Group Health for your California Company

Starting or changing your group health insurance policy for your California Company can be done at anytime of the year.

To start a new plan you only need two people.  An employer and one employee, or a partnership.  It doesn’t matter if you are a sole proprietor, incorporated or other.

Anthem  –  Blue Shield  –  Kaiser  –  Aetna

Changing plans or company .. If you simply wish to change plans within the same insurance company, it’s best to make the desired changes during your policy anniversary month.  If you wish to switch companies, that can be done at anytime throughout the year.

Health  –  Dental  –  Vision  –  Life  –  Disability

The product features are going to be the same.  All companies offer the 4 metalic tier levels; Bronze, Silver, Gold and Platinum, along with the traditional plan types; PPO, HMO and HSA qualified plans.

When requesting a proposal, typically all you need are the ages of the employees and their dependents.

Participation Requirement …

The participation requirements for a Group health plans are:  70% for groups with 1-14 eligible employees.  50% for groups with 15 or more eligible employees.

Remember, group policies have a “participation” requirement.  Meaning, in order for a company to qualify for a group health policy there must be at least 50% – 70% of all eligible employees on the plan. If an employee is covered on their spouse’ group health plan, they do not count towards the participation requirement.

Also, employees must be on traditional payroll, independent contractors are not eligible for coverage on the group plan.

Advantages of a Group Health Policy …

  • Access to the largest networks of doctors, hospitals and other providers. Individual plan policies have seen their networks slashed. And many doctors are no longer contracting with Individual insurance providers.
  • Better prescription services.  Group plans typically provide better access to more prescriptions, and the costs can be significantly lower.
  • Optional Benefits … Dental, vision, life and disability plans with better coverage and flexible benefit options.
  • Mix and match plans with your employees.  You have the options to offer 1 or several plans to your employees. Some may want a ppo others may choose an HMO.  Flexibility!

Pediatric vision and dental coverage is included …

All small business medical plans PPO, HMO and HSA medical plans include PPO pediatric dental and vision coverage for age-eligible members.

Many Group Plans Include Wellness Programs …

Wellness discount programs offer a variety of member discounts on massage sessions, gym memberships, LASIK eye surgery, and even a popular weight management program. Online discounts of up to 40% off retail items (many with free shipping) include vitamins and supplements, yoga and fitness equipment, and much more. •

  • Discount Provider Network – Take 20% off the published retail prices when you use a participating provider in the Discount Vision Program network for exams, frames, lenses and more.
  • Alternative Care Discount Program – Get 25% off usual and customary fees for acupuncture, massage therapy, and chiropractic services, plus get discounts on health and wellness products, with free shipping on most items.
  • MESVision Optics – Take advantage of competitive prices on contact lenses,3 sunglasses, readers, and eyecare accessories, with free shipping on orders over $50.
  • QualSight LASIK – Save on LASIK surgery at more than 45 surgery centers in California. Services include pre-screening, a pre-operative exam, and postoperative visits.
  • NVISION Laser Eye Centers – Receive a 15% discount on LASIK surgery from experienced surgeons with offices in Southern California and Sacramento.
  • Hearing-aid discount – Save 30% to 60% off manufacturers’ suggested retail prices on major brands through EPIC Hearing Service. • Weight Watchers – Get discounts on three- and 12-month subscriptions, monthly passes, and at-home kits.
  • 24 Hour Fitness – Enjoy waived enrollment, processing, and initiation fees and discounts on monthly membership dues.
  • ClubSport and Renaissance ClubSport – Obtain a 60% discount on enrollments when joining with a month-to-month agreement. Enrollment fees are waived when joining with a 12-month agreement. There is a onetime $25 processing fee when you enroll.
  • NurseHelp 24/7 – Speak with registered nurses anytime, day or night, and get answers to your health-related questions, or go online to have a oneon-one chat. The NurseHelp 24/7SM phone number is conveniently located on the back of the Blue Shield member ID card.

Changing plans, switching companies, even changing brokers is easy. Please contact me anytime with questions.

John Conner

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Author: John

Medicare Options along with Individual and Group International Medical Insurance Options.

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