There is a special small-group health insurance open enrollment period for January 1st effective dates for groups that might not otherwise meet minimum participation or contribution requirements. It is a little-known window of time that could save you money and secure better healthcare coverage for you, your family & your employees.
What are the benefits to Small Group plans versus Individual Market plans?
There are many advantages of enrolling in the Virginia small group market versus the Virginia individual market including the following:
- Larger Plan and Carrier Selection – The number and quality of plans in the Virginia Small Group market far exceeds those available in the Virginia Individual market. For example, in 2021, Anthem only offers 8 plans in the Individual market as opposed to 60+ in the Small Group market. HMO plans are only available in the Anthem Individual market, but they offer PPO and POS plans in the Small Group market. Furthermore, the lowest deductible available in the Anthem Individual market is currently $2,000 whereas there are plans in the Small Group market with no deductible at all.
- Lower Premiums – In almost all areas of Virginia, small group market premiums are lower than Individual market premiums. Depending on your zip code, premium savings could be as high as 50% with group sponsored health insurance.
- Employee Retention - Offering a comprehensive health insurance plan shows that you care about your employees’ overall well-being and can be used to attract and retain valuable employees. With regular access to preventive care, group coverage is an easy way to keep your employees happy, healthy and productive at work.
- Tax Advantages – Group health insurance premiums and/or contributions may be 100% tax deductible as a business expense for employers. In addition, the employee’s portion of the premiums may be taken out on a pre-tax basis with a simple type of 125 Cafeteria plan. Consult with your CPA for additional information.
What are the Advantages of Enrolling During the Special Annual Open Enrollment Time?
Eligible small groups can start a group plan at any time during the year, but there are participation and contribution requirements that must be met. Most carriers require that 75% of full-time eligible employees must participate in small group plans, minus qualified waivers. In addition, every carrier requires that employers pay at least 50% of the premium for their employees. These requirements may be difficult for a small employer to meet due to employees not wanting to enroll or the cost of paying for the employee premiums.
During this special time once a year, employers can enroll in a group plan regardless of who chooses to enroll and pay nothing towards the employee’s premiums. In other words, if only one person chooses to enroll in the plan, you can still reap the benefits of enrolling in the small group market.
This enrollment period is for January 1st only and all paperwork must be submitted between November 1st-December 15.
Editor’s Note: If you are interested in exploring group health options for your small business, please contact RK Tongue’s Employee Benefits Department for additional information via email VDABenefits@RKTongue.com or call Melanie Nowak at 410-369-3953
Melanie Nowak is an Account Executive with R.K. Tongue Co., specializing in employee benefits. Her focus is helping small and mid-size employers implement and maintain group health, vision, life, and disability insurance plans that provide crucial protection for employees and their families. Melanie’s goal is to educate practice owners on the importance of offering employee benefits and how it can drastically help with recruitment and retainment efforts.