If you work for a small business that does not offer health insurance, this column is for you. It falls under the “amazing but true” category: You can have a health insurance plan equal to the best offered in your state, at no cost to your boss, and on a pre-tax basis (meaning premiums are deductible) to you.
Best of all, this type of plan is available to businesses with as few as two employees — even if only one employee decides to get the insurance. So if the owner has Medicare, for example, the other full-time employee(s) can sign up for this full-benefit group plan, with almost no paperwork involved.
Why don’t you know about this opportunity? Because no one has an incentive to sell this plan! It’s a little noticed feature of the Affordable Care Act designed to encourage small businesses to provide health insurance. But because the insurance industry is focused on large companies (with big profits to be made), no one is reaching out to small businesses and their employees.
The time to start thinking about this coverage is now, before the year-end rush, when people typically begin to worry about health insurance for the following year. So, show this column to your boss if your company has fewer than 50 employees and doesn’t offer health insurance.
Every year a special enrollment period occurs between November 15 and December 15. During that period employers can establish job-based plans, effective January 1 of the following year. During that period, all insurance companies that are selling plans in your state, on or off the health care exchanges, must agree to accept all small businesses that apply for coverage.
The insurers are required to offer comparable coverage to these small businesses and their employees, meaning there will be a choice of physicians and hospitals in the plan, just as the large companies negotiate for their employees.
Here are the key factors that make this opportunity so attractive.
—No employer contribution is required. Employers can contribute as much or as little as they choose, even if that amount is zero, and the employee pays the premium.
—No employee participation is required. As few as just one employee can elect to have coverage and have policy issued. So, if a lower-paid worker finds a better deal with a subsidized ACA plan, he or she can opt out of paying for this coverage. And there is no employer penalty.
—There are no pre-existing condition limitations on policies issued.
—Employees electing to enroll in the plan can pay their portion of the premium, and other qualified out-of-pocket expenses, with pre-tax dollars with proper plan design. (As a side benefit for employers, since this is a pre-tax contribution for the employee, the employer pays less in payroll taxes.)
There is no “name” for this section of the law. It’s simply called the “small business special enrollment period.” As noted above, few health insurance brokers are out selling this great deal. It’s sort of an “inside insurance” secret.
Among those that do are the Vesta Benefits Group (www.vestabenefitsgroup.com) and eHealth (ehealthinsurance.com). A health plan is one of the most valuable benefits an employer can ever offer, notes Allen Wishner, CEO of Vesta. “Even the smallest company needs to compete for talent, and now they can do so affordably.”
Amid this national debate about healthcare coverage, millions of people who work for small businesses — and their families — are adrift in a sea of bad choices. They may earn too much to receive a subsidy on ACA policies, making insurance too costly. Now, the boss of every small business has a chance to be a hero — offering a full-coverage, deductible-premium group health insurance plan to every employee who wants it — at no cost to the company!
Yes, this is the one deal too good to be true — but it is true! And that’s the Savage Truth.