Small EmployER Group Health & Medical Plans
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Small Group  EmployER Health Insurance

Employer Small Group Plans are now guaranteed coverage  with just one common law employee  ^{(AB 1083)}, who isn’t a spouse.  

No medical questions are asked! 

Small Business can enroll year around, you do not have to wait for Open Enrollment.   See the brochures and other pages in this section of our website, in the menu above and/or the site map, related &  child pages.

Email, Skype or Zoom us [email protected] for more information. 

We are here to help you get the most from your Employer Group Health Plan.

Our services and consultation are free as long as you appoint us as your agent for no additional charge as we are compensated by the Insurance Companies to help you.

To learn more about coverage in general, scroll down or see the Health Insurance Guides… 

Reasons to get Group Health Insurance 

1. You don’t have to worry about how to pay large medical bills, messing up your credit or filing bankruptcy.
   1. Piece of Mind
      1. You know you can get treated when you or a family member is ill or there’s an accident.
         1. Fixing a broken leg can cost up to $7,500
         2. The average cost of a 3-day hospital stay is around $30,000
         3. Comprehensive cancer care can cost hundreds of thousands of dollars
   2. You get the price the Insurance Company negotiates with the doctors and hospitals rather than the list or chargemaster rate.
   3. Don’t have to be on Medi-Cal.
2. Your employer may be paying 50 – 75 or even 100% of the premium!
3. The premium that your employer is paying for you, does not show as income on your Tax Return under Section 106
   1. If you are paying a portion of the premium, that can come off your AGI Adjusted Gross Income so you pay less taxes under Section 125 POP. 
   2. Group Plans may well cost less than an Individual Plan!  Don’t forget the tax savings.
      1. You might not qualify for subsidies with Covered CA if your employer offers an affordable plan.
      2. You can shop individual plans here.
4. Many options to fit your needs and budget.
   1. All options cover 10 essential benefits mandated under Health Care Reform.
5. There seems to be less chance of losing your coverage with all the political change and court cases.
   1. In Fact ACA/Obamacare has been declared unconstitutional and is pending in the Courts Texas v USA.
6. Emergency rooms can still send you a bill if you don’t have Insurance and they only have to treat you to resolve the emergency, not total care.
   1. You can have a family doctor and visit him before it’s an emergency.  Thus, being preventative and having a healthier and happier life.
7. Limits on when you can enroll in Individual Health Insurance
   1. Open Enrollment & Special Enrollment ›
   2. §6504 Special Enrollment Periods CCR California Code of Regulations ›
   3. Group plans have limits too…

8. 10 Reasons to Get Health Insurance

   People still need insurance.  It’s very expensive and difficult to set up a plan

   • to pay catastrophic medical bills.
   • A lot of people wind up filing bankruptcy when they get in a major accident or severe chronic illness.
   • This is what the principle of insurance is all about.
   • A lot of people paying a small premium in case of someone having a catastrophic loss.  Just like in Little House on the Prairie.  If a home burned down, the whole town helped build a new one.  ^{See New York Times 11.19.2013  for more information}.  *
   • Piece of mind, don’t have to worry how to pay for a humongous medical bill.  ^{Modesto Bee} *
   • • 
     • Breakout graphic of $63k Double Bypass & Aortic Valve Replacement Medical Costs have been an issue for a LONG Time Life Magazine 1993
     • 2018 Costs health.costhelper.com/heart-surgery *
9. 80% Medical Loss Ratio (MLR) – Actuarial Value
   • CA Insurance Rate Regulation
     • Premium increases? Why are they always going up?
       • Financial Impact of Health Care Reform on Premiums

Bibliography

1. insurance news net.com/in-a-tight-talent-market-most-employers-re-think-benefits-offerings
2. How can Covered CA help your Small Business?  VIDEO 
3. “What Employee Benefits Matter Most to Job Seekers?”; Monster Insights; 2015.
4. “2018 Employer Health Benefits Survey; Kaiser Family Foundation; 2018.
5. “2018 Employer Health Benefits Survey, opens new window“; Kaiser Family Foundation; 2018.
6. humana.com/why-employees-dont-enroll-in-group-health-coverage
7. insure.com/when-reject-health-insurance-plan-at-work
8. ehealthinsurance.com/health-insurance-benefits
9. healthcare.gov/protection-from-high-medical-costs/

• Employer #Small Group Health Plans – Introduction
  • Carriers – Companies Employer Group no index follow
    • Aetna Employer Group Plan Coverage
    • Blue Cross – Anthem – Employer Plans
      • Administrative, Renewal & Wellness Tools
    • Blue Shield – Employer Group
    • California Choice – Multiple Companies ONE Bill
    • Health Net
    • Kaiser Permanente – New Enrollment – Administrative
    • Oscar
    • Sharp Health Plan
    • SHOP – Covered CA for Small Business
    • Sutter Employer Health Plans 2022
    • United Health Plan UHC
      • Administration & Wellness
  • EmployER Definition – Health Care Reform
    • 1099 vs Employee & Other Defintions
    • EmployEE Definition
      • COBRA & California Cal-COBRA 36 months total coverage
      • Dependent Definition – Up to Age 26 – Add newborn baby
        • Registered Domestic Partners – Spousal Health Coverage?
  • Participation & Premium Contribution Requirements
    • Documents to show bonafide Employer in business
    • Enforcement -no index
      • 90 Day Maximum Waiting Period?
        • Late Enrollee – Triggers – Qualifying Events
      • Employer Group Association Plans – Trump’s Executive Order – CA prohibition
    • Management Carve Outs – §2716 – Similarly Situated
      • Common Ownership – Affiliated Companies – Corporations
  • Quotes Employer Group – California – Instantly
  • Tax Credits Small Business §45 R
    • IRC §106 Health Insurance Deduction for Employers & Employees
      • Schedule C – Self-Employment Income – Hobby? Office in home?
    • Section §105 -HRA Health Reimbursement
    • Section 125 – POP Plan Employee Contributions are Tax Deductible