Request a call Login

  • It’s clear that employee burnout and mental health issues have been an ongoing problem in the last several years. 76% of respondents in a Mental Health America and FlexJobs study agreed that workplace stress affects their mental health and 75% experienced burnout. Despite employees investing in programs to address stress and improve emotional well-being, a significant number of employees are still struggling with high levels of anxiety and burnout.

    According to a recent report from Aflac, 57% of employees are experiencing at least moderate levels of burnout. There has also been a decline in employees’ confidence that their employers truly care about their well-being.

    Aflac’s Chief Human Resources Officer, Jeri Hawthorne, notes that factors such as the upcoming presidential election, financial worries, long work hours, and other stressors could heighten the burnout issue even further this year.

    The Importance Of Employer Action

    Hawthorne stresses that the burden falls on small business owners to be at the forefront of addressing employee burnout and improving their situations. Burned-out employees are less productive, more likely to be absent or have behavioral issues, and more inclined to leave their jobs if they don’t feel their employer cares about them. Burned-out employees are also less likely to go above and beyond for clients, which can lead to a negative impact on your company’s performance.

    To combat this, Hawthorne recommends that employers take a proactive and engaged approach:

    • Regularly remind employees about available benefits, time off, and wellness programs, making them easy to access and understand.
    • Provide opportunities for employees to give back or volunteer, as this can boost their sense of purpose and well-being.
    • Continuously communicate about benefits and wellness offerings, not just during open enrollment periods.
    • Tailor communications and programs to specific employee demographics and their unique needs.
    • Solicit regular feedback from employees on what additional support they require.

    By taking these steps, employers can demonstrate their genuine care for employee well-being and work to reverse the troubling trends around burnout and declining confidence. Prioritizing mental health and emotional wellness will be crucial for organizations looking to support their workforce and maintain high performance.

    Show Your Employees You Care

    Remind your employees about taking paid time off (PTO) and about available benefits. Encourage employees to use the PTO they’ve earned, whether it’s for a vacation, personal matters, or simply to recharge. Employees proved that they could successfully work from home during the pandemic. Giving employees the opportunity to work and taking time off when needed is important.

    In addition, navigating employee benefit offerings during open enrollment can be overwhelming. It’s crucial to make these offerings, tools, and programs understandable and readily available for when employees need them and can easily access that information.

    Employers should also talk with their employees and ask for their feedback on their benefits packages and conduct surveys. Ask your employees what they are looking for and what they value. Act on their feedback and implement new strategies.

    Prioritize Employees’ Mental Health With GMS

    By partnering with GMS, you can demonstrate your commitment to your employees’ well-being and create a workplace culture that prioritizes mental health. This not only benefits your team, but also contributes to improved productivity, engagement, and overall business success. When you partner with GMS, we provide you with mental health benefits for your employees, such as:

    • Affordable health insurance plans through our group health insurance
    • Employee assistance programs (EAPs)
    • Access to our learning management system (LMS), where employees can partake in mental health training
    • Access to wellness programs
    • And more!

    Take the final step towards empowering your workforce. Contact GMS today to learn how we can help you implement a comprehensive mental wellness program that meets the needs of your employees and your organizations.

  • The expiration of COVID-19-related provisions requiring states to keep residents enrolled in Medicaid has cast a dark shadow over Texas, leaving an estimated 2.1 million individuals without health insurance. Texas, already grappling with the highest number of uninsured individuals in the country, has seen a drastic surge in the number of people being removed from coverage compared to any other state.

    The Human Toll

    The fallout of this mass loss of health coverage is dire. The state’s most vulnerable residents are now facing barriers accessing essential health care services. Not only has this negatively impacted individuals and families but also the state’s economy and fiscal health.

    Impact On Health Care Access

    The primary reason to maintain and expand health insurance access is to ensure that the state’s most vulnerable residents can obtain the care they need, thereby improving the overall well-being of individuals and families. With millions now stripped of their health insurance, accessing necessary medical care has become an increasingly arduous task, leading to detrimental effects on morbidity and mortality outcomes. In addition, the decreased productivity associated with adverse health outcomes is expected to take a toll on the state’s economic activity.

    Decrease In Health-Related Spending

    With 2.1 million fewer Texans covered by health insurance, health-related spending is expected to decrease, reducing business activity across communities and the broader economy. This decrease in spending not only affects the health care sector but also has far-reaching implications for various other industries and businesses.

    Rise In Uncompensated Care And Insurance Premiums

    Due to the surge in uninsured individuals, uncompensated care is no longer just a future possibility; it’s an imminent threat. This will place an unbearable strain on our health care providers, leading to a subsequent increase in insurance premiums. This exacerbates the financial burden on both individuals and the state’s health care system, creating a crisis that demands immediate attention.

    Economic Costs

    The Perryman Group’s estimates paint a picture of the economic costs of the mass loss of health insurance coverage. If this situation persists, the state will lose $58.9 billion in annual gross product and almost 509,200 jobs, factoring in multiplier effects. These economic harms are not confined to specific regions but are felt across the entire state, casting a wide net of distress.

    A Call To Action

    The repercussions of 2.1 million Texans losing their health insurance are far-reaching, encompassing human suffering and economic distress. Urgent and decisive action is needed to address this crisis and prevent it from spiraling further out of control.

    Policy Interventions

    Policy measures aimed at reinstating and expanding health insurance access for the affected individuals must be prioritized. These measures should focus on ensuring health care remains accessible and affordable for all Texans, regardless of their socioeconomic status.

    In addition, collaboration between government agencies, health care providers, and community organizations is essential to formulate comprehensive strategies that can effectively mitigate the impact of the mass loss of health insurance coverage.

    A Ray Of Hope For Small Business Owners In Texas

    In the midst of a health care and economic crisis that has left millions of Texans uninsured, there is light at the end of the tunnel – Group Management Services (GMS), a professional employer organization (PEO). As experts in providing comprehensive HR solutions, GMS can play a pivotal role in helping these businesses navigate through these challenging times.

    As a small business owner, you must step in now more than ever to support your employees. By offering tailored employee benefits management, including affordable health insurance options, GMS helps small businesses attract and retain talent. GMS is the only PEO that provides an in-house master health plan that helps you avoid large swings in usage, trends, and renewal rates. In addition, our benefits experts provide guidance on how to best utilize your plans, maintain compliance, and stay on top of ever-changing rules and regulations.

    At the end of the day, you want what’s best for your employees. Partnering with GMS is not just supportive; it’s transformative. Contact our experts today to learn more.

  • Health spending has steadily increased over the last few years, making health insurance one of the most highly prized employee benefits. Employer-provided health care plays a crucial role in recruitment and retaining top talent. In an era where employees are increasingly open to changing jobs, businesses are reassessing the benefits they offer, including health insurance – however, not all health plans work the same way.

    Group health insurance varies in terms of how the insurance is purchased and how it affects the group’s premiums and plan options. If you’re looking for ways to navigate your options, we’ve compiled a few of the most popular plans available.

    Group Health Insurance Options

    While all health plans have their pros and cons, it’s up to you to decide which makes the most sense for you and your employees’ needs. The following are common types of group health insurance options available for small businesses.

    Fully Insured Plans

    A fully insured plan is one of the more traditional types of group health insurance. Fully insured plans involve the insurance company taking on the risks involved with health care costs. Your business is then charged an annual premium for the benefits in the insurance policy, which is partially paid for by the employees.
    The insurer uses a variety of factors to calculate group health insurance premiums, including:

    The insurer uses a variety of factors to calculate group health insurance premiums, including:

    • Size and health of the group
    • The average age of the group
    • The employer’s claims history
    • Types of occupation
    • Level of coverage and add-on benefits

    Self-Funded Plans

    While the insurance company covers employee health costs in a fully insured plan, self-funding burdens the employer. In a self-funded plan, you’ll pay for employees’ health care claims and administrative costs directly rather than paying fixed premiums to an insurance company. This can often lead to more affordable rates and more control over your plan, with the tradeoff of your business accepting the risk of paying for catastrophic claims.

    The potential risk is why self-funded plans are more prevalent among larger companies and organizations that can easily absorb fluctuations in health care costs and want more control over their benefit offerings. However, small groups can also take advantage of self-funded plans. Small businesses can opt for a partially self-funded plan if they have a financial buffer or stop-loss insurance. This option allows small businesses to reap some of the benefits of self-funding while limiting risk.

    Level-Funded Plans

    Level-funded plans strike a balance by merging elements from fully insured and self-funded models. They’re an excellent fit for smaller businesses that might need more time to embrace the risk of a self-funded plan but are prepared to step away from fully insured premiums. They offer cost-saving potential and greater control compared to fully insured plans while still providing financial predictability.
    Unlike traditional plans with annual premiums, level-funded options are charged at a monthly payment rate. Insurance carriers will use census information to determine the amount your small group should pay. This rate is based on factors such as claims allowances, fees, and stop-loss coverage premiums. At the end of the year, the carrier will adjust the monthly level based on group performance.
    The employer is typically refunded if there is a surplus in the fund due to lower-than-expected claims. This approach allows small businesses to manage costs efficiently and consider a future transition into a self-funded plan.

    Health Maintenance Organization (HMO)

    An HMO is a group coverage setup where members pay for specific health services through monthly premiums. These plans prioritize cost-effective and comprehensive health care services for their members. With an HMO, you gain access to a designated network of health care providers and facilities, but your coverage is typically limited to services within this network. This focus on in-network care makes HMOs more affordable than other health insurance plans. However, seeing any physicians or facilities not included in your HMO network can result in a group member having to foot the entire bill.

    Preferred Provider Organization (PPO)

    PPO plans are like HMO plans, except with more flexibility. Like HMOs, PPOs also maintain a network of preferred health care providers, encompassing doctors, hospitals, and specialists. However, what sets PPOs apart is the freedom they grant their members. PPO members can choose to receive care from within the in-network providers or venture outside to out-of-network providers without having to cover the entire cost themselves. Instead, these visits will result in higher co-pays and additional service costs, giving members more freedom than HMO plans.

    High-Deductible Health Plan (HDHP) With A Savings Option (HDHP/SO)

    An HDHP is based on lower premiums and higher deductibles for group members. This means that members with this type of health care insurance will have to pay more out-of-pocket before the plan pays for its share. The tradeoff, however, is that this route allows monthly premiums to be lower, making it a good group health insurance option for employees who don’t use many medical services.

    In addition, you can pair HDHPs with savings options such as a health savings account (HSA). These accounts allow members to make tax-free contributions to an account that can be used to pay for health care costs, ranging from co-pays to primary medical services. The funds in these accounts roll over every year, making them a great retirement savings option, too.

    Health reimbursement accounts (HRAs) are another potential savings option that can be tied to an HDHP. These accounts are similar to HSAs, except employers make the contributions instead of employees.

    Choosing The Right Type Of Health Insurance For Your Small Business

    Finding the right group health insurance plan for your budget can be difficult. Balancing benefits administration and budgets can be overwhelming for anyone without a firm grasp of the health care system.
    That’s why many small business owners work with a professional employer organization (PEO) to help weigh their group health insurance options and handle the administrative burden of health care coverage. Whether your organization lacks an HR department or simply needs a resource to make more informed decisions about the management of benefits, GMS is here to help.

    GMS changes the approach to increase affordable options and give your employees access to small business health insurance. We give small businesses the buying power of a large corporation. Contact GMS today to speak with one of our experts about how we can help you offer quality healthcare plans that work with your budget.

  • When you run a small business, offering group health insurance plays a critical part in attracting and retaining top talent. According to a study by MetLife, 81% of employees named health insurance as a “must-have” benefit, while only 3% said that it wasn’t needed. While other factors impact job decisions, it’s no secret that healthcare coverage plays a key role in making your business a more desirable place to work.

    The advantages of offering group health insurance are clear, but there is a drawback for businesses – it’s not cheap. Group health coverage can cost a small business thousands of dollars per employee, and those annual costs can add up depending on the size of your workforce. It’s also common for premiums to rise year over year.

    Want to know why premiums are getting more and more expensive? We’ll break down what impacts your premiums and why rising costs are a common trend.

    What Impacts Your Group Health Premiums?

    The cost of a group health insurance premium is driven by several different factors. Insurance companies use these different considerations to raise or lower your group’s rates. The biggest factors that will dictate how much you and your employees pay include the following categories.

    Group size and overall wellness

    The first thing an insurer considers when calculating your company’s premium is the size of the group. Larger groups tend to enjoy lower costs because other factors can be spread across a greater number of individuals, whereas small groups won’t enjoy the same economy of scale.

    In addition to size, insurers also evaluate the general health and wellness of a group. A group that presents a higher risk of costly claims is likely to pay higher insurance rates. This reality is simply because the insurer estimates how much they can anticipate in paying out for claims in any given year, which is why your premiums may be higher.

    Age of the group

    The unfortunate truth is that as an individual ages, medical issues tend to be more common. Insurers will typically use the average age of your group members to calculate your premium. If your group skews older, your premiums will likely be higher than average.

    Group member occupations

    Some occupations inherently carry more health risks than others. The level of risk based on certain industries or jobs directly impacts the cost of group insurance premiums. For example, a staff comprised mostly of accountants will present a lower risk than a group of construction workers. As such, the construction company is likely to have a higher number of claims and more expensive premiums in this scenario.

    History of claims

    Your past also plays a direct part in premium calculations. The total cost of past claims can negatively or positively impact your rates. If your group has several members undergo costly medical procedures, your premiums may increase the following year. This adjustment is the result of an insurer using current data to estimate how much your group should pay for its coverage.

    The Reasons For The Rising Costs Of Healthcare

    In recent years, the cost of offering health insurance seems to be on a never-ending upward trend. That perception isn’t an illusion – rising healthcare premiums are a real trend instigated by a variety of factors.

    Increase in medical expenses

    Demand for medical services has seen a big increase due to government programs such as Medicare and Medicaid. Many individuals who lacked coverage are now on these programs. This rise in demand and hospital visits effectively causes a similar rise in medical care costs and premiums. Prescription drug spending is also on the rise, which adds yet another layer to why the costs of health insurance keep increasing.

    Population growth

    Sometimes rising healthcare costs is simply a matter of having more patients. Our population continues to grow, which simply leads to greater national health expenditures. As a result, the overall population increase puts a greater strain on the healthcare system and leads to higher operational costs that impact everyone’s premiums.

    Advancing age of population

    The population of the United States is not only increasing, but also aging. As of 2020, there were approximately 47 million people in the United States over the age of 65. As recently as the year 2000, this number was only 31 million. The aging of the population won’t slow down anytime soon, either. It’s projected that our population will include 65 million people over the age of 65 by 2040.

    With an aging population comes increased healthcare expenses. The older we get, the more medical issues we face. Therefore, a country whose senior citizen population is increasing is going to see hospitals that are hit hard on resources. In addition, the average group age can increase, leading to a more direct impact on your small business’ premiums.

    Increase in chronic illness

    As a nation, we are facing more chronic diseases now than ever before. The largest culprit is diabetes, followed by high blood pressure and high cholesterol. Simply put, the growth of chronic illness in the country leads to long-term care and greater costs for constant coverage to treat these conditions.

    How Can a PEO Help Lower Healthcare Premiums?

    A Professional Employer Organization (PEO) allows businesses to balance the benefits of group health coverage with the costs of health care spending. A PEO like GMS can help you offer top-tier coverage through more affordable insurance options. This cost-effective approach is made possible through both economy of scale and expert benefits administration.

    Increased buying power

    When you partner with a PEO, you aren’t buying group health insurance on your own. One tremendous benefit of a PEO is that it represents many organizations rather than just yours. This network of relationships means that a PEO can treat several companies as a single group while dealing with insurance companies. This grouping of organizations means that your small business can see the same types of benefits and cost savings that can typically only be obtained by larger corporations.

    More importantly, a PEO will split its portfolio of organizations into separate groups based on their own demographics. This means that your company will not be grouped in with every other company under the umbrella of your PEO, but instead will be treated based on your own group’s ratings. This means you will see the lowest cost possible, without cutting back on your actual coverage.

    Benefits administration and payroll

    A PEO can also help ease your administrative burden by enabling your healthcare admin and payroll to integrate with one another for a streamlined process. For example, payroll deductions will be set up automatically when new employees are onboarded and opt into health insurance. Paycheck deductions can be automated, including determining what should be pre-tax and post-tax.

    The process of employees enrolling in benefits or renewing during open enrollment can also be simplified by a PEO. Dedicated account managers and online systems make it simple to educate employees on their options and help them choose their coverage elections in the same online portal.

    In short, a PEO makes your benefits administration simpler and more cost-effective. It’s almost a full-time job to simply deal with the health benefits for your employees. That’s why our experts can help you invest in quality, affordable coverage and save you valuable time by handling time-consuming administrative tasks.

    Are you ready to streamline your administrative processes? Contact GMS now to talk with our experts about all your health insurance needs.

  • As a small business owner, you’re in charge of making many critical decisions that impact your employees. Determining which benefits and employee perks you offer is one choice that plays a direct role in attracting top talent and retaining key members of your company.

    These days, health insurance is a major sticking point for new and current workers. The Society for Human Resource Management (SHRM) found that nearly half of employees ‘said health insurance was either the deciding factor or a positive influence in choosing their current job.’ That willingness to choose jobs based on health insurance makes a competitive benefits package even more important for a growing business.

    Of course, offering health insurance is also a notable expense for a small business trying to grow. Fortunately, the small business health care tax credit allows qualifying organizations to offset some of those costs and provide quality health insurance for their employees. Here’s what you need to know about this tax credit and whether it can help your business.

    Which Small Businesses Qualify for the Health Care Tax Credit

    While any business that offers health coverage would love to save money, the IRS does set some stipulations for which organizations will benefit from the tax credit. Your business will need to meet the following criteria to be eligible for the small business health care tax credit. 

    Your business must have fewer than 25 full-time equivalent employees

    Full-time equivalent (FTE) employees are typically counted as those who meet “an average of 30 hours of service per week for a calendar month or at least 130 hours of service in a month.” Any employee that performs services for your business would normally be counted, but the IRS requires employers to alter this calculation for the tax credit.

    Instead of counting 30 hours per week as one FTE employee, the health care tax reviews hours from an annual perspective. One FTE employee for the tax credits equals approximately 2,080 hours per year. Any part-time employees who combine to equal more than 2,080 hours would count as one FTE employee in these calculations.

    The IRS asks employers to not include the wages and hours worked by certain types of employees toward their 25 FTE employee limit. These individuals include:

    • The owner of a sole proprietorship
    • Any partner in a partnership
    • Shareholders of S Corporation owning more than 2%
    • Owners of more than 5% of the business or other businesses
    • Family members of the above
    • Seasonal employees who work 120 or fewer days per year

    Your business’s average wages must be lower than $56,000 per full-time equivalent

    In addition to meeting FTE requirements, your business must also meet certain wage thresholds. The IRS set the average annual wages at $50,000 back in 2014 and have adjusted the amount each year for inflation. As of the 2020 tax year, businesses must pay average wages of less than $56,000 to FTE employees to qualify for the tax credit. 

    Your business must offer a qualified health plan

    Any organization that wants to be eligible for the small business health care tax credit is required to offer a qualified health plan through a Small Business Health Options Program (SHOP) marketplace. There are also certain areas where a qualified health plan may not be available through SHOP. In those cases, an eligible business may still be able to claim the credit.

    Your business must pay health insurance premiums through a “qualified arrangement”

    According to the IRS, a qualified arrangement means that employers pay at least 50% of any premium costs for enrolled employee’s health insurance coverage. This arrangement only extends to costs incurred by those employees, meaning that any costs incurred by family or dependents do not affect the 50% threshold.

    How Much Can Organizations Receive from the Small Business Health Care Tax Credit?

    The exact amount of credit your organization receives depends on two main factors:

    • Whether your organization is tax-exempt or not
    • The size of your organization

    Eligible smaller businesses can receive a tax credit that covers up to 50% of the premiums paid for by the employers. Meanwhile, eligible employers who are tax-exempt can max out a 35% tax credit. This credit is available to both types of employers for two consecutive taxable years. Small business employers are able to carry that credit either forward or back as well.

    Of course, those numbers represent the maximum tax credit for your business. The exact amount your business can receive is based on a sliding scale where smaller employers will receive larger credits. According to the IRS, your maximum allowed credit will be reduced if you employ more than 10 FTE employees or have average wages of more than $25,000 (subject to change due to inflation).

    How to Claim the Tax Credit

    If your small business is eligible for the tax credit, you should fill out Form 8941 to calculate that credit. The IRS provides a detailed PDF with instructions on how to list your employees, their total hours, and how much you paid them. Meanwhile, tax-exempt organizations can file Form 990-T for their credits.

    How to Invest in the Right Benefits Package for Your Small Business

    Whether you qualify for a tax credit or not, it’s difficult to balance rising premiums and providing quality health care coverage that helps you attract and retain top talent. Fortunately, Professional Employer Organizations (PEO) like GMS make it possible for you to provide top-tier coverage at affordable prices.

    As a PEO, GMS is a natural fit for health insurance administration. We represent hundreds of businesses and can leverage our greater buying power to keep premiums down and give you access to quality plans at cost-effective prices. GMS also gives you and your employees access to experts who can help you stay on top of regulatory changes and educate group members about how to best use your plans.

    Let’s face it, benefits administration is confusing and time consuming. GMS helps you invest in quality, cost-effective coverage and allows you to reclaim your valuable time. Contact GMS today about group health insurance and ancillary benefits that makes sense for your small business.

  • Small business owners weigh many factors when deciding whether to invest in a group health insurance plan, but oftentimes the decision comes down to dollars and cents. The Kaiser Family Foundation’s 2016 Employer Health Benefits Survey notes that the high costs of insurance premiums are the primary reason why firms won’t offer health benefits. Even for business owners who do offer plans, rising insurance premiums can create a lot of stress and confusion, especially if the owner doesn’t know how these premiums are calculated and how they can manage them.

    Employers can have many questions for group health providers, and that includes exactly how much they can expect to spend. Here’s a rundown on what the insurance industry uses to calculate your group health insurance coverage premium, as well as some strategies that can lead to lower costs.

    Image of group health insurance plan premiums for small business owners.

    How are Group Health Insurance Premiums Calculated?

    According to the KFF 2016 survey, the average family coverage premium is $18,412 per year and single coverage is $6,435 per year. Of course, every business is different, so your premium may end up being higher or lower depending on a variety of factors that are used to calculate the costs for your plan. These factors include the following.

    Size and Health of the Group

    The total number of people on your group plan can impact how much you pay. This number includes not only your employees who opt in to your plan, but also any family members who also opt in to your plan through an employee. A larger group of people can help lower your premium by spreading the associated health risks of a few people over an entire group.

    However, the overall health of a group does affect your premium. While the Affordable Care Act doesn’t allow insurers to change premiums or deny insurance based on an individual’s pre-existing conditions and overall health status, the American Academy of Actuaries notes that the overall health of the group can play a role in determining premiums.

    “If a risk pool disproportionately attracts those with higher expected claims, premiums will be higher on average,” the Academy writes. This factor can work in your business’ favor, as the Academy also notes that “If a risk pool disproportionately avoids those with higher expected claims or can offset the costs of those with higher claims by enrolling a large share of lower-cost individuals, premiums will be lower.”

    Average Age of the Group

    While the ACA no longer permits insurers to use certain factors like gender to alter premiums, it still allows insurers to consider age in premium determinations. According to independent actuarial and consulting firm Milliman, “rating by age is still allowed under the law as long as the ratio of the highest-cost adult age band to the lowest-cost adult age band does not exceed 3:1.” In a group plan, this means the average age of your group can play a part in what you pay.

    An Employer’s Claims History

    All those visits to the doctor can add up. Insurance providers use the number of total claims and how expensive those claims are to determine adjustments to your premiums over time. When it’s time to renew your policy, an insurer will review your group’s claims history and adjust accordingly. If a few employees had some medical issues that led to frequent or costly visits, that may be reflected on your updated premium cost.

    Type of Occupation

    Different lines of work carry different levels of risk. Your insurance provider may adjust your rates depending on the general occupation of your workers. For example, clerical staff don’t face the same health risks as factory, construction, or offshore workers, so insurance premiums for a group of office workers may be less than other occupations.

    The Type of Coverage and Desired Add-on Benefits

    Not all small business health plans are the same. The level of coverage will play a big role in how much you and your employees pay. Better coverage and lower out-of-pocket costs can lead to higher premiums. Bundling extra add-ons such as dental and vision plans can also increase your premiums due to the extra coverage.

    How Can I Save on Group Health Premiums?

    Health insurance premiums can be expensive for a small business owner, but you don’t necessarily have to resign yourself to what your company is being charged. There are potential strategies that you can use to help you lower your costs and improve the health of your employees.

    Workplace Wellness Program

    Since the number of claims has a direct impact on your premiums, it can pay to improve the overall health of your employees. A customized workplace wellness program can help foster healthier lifestyle choices through health education and wellness activities. This in turn can lead to fewer doctor’s visits caused by preventable diseases, leading to a healthier, more active workforce and lower overall premiums. 

    Telemedicine

    Another way to limit the number of doctor’s visits is to give your employees access to a 24/7 mobile doctor. Telemedicine services give your employees the freedom to connect with a professional physician via phone, video, or online chat. This allows them to get the answers they need without having to schedule an in-person appointment with the doctor, meaning no copay for them and no extra claim for your plan.

    Economy of Scale

    Depending on where you get your insurance from, you may be able to take advantage of economy of scale. While larger companies have more employees and greater buying power, smaller business don’t have quite the workforce to take advantage of savings associated with economy of scale. However, a Professional Employer Organization can give you the buying power to lower premium costs. 

    A PEO can leverage the collective buying power of all their group health clients, acting as one large company that can purchase plans at lower premiums as a result. This helps your business avoid costly administration fees and save without sacrificing on the quality of your group plan. 

    Partnering with a PEO also opens you up to cost-saving strategies such as wellness programs, telemedicine services, and more. If you’re interested in learning more about how a PEO can help your business save on insurance premiums and make your businesses a healthier place, contact GMS today.

  • It’s always a good idea to get more information, especially when your business is investing in something as important as health care. For an employer, that extra information is essential when finding the right group health coverage.

    Even if you have a good grasp on the basics of group health insurance, it doesn’t hurt to ask a provider a few important questions before you purchase a plan for your business. Here are some key things that you should ask a provider when you’re ready to buy group health insurance coverage.

    Five Questions Small Businesses Should Ask Group Health Providers

    What are the different plan options available to my business?

    If you choose to offer health benefits, there are several types of group plans that you can offer to your employees. These plans include:

    • Fully-insured plans
    • Self-funded plans
    • Level-funded plans
    • PPO (preferred provider organization)
    • HDHP/SO (high-deductible health plan with a savings option)
    • POS (point-of-service plan)
    • HMO (health maintenance organization)

    Each one of these types of plans offer different types of benefits. As such, some plans may be better suited for your business than others. For a breakdown on the advantages and disadvantages of each type of plan, check out our post on the different types of group health insurance.

    While many businesses offer only one type of plan, that doesn’t mean that your organization is limited to a single offering. According to the Kaiser Family Foundation (KFF) 2021 Employer Health Benefits Survey, 25% of organizations offer two or more plan types in an effort to diversify and improve their overall benefits package for employees.

    What does my plan cover?

    If you’re going to purchase something, you should know what you’re getting. Make sure to ask your group health insurance provider for a detailed breakdown of what your plan covers so that you and your employees know what to expect.

    It’s also important to ask about additional benefits, such as dental and vision insurance. While some plans have add-ons for ancillary benefits, it’s not always the case. That distinction is important because nearly 90% of employees would consider a lower-paying job in exchange for better health, dental, and vision insurance. Your plan plays a pivotal role in attracting and retaining talent, so make sure your provider gives you everything you need to know about your plan coverage.

    How much will group health insurance cost me?

    According to KFF, the average annual health insurance premiums in 2021 are $7,739 for single coverage and $22,221 for family coverage. Employers contribute an average of $6,440 and $16,253 for single and family coverage respectively.

    Of course, those numbers are just the averages. Your business’ exact health insurance costs can go up or down depending on a variety of factors. The specific factors that insurance agents use to determine group health premiums include:

    • Size and health of the group
    • Average age of the group
    • An employer’s claim history
    • Type of occupation
    • Type of coverage and add-on benefits

    Who should my plan cover?

    As an employer, you do need to abide by some ground rules in terms of who is eligible for group health insurance coverage. Any business that provides health coverage must offer it to all full-time equivalent employees. However, that does mean that employers have some wiggle room in terms of part-time employees and family members.

    Simply put, employers can either decide to offer coverage to all part-time employees or none at all. The same principle applies to family members and dependents of eligible employees. Not offering coverage to these groups can help lower your costs, but may make your plan less attractive to certain employees. As such, you’ll want to iron out these details and determine which options align best with your business’ needs when buying group health insurance.

    Who can help me if I have any questions or problems?

    You shouldn’t feel like you’re stranded on an island when you have questions about health insurance. A good health insurance provider should have a team in place that can assist you with any potential questions and issues in the future.

    Ask each provider about their customer service to find out who your contacts will be and how their process works. If they don’t give you many details about who can help you, that’s a red flag that they may not have your back in the future.

    Group Health Insurance Coverage From A PEO

    It can be a tricky to find an attractive group health plan that won’t break the bank. Fortunately, a Professional Employer Organization may be able to help you find the best of both worlds.

    At GMS, we can help you choose a group health insurance plan that’s right for you and your employees. Thanks to a higher collective buying power and other cost-prevention strategies, GMS can help you lower your premiums and help you save. We also have the experts to help you make informed decisions about benefits management and oversee plan administration so that you have time to focus on the rest of your business.

    Ready to invest in quality group health insurance at a lower cost? Contact us today to talk to one of our experts about what we can do for your business.

  • Managing health insurance for a small business can get complex in a hurry, especially if you’ve never dealt with group plans before. When it comes to small business health plans, you’ll quickly find that not all health insurance plans work the same way.

    Instead of getting overwhelmed, it’s a good idea to step back, take a breath, and start with the basics. Let’s go over what you should know about small company health insurance before you start offering plans  to your employees.

    Image of financial documents for group health insurance coverage. 

    What’s the Difference Between Group Health Insurance and Other Types of Insurance Plans?

    Investopedia defines a group health insurance plan as “a plan that provides healthcare coverage to a select group of people.” As an employer, this is the type of plan that you would typically offer your employees as one of their major benefits. 

    However, people can also opt for an individual health insurance policy. In this case, an individual person can purchase an individual health insurance policy that covers one person or that person’s family. However, these individual people can also opt to be covered by their employer’s group health plan instead, if it’s offered by the employer.

    Another key difference between group health insurance and individual plans is the how an insurer will determine your premium. Individual plan premiums are based on the medical history on an individual or a family. Group health insurance operates with a much larger group of people, which means that they will balance the risk factors of the entire group to determine your premium. This can help lower premiums by spreading the associated risks over the entire group.

    There’s also different types of group plans, such as fully-insured group health plans and self-insured plans, also known as self-funded plans. A fully-insured plan is the more traditional option, where the insurer sets premium rates for the year, collects those premiums, and pays for claims based on your plan. A self-insured plan allows a business to be in control of its own plan. 

    Self-funding can be risky for small businesses worried about potential losses from claims, but it can help them save by eliminating the additional fees that insurance companies apply to their premiums. One way to get protect your business from potential losses is by investing in a stop-loss policy that allows you to evaluate savings and exposure. If that sounds intriguing to you, check out our post on why self-funded health insurance might be right for your business.

    Do I Have to Offer a Group Health Coverage?

    Yes and no, depending on your business. The Affordable Care Act (ACA) mandates that Americans have health insurance and can penalize those without coverage. However, small businesses with fewer than 50 full-time equivalent employees aren’t necessarily required to provide health insurance to its employees. Still, it can be a good idea to do so.

    According to a survey by the Society for Human Resource Management (SHRM), 95 percent of HR professionals named health care benefits as one of the benefits most important to their employees. SHRM also cites that 29 percent of employees looking to leave their job do so because they want a better overall benefits package. Quality medical insurance for small companies can serve as a great tool to retain talented members of your team and attract other skilled workers.

    What are My Responsibilities if I Offer Group Health Insurance?

    If you do offer group health insurance to your employees, you’re going to have to follow a few rules set by the ACA. To start, if you do offer a group health insurance plan to your full-time employees, you must offer it to every single one of them. You can’t pick and choose who gets coverage and who doesn’t and you can’t deny coverage to employees with preexisting conditions. You can also choose to offer coverage to part-time employees as well. Keep in mind that your employees have the option to extend their benefits to their families as well.  

    Of course, there are also financial responsibilities attached to offering health care coverage.

    Other responsibilities include:

    • Covering Essential Health Benefits in the group health insurance plan
    • Offering health insurance to new employees within 90 days of their start date
    • Providing employees with a Summary of Benefits and Coverage

    Managing Group Health Insurance for Your Business

    Even once you know the basics, it can be difficult to handle your group health insurance coverage and deal with rising premiums at the same time. A Professional Employer Organization can provide you with the expertise to offer quality insurance for your employees and the buying power and cost-prevention strategies to lower those costly premiums. Contact us today to talk to one of our small business medical insurance experts about how we can help you offer a quality healthcare plan to your employees.

  • Dealing with health insurance is one of the biggest challenges for a small business owner. Between the cost of insurance and the need to attract and retain talent, offering insurance is a major decision. Add in all the uncertainty that surrounds your responsibilities and health insurance can be a major headache.

    Simply put, health insurance administration is confusing. It’s understandable why employers are unsure about the health insurance requirements for small businesses – there’s a lot of information and only so much time to manage everything. This post will break down what you need to know about small business health insurance requirements and how you can keep your company compliant.

    Do Small Businesses Have To Provide Health Insurance?

    When it comes to small business health insurance requirements, this is likely the biggest question on your mind. The exact definition of a small business can differ from one organization to another. According to the Affordable Care Act (ACA), any business with 50 or fewer full-time-equivalent employees counts as a small business.

    That cutoff is significant because businesses with 50 or fewer full-time equivalent employees are not required to offer health coverage to their employees. However, these businesses are still required to provide a report about healthcare information to employees. This report should cover certain information about the health insurance marketplace, outlining what it is and how employees can contact the marketplace.

    A doctor going over the health insurance requirements for a small business.

    Requirements For A Small Business That Offers Health Insurance

    Despite health coverage not being mandatory, many small businesses with fewer than 50 full-time employees still choose to provide workers with health insurance because quality healthcare coverage can help businesses attract and retain top talent. This decision can be very beneficial, but it does mean that small business owners will need to take on a few new responsibilities.

    Minimum employer contribution for small business healthcare

    If an employer opts to offer group health insurance, the business must pay at least half of the monthly health insurance premiums. Employers must also meet the affordability threshold for the health coverage they offer. In 2022, an employee’s monthly contribution couldn’t exceed 9.61% of their income. The IRS adjusts this rate every year and has already announced that the affordability requirement will go down to 9.12% in 2023.

    Employees eligible for coverage

    Small businesses that offer health insurance are required to offer coverage to all full-time equivalent employees. Full-time equivalence requires an average of 30 hours of service per week for a calendar month or at least 130 hours of service in a month. You can also choose to offer health coverage to your part-time employees as well, although it is not mandatory.

    An employer may not discriminate between employees when offering insurance. If you offer insurance to some full-time employees, you must offer it to every employee. You must also provide health insurance to each employee’s dependents up until they turn 26 years old. However, federal law does not require employers to offer coverage to any spouses or other domestic partners.

    90-day maximum waiting period

    When an eligible employee is hired by a business that offers health insurance, that employee must be offered health insurance within 90 days of his or her employment start date. Employers may institute a waiting period before new employees can enroll in the company’s health insurance plan. A small business owner may also decide to waive this waiting period and allow employees to enroll as soon as possible.

    Summary of benefits and coverage (SBC) disclosure

    Employers are required to provide eligible workers with an SBC form to help individuals understand their options. This form explains what an employer’s plan covers and exactly what it costs employees. This includes breakdowns of specific costs, such as deductibles and out-of-pocket costs for varying medical events. The Department of Labor provides an online SBC template and other resources for any owners who provide health coverage.

    Tax Reporting Requirements For Small Business Health Insurance

    Offering comprehensive health coverage isn’t enough to meet your requirements. There are also certain tax reporting requirements that small business owners must follow if they decide to offer group health coverage. The following requirements include:

    What It Takes To Manage Healthcare Benefits

    In addition to following special requirements when offering healthcare, small business owners also need to consider how they’ll manage this new benefit. While employers can go through the Small Business Health Options Program (SHOP) to offer coverage for small groups, this means you’ll have to handle policy administration and health insurance billing.

    Fortunately, you don’t have to take on employee benefits administration alone. As a professional employer organization (PEO), GMS can leverage its buying power to procure quality group health insurance coverage with lower premiums than a small business would be able to obtain on its own. GMS also gives you access to trained benefits experts who can help small businesses stay compliant with any health insurance requirements.

    Looking to invest in health insurance for your small business? Contact GMS today to talk to one of our experts about how we can help you attract and retain quality employees through benefits administration and other services.

  • Health insurance comes with many responsibilities for small business owners. Regardless of whether you’re trying to cut health insurance costs or reward specific employees, you may wonder exactly how those responsibilities affect who you offer health insurance coverage. Can you pick and choose who can be a part of your health plan, or are there federal regulations involved? As you may expect, there are some rules you need to follow.

    Employees at a company that offers group health insurance coverage.

    Do I Have to Offer Health Insurance to Everyone?

    If you’re a small business owner, the answer depends on if you decide to offer health insurance to your employees. Businesses with fewer than 50 full-time employees aren’t required to offer health coverage, although many do because good health insurance is an attractive benefit for employees. Once you decide to offer health coverage, you must offer it to all full-time equivalent employees. As we noted in our post on small business health insurance requirements, full-time equivalent employees include those who meet “an average of 30 hours of service per week for a calendar month or at least 130 hours of service in a month.”

    It’s important to note that this means that you aren’t required to offer health coverage to part-time employees. You can choose to include part-time workers in your plan, but the setup is the same as it is with the full-time employees; if you offer coverage to one part-time worker, you will be required to offer it to all part-time workers.

    Benefits PDF

    Do I Have to Offer the Same Health Insurance to Everyone?

    While you can’t pick and choose which individual employees get health insurance and which don’t, you don’t necessarily have to offer all your workers the same level of health insurance. As an employer, you can offer varying levels of benefits based on employee-based classifications. These distinctions include:

    • Full-time vs. part-time (if part-time is even offered health coverage)
    • Different geographic locations
    • Date of hire or length or service
    • Job titles

    While you may be able to justify different levels of benefits through employee classifications, it can’t be for discriminatory reasons. It’s illegal to base decisions on benefits or other employment privileges on any factors protected by law. These include:

    • Race
    • Color
    • Sex
    • Religion
    • Health factors
    • National origin
    • Age
    • Disability
    • Genetic information

    Offer Group Health Insurance Coverage Through a PEO

    One of the reasons that small business owners are hesitant to invest in health insurance is that it can be expensive. Fortunately, a PEO can offer you a more cost-effective solution that can help attract and retain top talent. 

    Since Group Management Services represents multiple small businesses, we can leverage our buying power to get lower premiums on quality plans. Not only can we help you offer an attractive health insurance plan to your employees, we can also assist you with benefits management so that you get the most bang for your buck while helping you stay compliant. Contact GMS today to talk to one of our experts about how outsourcing payroll administration can benefit your business.