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Group Health Insurance

Indiana Group Health Insurance applies to a collection of people who are part of an organization or business. The cost is spread out among the employees based on various factors that can change the price of your plan dramatically. A minimum of 1 employee is required to enroll for you to be eligible for group health insurance. The passing of the Affordable Care Act (ACA) has had a huge impact on Indiana Group Health Insurance.

Micro Groups with less than 10 employees

This health care market has been significantly impacted by health care reform. In the past, one of the biggest benefits of small group insurance was a guaranteed issue. This means that a business could offer a group health plan to their employees and the employee could not be turned down. With the Affordable Care Act, we now have guaranteed issue in the individual market place. This is a game changer for many small companies. At Nefouse & Associates we have pioneered the process of shifting group health coverage to the individual market. This has created a huge saving for most of our micro group clients.

Small Group under 50 employees

Currently, if you have less than 50 employees you are considered a small group. In 2016, if you have less than 99 employees your company will be considered small group.

The small group market has been forever changed by the Affordable Care Act. We have seen many health insurance companies pull out of Indianapolis, which has created a lack of carrier competition. There has also been an introduction of new plan designs from carriers who are willing to create competition. There is still the traditional fully insured approach. The ACA has impacted the election significantly but it is still an option. There new plan designs are coming in the form of partial and self-funded plans for small groups. These options are giving small groups premium reimbursement or even a check at the end of the year based on utilization. We are even seeing stop loss insurance that could be affordable to most small groups. The industry will continue to create attractive small group insurance vehicles.

100-250 employees

This has always been a tough market locally. Do you self fund or do you go fully insured? Every business is different. We have fully insured this market over the years and reduced the majority of liability. We have also self-funded this segment which created immediate savings with large long term savings. There is an emerging private exchange option for these size groups. This is really the old cafeteria approach but with advanced technology behind, this option is still under development but we believe it may be a solution.

Large Employers

Here at Nefouse & Associates, we have a long history of taking care of large employers. We are able to negotiate every aspect of the health insurance package. Our fierce negotiations for clients yield huge savings and at the same time keeping the employees very happy. We have had success in this market because of our industry knowledge and the relationships that have been developed over the years. If your company is in this category and you want to get the deepest network discounts and the lowest administration cost, we can deliver that to you.

Compliance

With companies that have reporting requirements under the ACA, the benefit admin platform can save hours data collection. A good system should provide applicable large employer calculator (ALE) which can determine if a group is required to report under the ACA. Then have the option of generating those reports from the benefit admin system.

Cobra administration integration is now an option for moth benefit admin systems. Multiple third-party administrators (TPA) are contracting with admin system to streamline offering cobra to qualified beneficiaries. Within the benefit admin system, when an employee is terminated then the communication goes directly to the TPA and they administer the Cobra offer. The goal is to where the employer only must touch the termination one time.

Human Resource Information System

Benefit administration system also integrate additional HR services. Humana resource information system (HRIS) which provides human resource management which can aid in a company’s growth and employee communication. HRIS tools can provide Personal Time Off (PTO) tracking, company statistic, performance reviews, company directory, employee events, company calendar, and the ability to send employee surveys.

More benefit admin system is incorporating payroll integration with the services they offer. Having one integrated system for benefit administration & payroll eliminates the need for duplicated data entry. When employee has a payroll, deduction change from a benefit election, the systems automatically update. Most companies that offer payroll services are contracting with benefit administration platform.

If your payroll company is not integrated with the benefit administration platform, most bene admin systems will allow a deduction report to be generated which then can be uploaded into the payroll vendor.

The group health insurance market is forever changing and we operate with a proactive approach. Our performance is what sets us aside from other agencies. It does not matter if you are a startup company or Fortune 500 we will help you meet your goals.

Indiana Group Health Insurance Administration Resources

Indianapolis Group Health Insurance Application Process
Group Participation and Contribution Requirement
Group Health Insurance Employee Responsibilities
Effective Dates for your employees

Looking For A Reliable & Dedicated Indiana Group Health Insurance?

In 2013, we should see the final implantation of health care reform. The final stage should open an additional markets and strategies for group health insurance.

In 2014, group health insurance will no longer have medical underwriting. This is call guaranteed issue. No longer will an employee have to complete application and answer medical questions. No longer does a group overall health have any impact on premium. So for small groups, the company sponsored wellness program may not impact group health insurance premium.

High utilization group will benefit from this pooled rating. There is a chance that these groups could see their full insured medical premium drop. Then healthy groups would see their medical premium increase.

The new health insurance market is the Federal Health Insurance Exchange. In this exchange people could qualify for tax subsides. This will create a difficult decision for some employers. Most employees may benefit more from these subsides than what the employer can offer them. An employer will have to decide if they want to continue to offer a group health plan.

If a group drops the group health but still want to help the employees there is way. The option would be a Health Reimbursement Account. (HRA) With this account the employer could give a defined contribution to each employee for medical expenses. The employee then could use these dollars to reimburse for individual medical premium. So now you have an employee picking up a tax subsidy with a HRA reimbursement. This employee could end up with little expense for medical insurance. The employer could reduce their expenses significantly. Even if the employer has to pay the penalty for not providing insurance the saving could be worth it.

Other group options will be a traditional approach to health insurance. Employers sponsoring the group health plan so they can retain and attract quality employees. If your employees have a high skill set, it may be very difficult to drop a group health plan.

There will be some new option on the traditional employer approach. In Indianapolis we are seeing small group entertain self funded products. There is also defined contribution approach. This where you have multiple plans in place and the employee chooses the plan. You have a base plan that employer pays the majority of and then if the employees want to buy up they can.

The first thing an employer needs to establish is their philosophy for group benefits. Once you have that, then you can explore the options and find one that fits. That philosophy can change and you need to have someone that will be proactive with different approaches. That is what we do!

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