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Tuesday, October 24, 2017

Do you fit into the category of small business enrolled in the group health insurance market, and you’re tired of yearly increases in premiums with few options??

Read on. This article is for you!

No need to wait until open enrollment or renewal when you are a business. Start saving today!

The Small Business Field Is Wide Open: Know Your Options

While your head is spinning with information about all the new laws implemented by the ACA, we bring forth an array of new options. First off, there’s Qualcare, which is growing in popularity, in addition to the traditional options from popular insurers such as Oxford, Horizon, AmeriHealth and Aetna. Each carrier offers unique insurance options to suit your health insurance needs.

I know that you are excited to hear what Qualcare is about, but before I go ahead and point out its qualities, allow me to explain the two main types of groups.

Age-Banded Group vs. Composite Group

An age-banded group by definition is a group whose quotes are based on age. In other words, cost of premiums is assessed by using the age of each employee and their spouse. Age-banded group rates tend to be higher in premiums. 

Composite groups use a general group rating. The health insurance carrier determines the rate of the premium by averaging the age of all the employees in the group. A rate is determined for each enrollment type.

Qualcare uses composite group rating.

Qualcare Is Different From the Rest

Compliments of our pleased clients to support all the info you’ll be reading going forward, so you don’t have to take my word for it. One major aspect of Qualcare’s structure is that it is not age-banded, and therefore, by quoting the group with an average middle age, premiums tend to be lower. Qualcare is one of the top-rated carriers with close to one million satisfied clients that report satisfaction with the benefits provided.

Self-Funding/An Alternative to Classic Health Insurance

Cosmo insurance also has many clients enrolled in self-funded plans, which is another great option for New Jersey businesses. Self-funded plans are administered by the carrier. Other than that, all copays, billings and other benefits are similar to conventional plans. Rates are most often superior with self-funded plans and are not age-banded.

Self-funded insurances pool the entire employee body including all age groups and health conditions. It is therefore most popular amongst small businesses employing a young and healthy employee body with six or more employees. Pooling employees also prevents your premium from skyrocketing due to older and/or unhealthy employees. With ACA provisions premiums have increased overall because carriers must now ensure individuals with pre-existing conditions with expensive procedures and pricy drugs.

The best perk about self-funded plans is their refunded premiums. Yes, you read right! A self-funded carrier will return any excess in premium paid at the end of the year.

This is how it works. Premiums costs are divided into three equal parts. One portion goes toward administrative costs. Another part goes into a claims fund to pay the estimated amount that the insured anticipates to accrue for the group’s health claims over the year. The remaining portion is saved for stop-loss—money set aside for larger claims that are not expected.

As promised, the carrier will return the money that was not used for claims. Generally speaking, an approximate third of the premium is refundable. Statistically, over 50 percent of enrollees in these plans have parts of their premiums refunded to them.

What Plan Best Suits My Company’s Needs?

Our Google reviews will speak for themselves. Here’s the main benefit of signing up with a broker as opposed to going direct with the carrier: As a broker, I shop and propose all of the best-suited options for your company with no extra cost to you. As an added advantage I service your company all year round when it comes to claims, billing and Cobra administration, as well as changes to plans and adding or terminating employees. You’ll find the explanation of all of the insurance plans and benefits to be a breath of fresh air compared to the headache that you’ll have trying to enroll on your own.

I’m always in the know when new laws and new options are out, and as your broker I will share my knowledge with you.

Get more choices. Get better options. Get service.

I look forward to reviewing your best options with you.

By Mark Herschlag

 Mark Herschlag is the founder and CEO of Cosmo Insurance Agency, which is based in Ocean County. Cosmo Insurance Agency offers personalized solutions for individuals and businesses looking to obtain health, life, dental, long-term care and disability insurance.

For more information or for a free, no-obligation quote, please call 201-817-1388 or email [email protected].