Health Insurance

December 11, 2017
Group Health Insurance

Need A New Group Health Insurance Plan on 1/1/18? Start Now!

Business owners who have not offered their employees health insurance benefits in the past may have good reason to do so now. The individual health insurance market in Indiana is in shambles, making it difficult for everyone seeking coverage to find an affordable quality plan. Group health insurance plans are not just for large organizations anymore. If you are a business owner looking for coverage for yourself and your family, you may want to consider implementing a group plan for your company. It may end up costing you the same for better coverage and happy employees. However, the time to act is now. With the year quickly coming to a close, there is little time to get a group health insurance plan in place by 1/1/2018. Below we offer some steps you can take to streamline the process to help ensure your coverage begins when you need it. Step 1: Contact an independent health insurance broker to begin the process of searching for coverage. Because they do not work for just one insurer, independent brokers like Wharton Insurance & Financial Services can shop around for plan choices that match your budget and needs. Depending upon the makeup of your employee base, your broker will direct you to either community-rated plans under the Affordable Care Act, or medically underwritten plan options. Step 2: Community-Rated Plans – Gather census info for your employees, such as gender and age. No medical information is required at this time, which works well for companies who do not have a healthy workforce. While that can be difficult to determine, usually the age and lifestyle of your employees can give you a clue about their health. This information will be used to help determine which plan best suits you and your employees. Medically Underwritten Plans – These plans are based on the medical risks shouldered by the insurer by covering your group. Therefore, medical information must be collected. Your broker will direct you and your employees to a portal where each person can supply their information privately. The data is not shared with anyone but the insurer, who will determine your plan choices and premiums. There are preferred rates for healthy groups, so if you have a young, active employee base, these plans may offer the best options. Step 3: Plan to meet with your broker to review your options, choose a plan, and schedule employee enrollment meetings. At Wharton Insurance, we meet with all of our clients’ employees to ensure they understand their options, coverage and premiums. We want them to feel confident in signing up for and using the plan you have chosen for them. Time is running out to offer you and your employees group health insurance by January 1! For more information on how Wharton Insurance can help, send us an email, or give us a call at 317-663-4138.    
December 1, 2017
open enrollment

Managing Open Enrollment for Your 2018 Health Insurance Coverage

Whether you receive health benefits from your job, the marketplace or an association, you have probably been hearing a lot of urgent messages about open enrollment. It is this time of year where individuals and businesses alike have to make important decisions about their health insurance coverage. It is also the only opportunity to make changes to your plans without a qualifying event. Below we offer some items to consider as you make your way through open enrollment for your 2018 health insurance coverage. Individuals: With the Affordable Care Act in disarray, Indiana residents who were relying on the heath insurance marketplace for coverage are having to look for other options. Many have received notification from their 2017 insurer of a discontinuation of coverage. There is still one option for individual policies in Indiana’s health insurance exchange though AmBetter. We suggest you begin your search by assessing your current plan and looking for a new policy that will offer you the same or better coverage. Be prepared to provide employment, gender, home county and smoker status information to obtain a quote. Also be careful to note deadlines to sign up and when coverage will begin. Employees: Your employer received rate increases and plan changes in early fall and may have faced some hard decisions about the bottom line impact of offering health benefits. Open enrollment is the time where employees may have to make some decisions as well. It is important to read through information provided and to take advantage of any information sessions or assistance by the insurer. At Wharton Insurance and Financial Services (WIFS), we hold open enrollment meetings for all of our clients’ employees to ensure everyone understands the plans and what changes can be made. It may be that you will have to assess which offered plan works for you and your family in 2018, or you may have new circumstances that need to be addressed. Even if you have no personal changes, we suggest you review your company plans carefully so you will know what to expect for the coming year. Association Members: Many associations offer access to health insurance coverage as a benefit to membership. Similar to companies, these organizations have an open enrollment period to allow participants to assess their plan choices and costs, as well as account for life changes. This time of year is also when new members may enroll, so if you are looking for health coverage, it may be worthwhile to investigate membership in an applicable local association. For example, WIFS manages the health insurance plan for the Builder’s Association of Indianapolis, an organization focused on the local home improvement sector. It may be that your work or other affiliations could help provide you with quality health insurance coverage. Wharton Insurance and Financial Services has helped individuals, businesses and associations work their way throughout the rapidly changing world that is health insurance. If you have questions or are looking for coverage for yourself or your employees, send us an […]
November 2, 2017
employee health insurance

My Employees and I Are Losing Individual Health Coverage. What Are My Options?

With the demise of the individual health insurance market in Indiana, many small business owners are losing their health insurance right along with their employees. If you were relying on the ACA Exchange to cover you and your employees, you are well aware that option is now questionable. With your employees scrambling, you risk losing your workers to competitors by not offering health benefits. Besides, you and your family need them too! BAGI Group Health Insurance Plan As a BAGI contractor member in good standing, your company may be eligible to participate in the BAGI Group Health Insurance Plan. By pooling the employees from each member company into the coverage, the BAGI plan is able to offer large-company benefits to small businesses. Brokered by BAGI member Scott Wharton, and managed by Anthem, participants have 12 plan choices from benefit-rich and low out-of-pocket options, all the way up to plans with the maximum-allowed federal out-of-pocket limits. With BAGI’s program, you and your employees get affordability, quality and choice in their health insurance coverage. Small Employer Case Study Wharton Insurance had a small business owner reach out to them because she was losing her individual health insurance. She had not offered an employee plan in the past and was paying $12,000 a year out of pocket just to cover herself on the individual market. The Wharton Team suggested she look at offering a group plan that would include coverage for herself and her employees. The price tag could be the same for better coverage, and she would get the added bonus of making her employees happy. The BAGI plan could provide the same benefit to your company. Take Action Before It Is Too Late Open enrollment started November 1 for AmBetter, the only Affordable Care Act (ACA) approved individual plan available in our state. For many people, that lack of competition could mean lower-quality benefits for higher costs. Fortunately, there are other options if you are a business owner interested in providing coverage to your employees as well as yourself. However, you must act before the December 15th deadline to ensure coverage beginning January 1, 2018! As long as you have 2 or more employees, the BAGI plan may be the right choice for your business. As an independent insurance broker, Scott can also look into other options if the BAGI plan does not fit your situation. There is no cost to explore your options and it only takes about a day to complete. For more information about how you can find the coverage you need and offer your employees the health benefits they are looking for, email Scott or give him a call at 317.663.4138.      
October 26, 2017
Employee Health Benefits

Your Employees Want Health Insurance. There Are Ways to Give It to Them.

Are you like many other Indiana employers who are struggling with attracting and retaining employees? The corrosion of the individual healthcare market coupled with low unemployment means that one way to deal with this issue is to offer group health insurance. However, smaller businesses do not always feel they have the resources to compete on that level. Below, we offer two case studies on how we were able to offer our businesses clients affordable and high-quality options to help them achieve that goal. Case #1: Small Business Owner Needs Individual Coverage A small business owner with five employees had not previously offered a group health plan and was not sure she wanted to move in that direction. She had been paying $12,000 a year out of pocket just to cover herself on the individual market. The current dearth of individual plan options led her to us for help. We suggested that she explore a community-rated group plan, where she would be covered as well as her employees. The price tag could be the same for better coverage, and she would get the added bonus of making her employees happy. With Wharton Insurance, there is no charge to explore your options with us and it only takes about a day to complete. The final result could end up serving your needs better! Case #2: Manufacturing Company Needs to Compete for Employees A manufacturing company in Indiana came to us exasperated with the current state of their human resources activities. With 130 employees operating in five states, they did not have the formal HR structure that size of organization needs—they did not even have an employee handbook. In addition, they were struggling with attracting and retaining employees because of their current health insurance plan. Offering a competitive plan with multiple choices had been a problem, and they needed to figure out an option that would allow them to challenge the larger competitors attracting their workforce. WorkSmart Solutions, an Indiana-based Professional Employer Organization or PEO, was the best solution for their issues. PEOs allow small businesses to work like Fortune 500 organizations through the power of pooling. Their employees join the over 7,000 others managed under the PEO umbrella, allowing the business to offer their employees a rich benefit package with many plan choices. The HR Admin services included with PEO partnership also helped the management team get their HR needs under control. Health insurance is not what it used to be. If it has been a while since you explored your options, you may be surprised by what is possible. The Wharton Insurance Team would be happy to help. Send us an email, or give us a call at 317.663.4138.  
October 11, 2017
BAGI group health

Health Insurance Options for Small Business Owners

With the largest providers of individual health insurance coverage in Indiana pulling out of the Affordable Care Act exchanges, business owners are scrambling. Not only are they at risk of losing their employees to competitors that offer group health plans, they are losing their own coverage too. As a small employer, you may feel there are just too many barriers to offering an affordable employee health insurance plan yourself. Too few employees, high costs and poor risk ratings are the top three worries, all of which most likely can be overcome because you are a member of the Builder’s Association of Greater Indianapolis or BAGI. BAGI offers a group health insurance plan to its members which focuses on providing a quality option to small businesses. Too Few Employees to Qualify If you are like many BAGI members looking for health insurance options, you are the owner of a small, closely held business. The BAGI plan has been crafted to allow for a group health plan to be written just for a business owner and his/her spouse, as long as they are both covered and both are 30+ hours per week employees. So, two employees, including yourself, is enough to qualify for the BAGI plan. Insurmountable Costs The key to assessing the cost of group health insurance is to consider the amount you have to pay, not the set premiums. As an employer, you only have to pay 50% of the premium for your employee to be competitive—not the full amount for the individual or any part of family coverage. Offering access to an individual plan with or without family coverage is what is essential, not necessarily paying for all of it. Another idea to consider is that if you need to purchase health insurance for yourself, implementing a group plan could reduce your personal premiums. If health insurance is going to be an expense for your business anyway, it makes sense to make the most of the line item. Poor Health Risk Ratings The first step in offering an employee group health insurance is the underwriting process to assess your group’s risk factor score, which determines the level of premium you will pay regardless of the plan you choose. For employers with healthy employees, this step is easy. However, if your workforce has medical issues, worry sets in. Fortunately, Scott Wharton of Wharton Insurance & Financial Services, who manages the BAGI plan, can look at other options in the brokered group marketplace if the BAGI plan is not favorable to your situation. Knowing that there are other options available should alleviate the angst associated with the underwriting process. The BAGI Group Health Insurance Plan BAGI’s group health insurance is implemented by Anthem, who has a lot of experience with providing association-based plans within multiple industries. They understand our local marketplace and have structured the program to serve BAGI members well. There are 12 coverage options to choose from, all of which allow you and your employees to use local doctors […]
September 27, 2017
employee health insurance

Don’t Lose Your Workforce Over Employee Health Insurance Benefits

The individual health insurance market has essentially collapsed in Indiana. With the largest insurers no longer participating in the exchange set up under the Affordable Care Act, people without access to a group plan through an employer find themselves in a difficult place. If you are a business owner who relied on grossing up wages to help your employees purchase their own quality health insurance plans, it is important to know what they no longer have that option. Your business is now at risk of losing employees to competitors that provide health benefits. Fortunately, there is another employee health insurance option available to small businesses. Organizations classified as MEWAs, or Multiple Employer Welfare Arrangements, have always been exempt from the ACA and therefore exist outside of the exchange. This exemption allows Professional Employer Organizations (PEOs) like Indiana-based WorkSmart Systems to offer private group health insurance plans to its members. Partnering with a PEO allows small businesses to harness the power of pooling, by joining their employees with those of the other PEO members. Being a part of this larger group affords your employees the health benefits of a Fortune 500 firm at a reasonable cost. It may be that you were relying on the individual market for your health insurance as well and are now looking at your options. If you have at least five full-time employees, including yourself, WorkSmart is an option for your business. However, don’t let that number scare you off if it appears that you have fewer FTEs. There may be relationships within your business that qualify as employees that you have not considered. At Worksmart we can help you clearly define your workforce, which may open up the opportunity for PEO membership. While the fate of the individual health insurance market is uncertain, the fact is that you still need to run your business. Now more than ever, offering employee health insurance is a key factor in attracting and retaining a quality workforce. WorkSmart serves as the co-employer for over 7,000 Indiana employees, and medically underwrites their health insurance plan offering multiple benefit options. Their self-funded, trust-based model has allowed them to craft a balanced health benefits program that can help protect their partners from the policies coming out of Washington, today and beyond. To discover whether your business qualifies to participate in a PEO, send me an email or give me a call at 317.663.4138.    
December 6, 2016
heath insurance

Renewal Dates Are Approaching: 2017 Individual Health Insurance Options

While the majority of the US population has health coverage through their employer, there are still many people who look to the private insurance market or the Affordable Care Act exchanges for their individual health insurance. Unfortunately, those people are facing premium rate increases of over 20%, with most of our clients falling into the 25-28% range. The affordability that was meant to follow the ACA is under question and predictions from the recent election tell of changes to come. In the meantime, the ACA is still law and individuals are still required to have health care in 2017. With renewal dates coming up quickly, the Wharton Insurance Team is working diligently to find more affordable options for our clients. 2017 Individual Health Insurance Options: 1) Change Your Provider – If you are currently covered under an ACA health insurance exchange plan, it may be worthwhile to check out your options with an off-exchange insurance provider such as Anthem, IU or United Healthcare. On the other hand, if you already have a private plan, taking a look at ACA exchange plans may be worthwhile. Your insurance broker will be able to help you compare the benefits and premiums of all of your options to get you the best coverage for the price. 2) Reduce your Benefits – Regardless of whether you have an on- or off-exchange plan, another way to reduce your premiums is to reduce your benefits. Raising your deductible, out of pocket fees or co-insurance percentages can help you save on monthly premiums. You will want to consider the overall costs when making this assessment, as reducing your benefits may end up costing you more in the long run if you end up fully using your health insurance due to an unexpected illness. 3) Consider Short-term Major Medical Plans – Commonly referred to as catastrophic coverage, short-term major medical plans are a good stopgap option between your COBRA running out and signing up for a group health plan with an employer. The catch is that under the ACA, these plans are set to be banned beginning in 2017. However, it is unclear if that portion of the law will be enforced. Short-term major medical does not count as insurance coverage under the ACA, so you will be required to pay a fine at tax time. However, the total cost of the plan plus the fine may still be less than supporting a full insurance plan. 4) Decline Coverage – An available option we do not like to see anyone take is to go without health insurance. Under the ACA, you will be required to pay the fine for lack of coverage; however, it could be less costly than plan premiums—as long as you do not get sick! 5) Move to a Group Plan – If you are a business owner, as long as you have two FTE employees working a minimum of 30 hours per week, you are eligible for group health insurance plans. Historically, the premiums have […]
October 7, 2015
COBRA coverage options

Using COBRA? Employer Health Insurance Renewal Time Affects Your Premiums Too!

If you are currently on a COBRA plan through your previous employer, group health insurance renewal season is an important time for you too. The choices the company makes in regard to their group benefits plan will affect how much you are paying for your coverage too! These renewal periods offer you the opportunity to shop for other insurance options. COBRA plans are not usually the best option for health insurance because they: Offer limited plan options based upon generalized needs of the employee base and the company rather than the individual, Tend to be very expensive because the premiums are no longer subsidized by the employer, and COBRA coverage is usually chosen by those dealing with an on-going illness for familiarity and comfort level rather than best coverage. There are better health insurance options for COBRA enrollees. For some, the thought of finding better coverage seems like a daunting task. The WIFS Team can help you wade though your options within the Affordable Care Act individual marketplace. There are a plethora of coverage plans, allowing us to find one that is tailored to your needs. Rather than your previous employer, it is YOU who chooses the balance between coverage and deductibles or premiums that suits your situation. The only other opportunities to find coverage outside of COBRA are to find a new job that offers health insurance benefits, apply for an ACA plan during open enrollment (November 1, 2015 – January 31, 2016) or wait until your COBRA benefits run out. Now is the perfect time to understand your options, potentially saving you money and providing you with better health care coverage. Send us an email, or give us a call at 317-663-4138.      
September 10, 2015
ACA employer reporting requirements

Assuming Your Small Business is Free From Affordable Care Act Requirements? Think Again!

Let’s say you own a business with over 50, but under 100 employees, and you offer an affordable group health insurance plan. You’re clear from any responsibilities under the Affordable Care Act, right? Think again. Starting January 1, 2016, you will be subject to the same reporting requirements employers of over 100 people are currently managing. What do the ACA reporting requirements mean for your business? With the adoption of the ACA came additional paperwork that is tied to payroll reporting requirements. Now, employers have to send information to the Internal Revenue Service about their employee group health benefits, and they have to provide the value of that program to their employees. Formulas for determining full-time employee status have also changed and can have a great effect on determining accountability under the ACA. The penalties for miscommunicating this information are substantial, making it important that your Human Resources Administrator fully understand the complexities of these new reporting requirements. (Click here to learn more about the penalty structure that will affect businesses with 50+ employees 1/1/16). There is no need to figure out this new world all on your own! Wharton Insurance and Financial Services has many options to help ensure all of your bases are covered. We can guide you through the decisions surrounding offering affordable group health care coverage. We can help your employees find individual coverage if you want to disband your program. And, we can provide resources for managing the new intricacies of being an employer under the ACA. Send us an email, or give us a call at 317.663.4138 for more information.
August 19, 2015
healthcare deadlines

Healthcare Deadlines Important to Your Business & Family Are Approaching

Healthcare-related deadlines important to your business and your family are approaching: Mid-September: Group health insurance renewal letters will be sent out to businesses in mid-September. We are expecting an average rate increase of 15% this year, so do not wait until then to prepare. The WIFS Team can help you strategize on the best course of action to manage your increased costs. We have options for you. October 15-December 7: Medicare open enrollment affords policy holders the opportunity to make changes to their Advantage Plan or Supplemental policies. If your health or prescriptions have changed over the last year, or you feel you are paying more than you should, the WIFS Team can help you find the best plan for your current situation. December 1: For organizations that have legacy health plans, December 1 is the final renewal date for those policies. The ACA requires business interested in staying out of the community marketplace to keep their current plan with no changes. Policies that renew this year will be in affect until October 1, 2016 only, so plan for an earlier renewal process in 2016! January 1: Businesses with 51 or more employees will be subject to payroll reporting requirements that kicked in for 100+ employers earlier this year. Click here to read more about these new requirements. Organizations with 2-50 employees are still not subject to these regulations. Questions about how these deadlines affect your business and family? Send us an email or give us a call at 317.663.4138 to set an appointment. We’d be happy to help.
July 7, 2015
Affordable Care Act

What the U.S. Supreme Court’s ACA Decision Means for Your Business

The highly anticipated U.S. Supreme Court decision on the Affordable Care Act created certainty around the law. The issue under question was one of financing, regarding the 36 states that have opted to forgo setting up their own state health insurance exchanges and using the federal exchanges. The ruling clarifies that the residents of those states are entitled to take advantage of the available premium tax credit if they qualify. The subsidy structure already in place was affirmed, therefore the law has not changed, but the future has become clearer. Within a day or two of the Supreme Court’s ACA decision, Aetna announced its plans to purchase Humana for $37 billion. Centene announced it is buying HealthNet, and Aetna and Cigna are in merger-related talks. It seems evident that in the wake of the Supreme Court decision comes consolidation. The health insurance marketplace is shrinking to fewer providers, leaving less choice for individuals and organizations. The industry is lining up toward a two-tiered system: programs with funding coming from the Federal government and programs for those fortunate to have a job that offers group health benefits. The private sector will have a role in this new world, but it will change. As an employer, what does this changing landscape mean to you? According to a recent New York Times article, health care insurance providers will be seeking a double-digit rate increase for 2016, possibly between 20% and 40%. Federal mandates requiring companies who employ 50 or more full-time workers to provide group health insurance will kick in January 1, 2016. These mandates and associated penalties are already in affect for 100+ employers. Fortunately, we have group health insurance benefit options for you: 1) Join the BAGI Group Health Insurance Program The BAGI program takes advantage of the power of pooling resources. Joining together the employees of other BAGI builder members allows an even spread of risk, less rate volatility, and a potentially more affordable option to the double-digit rate increases we expect for 2016. As the sole administrator of the program, Wharton Insurance is in a unique position to help you take advantage of this option. Click here for more information on the BAGI program. 2) Continue with Your Current Group Health Benefits Plan As long as you do not make any changes to your current plans, the federal government is allowing a “Transition” renewal year in which employers can keep their current group health insurance plan. Electing this course of action means accepting your provider’s rate increase. A knowledgeable insurance broker can help guide you through your options, helping you weigh the pros and cons of keeping your plan. 3) Eliminate Your Group Health Benefits If you employ under 50 full-time workers, you can elect to not offer group health insurance benefits and send your employees to the marketplace. Individuals must have insurance or be subject to a penalty, so many employers who take this option often gross up employees wages to help offset the costs of health insurance. […]
April 8, 2015
GRAVIE health insurance

Non-Builder BAGI Members Have Group Health Insurance Options Too

Wharton Insurance & Financial Services works closely with the Builder’s Association of Greater Indianapolis to provide valuable services to their members. We facilitate the BAGI Group Health Insurance Program for builder members. WIFS also has options for non-builder members of BAGI who are not eligible to participate in the BAGI Group Health Program. WIFS can offer businesses that have 2-50 employees access to a private health insurance exchange called GRAVIE. A technology platform, GRAVIE serves business owners who wish to disband their group health insurance program but would like to continue to support the health of their employees. Employers may gross up the wages of their employees and then send them to GRAVIE to purchase their own individual plans. GRAVIE Benefits Both Employers and Employees: 1) GRAVIE has access to over 900 health insurance plans, and well-trained customer service associates available 24/7 to walk your employees though their choices. 2) As an employer, you are no longer in the health insurance business. No more yearly reviews of the plan choices, or open enrollment meetings. 3) Employees are given more control over their health care choices. They can find a plan tailored to their needs, and allow them to access federal subsidies that could end up saving them money. 4) Your company’s bottom line is no longer subject to the yearly rate increases on your group health insurance plan. By combining health insurance coverage with wages, you can more accurately budget what you would like to spend on labor. 5) In many cases, GRAVIE programs cost 20-40% less than what you and your employees have been paying toward your group health insurance plan, saving everyone money. The Affordable Care Act has brought many changes to the health insurance world, for both employers and employees. Starting January 1, 2015 all individuals must have health insurance, either through their employer or on their own, or be subject to a tax. Therefore, if you disband your health insurance plan, and an employee chooses not to buy health insurance with their increased wages, then they are subject to fines not you. Wharton Insurance is pleased to be able to offer this option to non-builder BAGI members. For more information about the GRAVIE program, send us an email, or give us a call at 317.663.4138.
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