business health insurance.

You should be forewarned, money from FSA accounts cannot be rolled over. They are, however, available to use for two years and two and half months after the benefit year. A terminated employee won’t be able to use leftover funds, unless there is a positive remaining balance and COBRA is elected.

Small business health insurance providers have made significant improvements in their services to simplify the administration of your plan. With HRAs, FSAs, and HSAs, your employees can use debit cards for medical transactions. Be sure to research this thoroughly. You will want to be sure your debit card plan is IRS compliant, and that you can use a large number of pharmacies. You should also pick a plan that can verify eligibility on the spot. Talk with your agent about linking transit, parking fees, and prescriptions to the same card. When picking the debit card options, please be sure to clarify the details of the substantion process. This is IMPORTANT! With other plans, the provider may assign someone to manage your plan. Or you may have to hire someone. Still, you should be able to login to your account and print insurance cards, important papers etc.

The next thing you can do is thoroughly assess your needs. Being that every member of your small business plays a key role in its success, it is vital that their needs are met. And understanding these needs is crucial to finding the right plan. Find out about chronic illnesses, and additional information related to past health issues. Know what your employees think about health insurance, and get them involved in the process.

Hiring an agent or a broker

Finding and understanding small business health insurance can be a daunting task. While some choose to go it alone, others need some professional assistance. You need to understand the difference between an agent and a broker, and how you can get the most from either of them.

A broker

Brokers function independently and usually work for several different companies. Since they have a variety of resources, they can usually provide more options and a better overall view of the marketplace. Brokers will assist you by evaluating the costs and designs of plans from your local major carriers. The cost isn’t everything, you want to get the coverage that you need.

Ask the broker how he or she is getting paid for their services. They should readily divulge that information. Some brokers may charge you a flat free. Some receive a fee from an employer, while others receive a commission from the insurance provider. Any commissions could be reflected in your premiums, but not to the point that you should worry.

An agent

Agents typically provide services for one company. They have a closer relationship to the insurance company than a broker would, giving them more leverage to make alterations to your plan. In some cases they can offer a particular plan for less than a broker, and may have access to additional services like worker’s compensation. To find out what different providers have to offer, talk to more than one agent. It may be time-consuming, but it could bring you closer to the most cost-effective solution for your small business health insurance.

One of the common options presented by agents is the employee-elect option. This is an arrangement where employees pick the plan they prefer. Those who don’t need as much coverage won’t be forced to pay so much, and those who do need it can get it without increasing the financial burden of the company as a whole.

How to Save On Your Small Business Health Insurance Plan

What’s important to remember is that there really is no inexpensive solution to health care. Even if your initial premiums are reasonably low, they could rise significantly at your next renewal. So saving money on small business health insurance is about doing a combination of things simultaneously to get good rates, and to then maintain those rates.. And it will require a consistent effort from you, your employees, and your insurance provider.

First, you can save yourself money by reading the fine print. You need to know exactly what your plan does and DOESN’T cover. There are also state mandated coverages. For example, in states like Illinois, your insurance must cover mammograms. Also, understanding the ins and outs of your plan will give you and your employees a better idea of how to deal with your insurance.

Next, you should shave unnecessary benefits. After reading all about your plan, you will find coverage for things you may not need. Eliminating these benefits can significantly drop monthly small business health insurance premiums. For example, eliminating coverage for brand name medications can reduce costs by more than 25 percent.

Wellness program have worked wonders for small businesses. A wellness program is any program designed to promote healthy living within the organization. Weight loss competitions benefit every participant. Add a financial incentive for further motivation. Stock the work fridge with water, and leave literature about healthy living lying around. Search the internet for calorie counting charts. Raising awareness entice workers to make positive changes. Active, exercising, diet-conscious employees have stronger immune systems, more vitality, and more productive workplaces. They also don’t deal with as many health issues. Fewer doctor visits and hospitilizations will help maintain lower annual premiums, because it will prove to your insurance provider that your business is a low financial risk.

Increasing your co-pay and deductible can go a long way towards cutting costs. For instance, raising co-pays by just ten dollars has saved companies as much as thirteen percent on their premiums. A higher deductible will significantly reduce your monthly premium. To lessen the financial burden of high-deductible health plans (HDHPs), combine them with an HSA. Combinations like these have saved both business owners and employees bundles of cash.

Check into getting a nurse hotline. A nurse hotline is a toll free, 24-hour-a-day, seven-day-a-week service. Employees can get medical advice from qualified, registered nurses. This method has deterred a large number of people from emergency visits, and it can also be used for preventative care as well. Insurers like Nationwide have them, or you may have to purchase from a third-party provider.

Increase the size of your group to reduce your monthly small business health insurance premiums. In a survey by America’s Health Insurance Plans, small businesses who employed ten people or less paid forty three more dollars on average than businesses with twenty six to fifty employees. Check around with other businesses owners, or fellow members of business organizations. Some states also have small business groups and pools for this purpose. Check with your state Chamber of Commerce and Department of Insurance.

Beware of heavily discounted plans. First, there are numerous scammers trying to get your money. They promise low rates, and usually cover little to nothing at all. The internet is notorious for swindlers trying to hustle you out of a buck. If you are going with a company you aren’t familiar with, please do your research. On another note, even reputable companies present problems. In an attempt to gain market share, Blue Cross offered small businesses discounted rates in 2008. For 2009, some of these same businesses were set to see increases of as much as 47% in their premiums. As the costs of medical care increases, the costs are shifted from the insurer to the insured, and discount plans become overpriced plans quickly.

Shop around. As mentioned before, talking to different agents will expose you to the best that insurance providers have to offer. Ask other small business owners about their providers. You can use trusted online resources like Netquote and Ehealthinsurance to shop around instantly. These services also let you compare plans side by side, and allow you to purchase your plan online. Even after you get your initial plan, it’s good to annually reevaluate your coverage. This will keep you on the up-and-up about what the market is offering. Keeping costs down is an ongoing effort, especially with rates and plans changing all the time from company to company.

Share some of the costs with your employees. Raising employee contributions isn’t a popular option, but it may be one of the only ways to absorb costs and maintain small business health insurance coverage. Communicate with your employees about how to keep costs down, and remind them that their increase is your increase as well.

The sad truth is that, no matter how many cost-cutting methods you apply, your insurance premiums are expected to continually rise. In addition to this, you can’t prevent every health problem with exercise and higher co-pays.

The Health Care Reform Bill won’t kick in until about 2013, so waiting on its benefits won’t do you any good. There is definitely a need for change, because the current system discourages competition and growth. With smaller businesses functioning as the backbone of this ailing economy, company medical insurance must BE affordable, and STAY affordable.

Business Brokers – How to Choose the Right One

The vast majority of small businesses are sold without the assistance of business brokers.

But if you do decide the hire a broker, here are some suggestions on how to pick the right one and how to structure the agreement in your favor.

What Business Is The Broker Actually In?

In many states there is no training or certification needed to become a business broker. In other states, brokers are required to hold a real estate license.

In these states it’s common to find real estate agents that do business brokering as a side business. If you deal with a broker who is also a real estate agent, make sure that being a business broker is more than just his hobby.

You will pay a pretty penny for the broker’s expertise and experience – you should make sure they have that experience when it comes to selling businesses and not just experience selling houses.

Questions To Ask

If you hire a broker you will be working with them closely for months to come; they will have access to your most confidential business records; the amount of money you put in your pocket at closing will be influenced heavily by the quality of work they do.

Therefore, you absolutely must check them out.

Here are some questions you should ask any prospective broker before hiring him:

1. How long have you been a broker?
2. Have you ever owned a business?
3. How many businesses similar to mine have you helped sell?
4. Can I see a blank version of your Listing Agreement?
5. What percentage of you income comes from brokering and how much from real estate (If applicable)

Ask them to provide you with references from previous clients. Then, I suggest you do something very unusual: Actually call the broker’s references!
I know a lot of people ask for references just to see how the person will react when asked (and to see if they actuality have any). But you can learn a lot about the broker’s reliability and professionalism by talking to people who dealt with that broker when they were in the exact same spot you are in.

Business Broker Fees

There are two benefits a broker can provide the business seller. First, he can locate potential buyers while maintaining the seller’s confidentiality. And second, a broker will qualify these potential business buyers so the seller saves time by not having to deal with weak prospects.

The big negative of dealing with a business broker is his fee, which averages 10-12% of the sale price. This fee is charged to the seller.

There is also a minimum fee. A very small business will pay a flat amount, typically $8-$10,000, instead of the commission. For a business worth $50,000 this minimum fee actually works out to be a higher percentage than the 10-12% industry average. But as a matter of practice, brokers usually won’t be interested in your business unless the asking price is above $100,000.

These fees are the reason most business owners choose to sell their business themselves and rely on their lawyers and accountants for the professional assistance they need.

The Broker Agreement

If you decide to use a broker you’ll be asked to sign a broker agreement which will detail the his fees. If possible, have your agreement include the following clauses:

Timing of Payments – Have it written into the agreement that the broker’s fee will be paid at the time you receive the purchase price – not at the time the sale is closed. This way, if you finance part of the sale price over a number of years, you pay the business broker as you get the money, not all up front.

Length Of Agreement – Your listing agreement should be for a limited time. If the broker locates the buyer within that time he gets paid. Be careful of lengthy agreements that lock you in with one business broker for more than 6 months. If he doesn’t produce, you want to be able to try other options. A 6 month business broker agreement is the longest you should allow. However, because selling a business can be a lengthy process, 3 months is usually too little time for the broker to find the right buyer. Try to settle on something between 3 and 6 months. If after six months, you haven’t closed the deal but you think the broker has done a good job, you’re always free to extend the agreement. But you want to be free to decide on an extension 6 months from now, not today.

Broker’s Guarantee – Include a paragraph stating that if you find the buyer, you don’t have to pay the commission. Without this clause, the broker is usually paid no matter who locates the buyer. Before signing any listing agreement, it is best to have your attorney review it to make sure your interests are protected.

Helpful Hints For Choosing A Business Bank Account

When someone decides that they want to open their own business, choosing the right bank may get lost in the shuffle of things they need to do. However, choosing a business bank account is an important decision for any business owner and they should be aware that they have choices. Making the right one is essential if a business wants to start out on the road to success.

The thing that many business owners fail to recognize is that they truly do need to do some research in order to find the right account for their needs. In many cases, they simply open an account with the bank that they use for their personal finances. This may seem like a good idea since they are already comfortable with the bank, but a bank with excellent personal accounts may not necessarily have the best business accounts.

Someone who is on the road to opening the doors of their own establishment may want to stick to another small business for their needs, but banking is not the place for this show of solidarity. In matters of money, it is important to go with trusted and familiar names, or online banks affiliated with familiar names. If a less familiar option seems too appealing to pass up, be sure to speak with other clients who can provide glowing reviews of the service.

The best way to go when choosing a financial institution is with the ones that has a specialized sector for handling small businesses. It is important that the bank understands the difference in needs between a small business and a large one. In addition to more specialized service, clients can enjoy a much simpler set up process than the one they would go through to register a large company.

Before signing on with any particular institution, it is important to read all of the fine print and make sure that all possible fees are clearly understood. When several transactions are made in a month, the fees can begin to add up and have an adverse effect on a brand new business. Many banks offer their newer accounts a period free of fees, so keep an eye out for those opportunities to save money.

Anyone who owns their own company realizes that they cannot get all of their work done within typical banking hours. This is why it is essential that the bank offers online service for clients to access their accounts at any time. With this important feature, people are free to do business when it conveniences them, not when it conveniences their bank.

When someone decides that they want to start a business, they may think of many things before they consider the hunt for a business bank account. It may seem simple, but it is actually an incredibly important decision for a new entrepreneur to make. A wise person will explore everything available to them before settling on a decision. Making the right choice in this matter will give any business the strongest possible start.

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