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What Is Group Health Coverage? Here’s Our Complete Guide

Business owners across New Jersey struggle to remain competitive and profitable. It’s hard to keep good employees and keep costs low at the same time. Group health coverage can help you do just that.

Yet, only 41% of small businesses with less than five employees offer insurance. Larger companies with less than 500 employees, about 61% offer insurance.

You can set your business apart by offering top-tier benefits like health insurance to your employees. Ready to learn more?

Read on to find out what group health insurance is and how it can help your business.

What Is Group Health Coverage?

Group health insurance refers to one health insurance policy for a group of people. The group is usually a small business or a trade organization.

How much does group coverage cost? It’s usually lower than if you or your employees were to get individual coverage. Insurance rates are based on risk to insurance companies.

Think of risk like getting a loan from a bank. People with good credit scores will get a better interest rate because they’re more likely to pay the loan back than someone with a bad credit score.

Banks want to protect their profitability, so they’ll charge more for people who are a higher risk. Health insurance companies also calculate their level of risk and profitability.

With individual insurance, there is a higher level of risk to the insurance company, especially if the individual is older. They’re more likely to need to use their insurance more often.

That will result in a higher premium for the individual. Group health coverage allows insurance to absorb risk between more people.

So, in a group of 10 people, some people may need to use their coverage more than others. Since the risk is spread out among more people, insurance companies are able to charge less.

Most group plans have a 70% participation threshold. That means that 70% of your group must participate in the plan. A business with 10 employees (including yourself) must have 7 people take part in the plan.

Are You Required To Provide Health Insurance?

Small business owners usually agree that health insurance can be a big benefit and lower employee turnover. That doesn’t mean that they’re going to provide group health benefits.

Are you obligated by law to provide health coverage? It depends. The Affordable Care Act says that businesses with less than 50 employees don’t have to provide coverage. Those with 50 or more employees do need to provide insurance to employees.

Just because you don’t have to provide health insurance coverage, doesn’t mean that you shouldn’t provide insurance. There are hidden costs to your business by not providing group insurance coverage to your employees.

For starters, how much does employee turnover cost your business each year? One study found that employee turnover costs about $15,000 per employee.

You can retain employees by providing health insurance coverage. Your employees are likely to leave for another position that offers that benefit.

You also need to account for sick days and lost productivity. Employees with health insurance coverage are happier, healthier and more productive.

Finally, there are potential tax credits and deductions for your business. That can lower your tax burden while creating a more productive workforce. In other words, you can be more profitable by investing in group health coverage for your business.

Shared Costs With Employees

When you buy group health coverage, you don’t have to shoulder the responsibility for the entire cost of coverage alone.

Most businesses will share the costs with employees. The percentage that your business pays and your employees pay will depend on a few factors.

You’ll want to weigh the premium costs, the number of employees you need to cover and your eligibility to receive tax credits. There is no set number, but it is something that you and your insurance partner can discuss.

Finding Group Health Coverage

Is your business ready to provide group health coverage? How can you provide the best coverage to your employees? Here are some tips to find the right group health insurance plan.

Gather Your Paperwork

You’ll need to get your paperwork together to apply for group insurance. You’ll need your business name, EIN, industry code, address and payroll records (Quarterly Tax and Wage Report).

A list of employees needs to be part of your application, too. That list needs to have each employee’s name, home zip code, gender, birth date, tobacco usage and participation in other health insurance.

Work with a group health insurance agent to find your options. They’ll take your information, look for plans on your behalf and go over your options with you.

You also want to educate your employees on their health insurance plan. Most people know they have coverage, but a very small percentage of people fully understand what is covered or not.

Take the time to educate your employees on the basic terminology. They need to what a deductible is, their monthly premium, their level of coverage and the doctors covered in the group insurance network.

Get Health Insurance For Your Business

Your employees are your company’s biggest asset. Doesn’t it make business sense to not provide health coverage as an employee benefit?

You could lose more money by not providing coverage in the form of lost productivity and employee turnover.

Group health coverage is a way to provide an affordable health insurance option to your employees. You’ll want to bring in the expertise of an insurance agent who can help you find the best group health coverage for you and your employees.

Contact us today to find out about how we help New Jersey businesses with their health insurance needs.