Small Business Health Insurance – An Employer’s Guide to Getting Small Business Health Insurance

Saving on your small business health insurance can be a challenge. But there are ways to overcome the financial obstacles and get the coverage necessary for your business. There are two major benefits of employer-based coverage. First these plans, although expensive, usually carry the best all around protection for you and your employees. Second, providing benefits plays a key role in attracting and retaining quality employees.

Why is coverage for small businesses so much more than for large corporations?

Health insurance for small businesses cost so much because of the high quality coverage concentrated among a small group of people. Every individual within the group represents a different level of financial risk to an insurance company, and this risk is added up and spread out among the group. Large corporations pay considerably less because the risk is spread to such a large group, where small business owners can see unreasonably high increases in premiums due to one or two members. Small businesses also have to insure their employees under state mandates, which can require the policies to cover some specific health conditions and treatments. Large corporations’ policies are under federal law, usually self-insured, and with fewer mandated benefits. The Erisa Act of 1974 officially exempted self-funded insurance policies from state mandates, lessening the financial burdens of larger firms.

Isn’t the Health Care Reform Bill going to fix this?

This remains to be seen. There will be benefits for small business owners in the form of insurance exchanges, pools, tax credits, subsidies etc. But you can’t rely on a bill that is still in the works, and you can’t wait for a bill where the policies set forth won’t take effect until about 2013. Additionally, the bill will help you with costs, but still won’t prevent those costs from continually rising. You, as a business owner, will need to be fully aware of what you can do to maintain your bottom line.

What can I do?

First you need to understand the plan options out there. So here they are.

PPO

A preferred provider option (PPO) is a plan where your insurance provider uses a network of doctors and specialists. Whoever provides your care will file the claim with your insurance provider, and you pay the co-pay.

Who am I allowed to visit?

Your provider will cover any visit to a doctor or specialist within their network. Any care you seek outside the network will not be covered. Unlike an HMO, you don’t have to get your chosen doctor registered or approved by your PPO provider. To find out which doctors are in your network, simply ask your doctor’s office or visit your insurance company’s website.

Where Can I Get it?

Most providers offer it as an option in your plan. Your employees will have the option to get it when they sign their employment paperwork. They generally decide on their elections during the open enrollment period, because altering the plan after this time period won’t be easy.

And Finally, What Does It Cover?

Any basic office visit, within the network that is, will be covered under the PPO insurance. There will be the standard co-pay, and dependent upon your particular plan, other types of care may be covered. The reimbursement for emergency room visits generally range from sixty to seventy percent of the total costs. And if it is necessary for you to be hospitalized, there could be a change in the reimbursement. Visits to specialists will be covered, but you will need a referral from your doctor, and the specialist must be within the network.

A PPO is an expensive, yet flexible option for your small business health insurance. It provides great coverage though, and you should inquire with your provider to find out how you can reduce the costs.

HMO (Health Maintenance Organization)

Health Maintenance Organizations (HMOs) are the most popular small business health insurance plans. Under an HMO plan you will have to register your primary care physician, as well as any referred specialists and physicians. Plan participants are free to choose specialists and medical groups as long as they are covered under the plan. And because HMOs are geographically driven, the options may be limited outside of a specific area.

Health maintenance organizations help to contain employer’s costs by using a wide variety of prevention methods like wellness programs, nurse hotlines, physicals, and baby-care to name a few. Placing a heavy emphasis on prevention cuts costs by stopping unnecessary visits and medical procedures.

When someone does fall ill, however, the insurance provider manages care by working with health care providers to figure out what procedures are necessary. Usually a patient will be required to have pre-certification for surgical procedures that aren’t considered essential, or that may be harmful.

HMOs are less expensive than PPOs, and this preventative approach to health care theoretically does keep costs down. The downside, however, is that employees may not pursue help when it is needed for fear of denial. That aside, it is a popular and affordable plan for your small business health insurance.

POS (Point of Service)

A Point of Service plan is a managed care insurance similar to both an HMO and a PPO. POS plans require members to pick a primary health care provider. In order to get reimbursed for out-of-network visits, you will need to have a referral from the primary provider. If you don’t, however, your reimbursement for the visit could be substantially less. Out-of-network visits will also require you to handle the paperwork, meaning submit the claim to the insurance provider.

POSs provide more freedom and flexibility than HMOs. But this increased freedom results in higher premiums. Also, this type of plan can put a strain on employee finances when non-network visits start to pile up. Assess your needs and weigh all your options before making a decision.

EPO

An Exclusive Provider Organization Plan is another network-based managed care plan. Members of this plan must choose from a health care provider within the network, but exceptions can be made due to medical emergencies. Like HMOs, EPOs focus on preventative care and healthy living. And price wise, they fall between HMOs and PPOs.

The differences between an EPO and the other two organization plans are small, but important. While certain HMO and PPO plans offer reimbursement for out-of-network usage, an EPO does not allow its members to file a claim for doctor visits out its network. EPO plans are more restrictive in this respect, but are also able to negotiate lower fees by guaranteeing health care providers that it’s members will use in-network doctors. These plans are also negotiated on a fee-for-services basis, whereas HMOs are on a per-person basis.

HSA (Health Savings Account)

An HSA is a tax-advantaged account used to pay existing and future medical expenses. HSAs are used in conjunction with high-deductible health plans (HDHP), which will make some with pre-existing conditions ineligible. Also, HSAs must be funded with cash. Communicating the terms of this account to your employees is important, as a large number of HSAs are underfunded or improperly funded. The health savings accounts were signed into the law by George Bush in 2003, and have become an affordable alternative to a group health plan.

When inquiring about an HSA, there will be a few things you will want to clarify. While HSAs generally cover routine medical expenses and copays, some can provide dental and vision care as well. And since HSAs can be combined with certain compatible plans, it is important to understand how money from the account will be allocated. And finally, you will want to know about cashing out your HSA balance. The amount is taxable and could be subject to a ten percent excise tax.

HRA (Health Reimbursement Arrangement)

An HRA is exactly what it sounds like. The employer reimburses the employee for health care. As an employer, you will usually have the option to contribute to a reimbursement fund, or to pay fees as they are incurred. These reimbursements can be deducted from your taxes, and are tax-free for your employees, saving you both money.

Some providers empower employers by giving them more options. HRAs, unlike HSAs, don’t have to be funded with cash money, placing a book keeping entry on your balance sheet is enough. You can usually control aspects of your arrangement such as reimbursement limits, whether you or your employee pays first, and if the previous year’s funds roll over.

HRAs are becoming a more popular option because of the control it has given small businesses. Combined with a high deductible health plan (HDHP), an HRA could be the most cost-effective solution to your small business health insurance problems. It’s always best to compare these plans to PPOs, HMOs, and EPOs to know what works best.

Fee for Service (FFS) or Traditional Indemnity

A fee for service plan is the most flexible small business health insurance option. You choose your doctor, and your hospital. You can see a specialist without a referral. This flexibility, however, comes with more out-of-pocket expenses and higher insurance premiums.

The typical FFS plan has a deductible ranging anywhere from five to fifteen hundred dollars. After this amount is reached, the provider will pick up eighty percent of your medical bills, and require you to pay the remaining twenty percent. Because of the rising costs of health care, and the potential for a small number of doctor’s visits to cost thousands, these plans can become incredibly expensive.

Flexible Spending Account (FSA)

A flexible spending account is a savings account to be used for medical expenses, and is funded by pre-tax dollars. Using pre-tax dollars means that your employees will actually show that they have less income, and will therefore have less taxes withheld. As an employer, you set the limit on contributions to the account per year. In addition to the employee contribution, you can also credit the account, or fund it completely from your general assets.

An FSA, especially if combined with an HDHP, can significantly reduce the costs of small business health insurance.

You should be forewarned, money from FSA accounts cannot be rolled over. They are, however, available to use for two years and two and half months after the benefit year. A terminated employee won’t be able to use leftover funds, unless there is a positive remaining balance and COBRA is elected.

Small business health insurance providers have made significant improvements in their services to simplify the administration of your plan. With HRAs, FSAs, and HSAs, your employees can use debit cards for medical transactions. Be sure to research this thoroughly. You will want to be sure your debit card plan is IRS compliant, and that you can use a large number of pharmacies. You should also pick a plan that can verify eligibility on the spot. Talk with your agent about linking transit, parking fees, and prescriptions to the same card. When picking the debit card options, please be sure to clarify the details of the substantion process. This is IMPORTANT! With other plans, the provider may assign someone to manage your plan. Or you may have to hire someone. Still, you should be able to login to your account and print insurance cards, important papers etc.

The next thing you can do is thoroughly assess your needs. Being that every member of your small business plays a key role in its success, it is vital that their needs are met. And understanding these needs is crucial to finding the right plan. Find out about chronic illnesses, and additional information related to past health issues. Know what your employees think about health insurance, and get them involved in the process.

Hiring an agent or a broker

Finding and understanding small business health insurance can be a daunting task. While some choose to go it alone, others need some professional assistance. You need to understand the difference between an agent and a broker, and how you can get the most from either of them.

A broker

Brokers function independently and usually work for several different companies. Since they have a variety of resources, they can usually provide more options and a better overall view of the marketplace. Brokers will assist you by evaluating the costs and designs of plans from your local major carriers. The cost isn’t everything, you want to get the coverage that you need.

Ask the broker how he or she is getting paid for their services. They should readily divulge that information. Some brokers may charge you a flat free. Some receive a fee from an employer, while others receive a commission from the insurance provider. Any commissions could be reflected in your premiums, but not to the point that you should worry.

An agent

Agents typically provide services for one company. They have a closer relationship to the insurance company than a broker would, giving them more leverage to make alterations to your plan. In some cases they can offer a particular plan for less than a broker, and may have access to additional services like worker’s compensation. To find out what different providers have to offer, talk to more than one agent. It may be time-consuming, but it could bring you closer to the most cost-effective solution for your small business health insurance.

One of the common options presented by agents is the employee-elect option. This is an arrangement where employees pick the plan they prefer. Those who don’t need as much coverage won’t be forced to pay so much, and those who do need it can get it without increasing the financial burden of the company as a whole.

How to Save On Your Small Business Health Insurance Plan

What’s important to remember is that there really is no inexpensive solution to health care. Even if your initial premiums are reasonably low, they could rise significantly at your next renewal. So saving money on small business health insurance is about doing a combination of things simultaneously to get good rates, and to then maintain those rates.. And it will require a consistent effort from you, your employees, and your insurance provider.

First, you can save yourself money by reading the fine print. You need to know exactly what your plan does and DOESN’T cover. There are also state mandated coverages. For example, in states like Illinois, your insurance must cover mammograms. Also, understanding the ins and outs of your plan will give you and your employees a better idea of how to deal with your insurance.

Next, you should shave unnecessary benefits. After reading all about your plan, you will find coverage for things you may not need. Eliminating these benefits can significantly drop monthly small business health insurance premiums. For example, eliminating coverage for brand name medications can reduce costs by more than 25 percent.

Wellness program have worked wonders for small businesses. A wellness program is any program designed to promote healthy living within the organization. Weight loss competitions benefit every participant. Add a financial incentive for further motivation. Stock the work fridge with water, and leave literature about healthy living lying around. Search the internet for calorie counting charts. Raising awareness entice workers to make positive changes. Active, exercising, diet-conscious employees have stronger immune systems, more vitality, and more productive workplaces. They also don’t deal with as many health issues. Fewer doctor visits and hospitilizations will help maintain lower annual premiums, because it will prove to your insurance provider that your business is a low financial risk.

Increasing your co-pay and deductible can go a long way towards cutting costs. For instance, raising co-pays by just ten dollars has saved companies as much as thirteen percent on their premiums. A higher deductible will significantly reduce your monthly premium. To lessen the financial burden of high-deductible health plans (HDHPs), combine them with an HSA. Combinations like these have saved both business owners and employees bundles of cash.

Check into getting a nurse hotline. A nurse hotline is a toll free, 24-hour-a-day, seven-day-a-week service. Employees can get medical advice from qualified, registered nurses. This method has deterred a large number of people from emergency visits, and it can also be used for preventative care as well. Insurers like Nationwide have them, or you may have to purchase from a third-party provider.

Increase the size of your group to reduce your monthly small business health insurance premiums. In a survey by America’s Health Insurance Plans, small businesses who employed ten people or less paid forty three more dollars on average than businesses with twenty six to fifty employees. Check around with other businesses owners, or fellow members of business organizations. Some states also have small business groups and pools for this purpose. Check with your state Chamber of Commerce and Department of Insurance.

Beware of heavily discounted plans. First, there are numerous scammers trying to get your money. They promise low rates, and usually cover little to nothing at all. The internet is notorious for swindlers trying to hustle you out of a buck. If you are going with a company you aren’t familiar with, please do your research. On another note, even reputable companies present problems. In an attempt to gain market share, Blue Cross offered small businesses discounted rates in 2008. For 2009, some of these same businesses were set to see increases of as much as 47% in their premiums. As the costs of medical care increases, the costs are shifted from the insurer to the insured, and discount plans become overpriced plans quickly.

Shop around. As mentioned before, talking to different agents will expose you to the best that insurance providers have to offer. Ask other small business owners about their providers. You can use trusted online resources like Netquote and Ehealthinsurance to shop around instantly. These services also let you compare plans side by side, and allow you to purchase your plan online. Even after you get your initial plan, it’s good to annually reevaluate your coverage. This will keep you on the up-and-up about what the market is offering. Keeping costs down is an ongoing effort, especially with rates and plans changing all the time from company to company.

Share some of the costs with your employees. Raising employee contributions isn’t a popular option, but it may be one of the only ways to absorb costs and maintain small business health insurance coverage. Communicate with your employees about how to keep costs down, and remind them that their increase is your increase as well.

The sad truth is that, no matter how many cost-cutting methods you apply, your insurance premiums are expected to continually rise. In addition to this, you can’t prevent every health problem with exercise and higher co-pays.

The Health Care Reform Bill won’t kick in until about 2013, so waiting on its benefits won’t do you any good. There is definitely a need for change, because the current system discourages competition and growth. With smaller businesses functioning as the backbone of this ailing economy, company medical insurance must BE affordable, and STAY affordable.

Success Strategy of Bill Gates As Small Business Entrepreneur For Your Own Home Business

Introduction

Strategies are strategies. Dismiss for a moment from your mind what some people are saying about Bill Gates’s offensive practices he used to transform himself from a small business entrepreneur to a titan in the business world. There are yet honest-to-goodness strategies we can glean from his sleeves. We can study, learn from them and possibly apply them in our own home based business. Upon this premise that this article was written.

Strategy of Bill Gates – Have a Vision

At the outset, I will lay down the results of my research on one secret strategy of Bill Gates. He used the same strategy to jump-start his small business to today’s business behemoth. Based on my research, the strategy of Bill Gates is grounded upon the following:

“Have a VISION of what you want to achieve
and hold on to that vision come wrath or
high water.”

His vision was:

“A Personal Computer on every desk.”

By the way, I didn’t want to use the grammatically correct expression “come hell or high water” – for personal reason – so excuse my grammatical preference. Anyway, let’s go back to our subject. When you have a vision, you can make the impossible possible.

Almost everybody is familiar about how once upon a time the small business entrepreneur Bill Gates secured mighty IBM’s contract to supply the latter’s operating system. When he was negotiating with the IBM people, he had no operating system as yet. He was able to buy a Disk Operating System or DOS for $50 thousand. In the end, he got the contract. Why?

Bill Gates was guided by his vision – that every desk all over the world should have a computer on it. This vision enabled him to provide IBM with a DOS operating system and have control over it including to whom he wanted it sold to.

Beginning Entrepreneur

Before he became an entrepreneur, Bill Gates had nurtured the vision that software will one day rule the world. During high school he spent many late nights with friend Paul Allen tinkering with the school’s computer system.

He dropped out of college after completing his junior year at Harvard. Instead, he and his bosom friend Paul Allen set up a small business – a software company – in far away New Mexico. This move was in accordance with his vision.

His vision became clearer as he moved from a total newbie to one with a small business to keep. His vision was clothed in clearer terms, as he negotiated the DOS deal with IBM.

Better late than never

Bill Gates’s company ultimately became the leader in the software arena. During the first half of the 1990’s – 1993 to be exact – he was among the last of the software titans to acknowledge the future significance of the Internet.

But once he did realize that indeed Internet was the wave of the future, he had the tenacity to reshape his vision. His vision retained its old flavor – that is, software dominance in commerce, industry and in every field. It was rehashed in his own words as follows:

“In the years ahead, the Internet will have
an even more profound effect on the way
we work, live and learn … this technology
will be one of the key cultural and economic
forces of the early 21st century.”

At this moment in time, Bill Gates is guided by the vision that the Internet is the wave of the present and the foreseeable future.

Lessons Learned

You can learn from Bill Gates by having your own vision for your small business. Lay down this vision in your mind. Then put it into writing. Read your vision everyday while at work in your small corner of the house. Your vision could be as short-term as the following:

“To make my web site land within the top five of
Google when people search for the keywords
‘home based business,'” or

“$200,000 earning this year from Google
Adsense,”or

“To enrich the content of my web site using
the theme ‘scrap book making.'”

Do not limit yourself to short-term vision. Aim for the long-term. A five to ten years period would suffice. Technology may change but your vision will essentially be the same. You may refine it if deemed necessary, like incorporating the effect of technological changes – as Bill Gates did.

Your Share of the Pie

Everybody – from Bill Gates down to your netpreneur friend – has recognized the tremendous role of the Internet in business developments. Some of the more immediate pressing concerns you should consider at this stage concerning your home based business are the following:

– General preference for digital transactions by clients. For example, as a beginning Internet entrepreneur you should meet your clients’ demands who favor the use of online payment system.

At this juncture, I would like to refer you to my web site at http://www.InternetMarketingLearningCenter.com which offers free learning stuff on Internet marketing and home based business. One category being tackled in the web site is the online payment system. You may read online news and keep yourself abreast of the best software companion for your small business.

– Choose products that are preferred by people at this time when the Internet is dominating people’s lives. It has been determined that information products and web shopping are favored by most consumers. Information products include your very own ebooks and “how-to” manuals.

– Make it your aim that your products are cheap, very useful, and the best among the rest of competing products. This applies most especially to shopping products. For your own digital products, you have the advantage of pricing them according to your own estimation.

You as the author of your own digital product determines the price level. It is no wonder why gurus like Jay Abraham, Jim Daniels and the late Corey Rudl have become so wealthy from selling their own digital pieces.

As for these three gurus, they will be among the titans that we will tackle in future issues of this series.

(c) 2005 Rick Tanzo. Reprint rights granted so long as article, by-line and active links are reproduced intact.

7 Tips For Selecting the Best Small Business Brokers to Sell Your Business

Are you thinking about selling your business? Have you ever gone through the process before? Are you confidant that you can do it yourself? Where would your time be better spent, running your business at peak performance while trying to sell it, or focused on the advertising campaign, networking, negotiating, and coordinating the closure of the sale of your business? Maybe you should consider doing what you do best, running the business, and search out small business brokers and let them do what they do best, sell businesses. If you go that route, here are 7 tips to choosing a business broker that makes sense for you.

1. Don’t get lost in the shuffle

You want your broker to have a proven record and a great reputation but you don’t want the organization to be so big that your deal is passed off to a junior staffer. You want the active involvement of the principals.

2. Do your due diligence

You’re about to engage the services of someone that is going to have a big impact on your financial life. Make sure you are comfortable with the relationship. Check with the International Business Brokers Association and see if your broker is a member in good standing. Follow up on the references provided and determine just how satisfied past clients are. Check with your local better business bureau and see if there are any unresolved complaints.

3. Use a specialist

Real estate agents and other professionals sometimes hold themselves out as business brokers on a part time basis. You want someone who makes their entire living selling businesses full time. Preferably somebody who has experience in your particular industry and someone who can point to successful sales they have made for your competitors.

4. Avoid heavy up front fee structures

Typically a business broker will charge between 10% and 15% of the sale price as a fee. While it is customary for them to ask for some up front fees to initiate the process, avoid those brokers who are looking for greater than a third. Also make sure that the up front fee is deductible from the sales fee when the business sells. Following this advice will save you from having to invest a ton of cash before you actually sell the business.

5. Only contract for the business selling services

Smaller business brokers will offer accounting and legal services that you will need during closing for an additional fee and these services are typically outsourced by the broker. It may be to your advantage to contract for those services directly leaving the broker with only the requirement to focus on the selling process and not generating add on fees.

6. Share your expectations

Before you select a broker you should have at least a general idea of what you want to accomplish by selling your business. You should have a rough valuation number and you should know if you want a cash sale or stock. Share this with the broker and see if he agrees with your plan. While there probably will be differences in valuation, your broker should be in tune with the rest of your objectives. If he’s reluctant or believes that it will be difficult to achieve your goals, find another broker.

7. Keep the whole process confidential

The last thing you want to do is let the word that you are seeking a business broker or that you are in negotiations with a buyer leak out. Once it becomes common knowledge that you are selling, your relationships with your employees, customers, vendors and bankers could be adversely affected. Have an exit plan for after the sale that includes sharing the news with all those listed above.

Using business brokers to help sell a business is usually the smart route to take for any business of substance. You want your organization to have as much “curb appeal” as possible during the process and that means you should be focusing your time on optimizing the business not chasing down buyers.

Is Going Direct Really Cheaper Than A Broker Or Price Comparison For Small Business Insurance?

The UK media is currently awash with advertising slogans from direct commercial insurance companies targeting small business owners in an attempt to make them switch their provider of business insurance.

‘Get 12 months cover for the price of ten’ and ‘You won’t find us on price comparison websites’ are typical of the slogans emanating from these companies, in a language more akin to the selling of car insurance than the traditional professional and almost stoic approach to the selling of business insurance cover.

In the current recession, price has become the determining factor in winning the war of market share for all goods and services and insurance is no exception. Prudent small businessmen and women are looking to cut costs in all areas of their business and the large direct insurance companies are well aware of this.

The large insurers are also aware that the UK market has over five million small businesses of which a fifth are sole traders, self-employed and people working from home, many of whom are familiar with purchasing their personal insurance direct with the provider, either by phone or on the Internet.

There are three types of provider in the current market for business insurance in the UK.

Intermediaries such as insurance brokers and agents, price comparison sites and direct commercial and business insurers.

Each has their own advantage and disadvantages, however whether one distribution channel is cheaper than another is often a subjective view from a particular trade, or dependent upon factors many of which cannot be quantified in price.

Direct Insurance companies claim to be able to offer cheaper polices because the cut out the costs of the middleman. It is certainly true that direct insurers do not have to pay an intermediary for the cost of the lead or introduction, however it is questionable whether this cost saving is actually reflected in the prices offered to the public.

Certainly there are economies of scale to be made by centralising the life-cycle of a policy from sales point to claim and renewal, however all those functions that are performed by an intermediary still have to be carried out in-house by the direct company and these have a cost.

Many large composite insurers often have distinct direct divisions with their own target market and premium rates. The same company may also have a broker or intermediary division or channel.

It is quite often the case that a large broker with a large book of business of, for example, small builders liability, will receive much more preferential rates then the same companies direct channel, because that insurance company wishes to retain that brokers clients.

Commercial Insurance brokers then are often able to offer preferential rates because they have more flexible schemes and arrangements than the direct channel.

One of the main benefits of using an insurance broker or intermediary in purchasing commercial insurance for small business, cannot be quantified in price and is worth the commission or fee that they may charge. That is advice, market and product information and knowledge, access to various markets such as Lloyds and some human help if the worst happens to a business and a claim is needed.

A commercial or business insurance broker is often able to negotiate far better claims settlements than if an individual were to deal direct with the insurer. The main reason for this is once again the insurer wishes to retain that brokers share of the total risk pool and will often pay out to a broker on an ex-gratia basis. This cost of this service is not quantifiable at the quote stage where small business cover may well just be valued for the price paid or the covers bought.

The third major way in which small business owners can purchase cover is by visiting a price comparison website. All the major UK comparison sites have recently begun to offer online cover aimed particularly at the small business sector, with under 50 employees. This is in direct competition with the direct insurers for television and media advertising space, aimed in particular at self-employed tradesmen and women who require business liability insurance and perhaps commercial van cover.

The comparison price proposition is that they can compare the market or at least a small section of it, to find the cheapest business insurance. They often do not provide any assistance in the purchasing decision-making process and the reality often is, that the cheapest commercial and small business insurance can be found in one of the other distribution channels.

It is therefore important that a small businessman shops around and takes some time to compare offerings including premiums, covers and services from all three sales channels. Prices tend to vary immensely by trade across the direct, broker and comparison markets and often it is a case of finding the provider or supplier who is the industry leader for a particular business type or trade in order to make large savings.