Every year business owners like you must contemplate what is the best approach to take for your business (and your employees) as it relates to offering Health Insurance and what is in the best interest of all - while also being a win-win to your bottom line.

Offering a Company Provided Group Health Insurance Plan to your employees? Considering it? Not offering Group Health and letting your employees “go it on their own”? If you are an employer with less than 50 Full Time Equivalent Employees it may be time to reconsider if ANY of these options are in your best interest. If you have not been following the news, recent changes to the Affordable Care Act implemented by the Biden Administration have substantially refreshed the Individual Health Insurance Market.

Here are a few key updates:

• The American Rescue Plan increased subsidy (premium) assistance for all Health Insurance Marketplace Participants effective April 1st, 2021. Over 75% of individuals that participate in the program now are eligible for a $0 Premium Plan!

• The Income “Cap” to qualify for Federal Subsidies is now eliminated for 2021 and 2022, and the amount that anyone pays in premiums will be limited to 8.5% of their household income. In laymen’s terms this essentially means that those who made “too much” money to qualify for subsidies in the past now qualify for substantial ones.

• The requirement for small employers (under 50 fte’s) to offer group health insurance is fully suspended, and legislation is in the works to eliminate the requirement for employers between 50 and 100 ee’s.

• In 2021 five Insurance Carriers participated in the NC Health Insurance Marketplace – big name, established carriers like BCBSNC, UnitedHealthcare, and Cigna. For 2022 (this fall’s open enrollment) there will be no less than EIGHT carriers participating. CVS Health is one of the new carriers entering the fray. In most counties that will translate to somewhere between 50 and 75 insurance plan choices!

Why am I telling you all of this? There is a smarter way to handle your benefits offering:

• Consider that the demographic of your employees (age, income, household size) in your industry makes them excellent candidates to qualify for very good Individual Health Insurance through the Marketplace at MINIMAL TO NO PREMIUM COST.

• Consider that many of your employees are opting out of your Group Health Plan (if your offer it) because of the premium costs (even if you just have them pay one half, or a third), it is still way more expensive than what they can obtain on their own through the Marketplace.

• Consider that if you offer a Group Health Plan you are probably only able to offer one plan option with one carrier. Meanwhile your employees could have the freedom of choosing between 50-75 plans offered by up to 8 carriers. What a difference!

• Consider that it your employees are “going it on their own” many are missing the opportunity to own health insurance because of lack of knowledge/help, which could be a liability to you later! Loan requests for medical bills, extended sick leave, and exaggerated workmen’s comp claims are just a few examples of the fallout to the employer.

• Consider that there are still creative ways to compensate or reimburse your employees for their Individual Health Insurance premium costs – if they have a premium – if you feel like you’d like to…

So what’s the alternative?

For 9 years, since the Affordable Care Act’s inception, my company has been assisting small employers like you (and your most important asset – your employees) with turn-key access and assistance with the Health Insurance Marketplace and the Insurance Plans offered there. Many companies like yours have used us to communicate to and enroll their employees in their Individual Health Insurance Plans at each Open Enrollment. Our FREE Assistance is YEAR ROUND. We become a fixture of support for each of your employees for all customer service needs and serve as a liaison between them, the Health Insurance Marketplace, and the Insurance Carrier.

And not only do we communicate and assist with the Health Insurance Enrollment, we help YOU with the messaging to your employees. We help them to understand all the positive reasons that you use the Health Insurance Marketplace rather than doing a group plan. We help them to see the BENEFIT of you offering them a professional point of contact to help them year round. We take care of your employees seamlessly for you (and usually remotely) with no disruption to your business.

And again, this service is completely FREE to you and FREE to your employees. We are compensated by the insurance carriers (with zero markup) in some form or fashion when an individual enrolls. Why have your employees navigate this on their own where mistakes are made, wrong plans are chosen, or better yet they get frustrated and quit?

A little more about me:

I have held my NC Insurance License for Life and Health since 2002. I carry Errors and Omissions Insurance but in my almost 20 years in business I have had ZERO complaints filed against me or my business. I have worked with fulfilling small business insurance needs for the same amount of time, and I have excellent references. I am also, of course, a certified Broker with the Health Insurance Marketplace, consistently ranked within the Circle of Champions for excellence in our work, and also part of the Marketplace’s Help on Demand Service. And finally, my company is appointed with every health insurance carrier that participates in the program. We cover the entire state of NC.

Also, I’m a really nice guy!

We help thousands of individuals each year with this process and we would love to help you and your employees. If you would like more information or to meet me in person to discuss the easy next steps so that we are ready to help your employees at Open Enrollment please give me a call or send me an email!

Sincerely, Don Hilke