OPEN ENROLLMENT: WHAT SMALL BUSINESS OWNERS NEED TO KNOW

It’s been estimated that there are more than 5.7 million small-business employees or self-employed workers are enrolled in the Affordable Care Act (ACA) marketplaces. In addition, more than half of all ACA marketplace enrollees are small-business owners, self-employed individuals, or small-business employees.

This is an impressive number when you consider that small businesses, according to the ACA guidelines, are those firms employing less than 100 employees. States have had the option of limiting pools to companies with 50 or fewer employees, as California has done, for example.

The reason this is significant is that owners of businesses with less than 100 full-time equivalent employees (FTEs) are not required by the ACA to offer health insurance options to their workers.

And regardless of what definition one uses to define a “small business”, the fact is that they make up the bulk of all businesses in the United States. 

Yet tens of thousands of these enterprises do just that. And if you’re reading this article, odds are that you, too, provide employer-sponsored healthcare for your employees – or you’re considering it now.

OPEN ENROLLEMENT, SMALL GROUP HEALTH COVERAGE, AND THE ACA

You may be familiar with the concept of “open enrollment” for health insurance. According to one legal site,

“Open enrollment is the time of year when individuals and families can enroll in a health insurance plan for the next calendar year. This is the only time each year when current employees can make changes to their health insurance policy, unless they have a major life change (often called a qualifying life event or QLE).”

However, while your current employees must wait for the open enrollment period to make changes to their plans or sign up for the first time, most small business employers can begin offering health coverage plans any time of the year.

The HealthCare.gov website explains that the Small Business Health Options Program (SHOP) is for small employers who want to provide health and/or dental insurance to their employees. If eligible, owners do not have to wait for an Open Enrollment Period and can start offering SHOP coverage to their employees any time of year.

The SHOP option is available for small employers, generally those with 1 to 50 full-time and full-time equivalent employees.

The other option for small business owners looking to start offering health insurance for their workers is to work directly with an agent or broker. J.C. Lewis, for example, offers health insurance plans only from leading health insurance carriers. We are licensed and certified by each carrier to offer coverage to small group employers with 1 to 50 employees.

Open Enrollment 2022 – 2023

According to HealthCare.gov, Open Enrollment for 2023 begins November 1, 2022, and will end on January 15, 2023, in most states. Some states, such as California, typically have an extended end date. 

During this time, employees typically make any changes or choose to continue with their current plans. However, small businesses can enroll in health insurance at any time. Just keep in mind the benefits may start on the first or 15th of the following month for most insurance companies.

If you already have an existing small group health plan, this is the time to inform your employees of the upcoming open enrollment period.

In October, create employee packets with important information and notify employees to review packets and make selections
In November, remind employees to make selections
In December/January, submit paperwork to carriers

On January 1, 2023, all changes, additions, or deletions employees have made to their plans will typically go into effect.

SMALL GROUP HEALTH INSURANCE BENEFITS

Providing health insurance options for employees also provides benefits for the employer.

For example, small business owners who opt to buy SHOP plan may also be eligible for a health care tax credit. The maximum tax credit covers 50 percent of the premiums paid for health coverage. To be eligible, however, you must:

Have less than 25 full-time equivalent employees (FTE)
Pay an average wage of $56,000 per year or less per FTE
Offer a qualified SHOP plan to your employees
Pay 50% or more of costs of coverage (employee-only) for each employee

Another benefit for employers is obtaining affordable health coverage for both themselves and their families.

And providing affordable, quality healthcare insurance for employees results in a healthier workforce, less sick days, greater productivity, stronger employee retention, and a more competitive benefits package offering.

CALL J.C. LEWIS INSURANCE TO PLAN YOUR SMALL GROUP HEALTH INSURANCE

At J.C. Lewis Insurances Services, we understand that you want to provide your employees with the best benefits package that you can offer. But we also understand that there are many factors and considerations involved when choosing a health coverage plan.

As a family-owned and operated California health insurance agent licensed to do business in California, we specialize in medical insurance plans for small businesses and for Medicare supplemental and prescription drug plans for seniors.

We can tailor our recommendations to your particular needs since we are licensed with most major carriers in California. And, with J.C. Lewis Insurance Services, you save time and money, and we can quickly define your particular needs and recommend the best products and prices to meet those needs.

When you’re choosing medical insurance for you and your employees you are likely to have several questions and concerns. JC Lewis Insurance Services welcomes your questions about small group health coverage, and you can be confident that we will help you find the right solutions.