small business health insurance va

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How to Pick the Best Small Business Health Insurance

Finding health insurance for your small business doesn’t need to be difficult. We’re here to make it easier, with a helpful guide. Business owners say finding the right health insurance is one of the most challenging tasks of running their company. There are many things to consider, and the cost is at the forefront of most people’s priorities. However, you can provide your employees with small business health insurance and get a great deal.

Why Should I Get Small Business Health Insurance?

There are many advantages to small business health insurance offers. First of all, it’s a legal requirement if you have more than 50 employees. If you don’t offer health coverage, you’ll face a fine, so it’s important to look at the options. Naturally, you want a cheap option but consider your employees too.

Not many business owners know this, but getting health coverage for their employees makes them eligible for tax credits. However, you’re only suitable if you have 25 or fewer employees. There are many other incentives of small business health insurance, including more tax credits and money off premiums. 

Benefits for Employees

Getting health insurance for your employees offers them the chance to remain fit and well, which is essential for work. Many individuals cannot afford proper health insurance, so they’re happy when an employer offers them some form of coverage. It’s a no brainer, really. Employees who feel valued by their employer work harder.

If you’re worried about the costs, there are plenty of payment options available. Feel like being the coolest boss in the world? You can cover all the premium payments. However, there are options to split the premium costs with your employees, meaning everyone saves money. 

Budgeting for Small Business Health Insurance

The cost of your insurance depends on how many employees you’re covering, and how comprehensive the coverage is now. You can choose how much of the premium you’re willing to cover, and many businesses use this option. For example, if you can afford 80% of each employee’s cover, they’ll pay the extra 20%. This is ideal for both yourself and the employees, but there are plenty of other percentage options available.

It’s important to do proper research when looking for your insurance provider. There might be policies that are more suitable for your industry, so don’t rush into anything. Take your time and weigh up the pros and cons. You should also consider how much your employees can afford, and which premiums are essential for them. 

How to Find Insurance

Some insurance companies prefer to work through brokers, but if you contact them directly, you might get some great deals. Going straight to the source and cutting out the broker means you’ll save more money, so don’t be afraid to go to the company. There are many review sites such as Consumer Affairs, which list the best small business health insurance, providers.

The governments’ health insurance exchange (SHOP) could also be beneficial for you. Not only do they have helpful information about individual’s states requirements, but they also offer up to 50% tax credits. There are loads of insurance policies available, and using the SHOP could save you time and money. 

Should I Get a Broker?

So many individuals ask this question, and there’s no right or wrong answer. Yes, brokers have their advantages, but they also have disadvantages. If time is an issue, then a broker does all the leg work and will find you the best insurance policy for your business. They also have contact with many providers and could get you a discount on premiums.

However, brokers cost money, and sometimes they charge a lot for something you could do yourself. If you’re willing to spend time researching and reaching out to companies directly, then you’ll save more money. Choosing the wrong policy without the advice of a broker could impact your business.

Finding small business health insurance can be time-consuming, but the benefits outweigh the initial task. 

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How To Get Your First Health Insurance: All You Need To Know About It

Buying health insurance for the first time seems confusing at first. You are presented with so many insurance options that you are unsure which is best. In reality, getting your first health insurance plan does not have to be daunting. You need to be clear on a few things, such as what expenses you need insuring and how you will pay for the insurance.

Once you know your budget and coverage needs, selecting a plan becomes much easier. Below, we show you what the different insurance options offer, as well as how to select the best plan.

Types of Health Insurance Plans

To make the correct choice of health insurance, you need to be aware of the different insurance types you can choose from. The most common ones are:

• PPO (Preferred Provider Organization) – These are insurance plans which give you access to a network of doctors under a common agreement. Under this plan, providers agree to charge you less than non-members. In addition, PPOs are notable for giving you wide access to doctors as well as specialist visits without needing a referral.
• HMO (Health Maintenance Organization) – HMOs give you a primary care physician who has to issue a referral for specialist visits. You get less choice on the doctors you can see.
• HDHPs (High Deductible Health Plans) – An HDHP is an insurance plan which has a high amount you must pay out-of-pocket before it kicks in. Monthly insurance premiums, however, are lower than with other plans.

Paying for Your First Health Insurance

Subscribing to a health insurance plan involves meeting certain obligations in exchange for the benefits. An important part of the contract is your payment of insurance premiums.

You must pay your monthly premiums on time and in full. If you are late or delinquent in paying premiums, you might forfeit the insurance.

Having lapsed insurance premiums is a huge disadvantage when you unexpectedly fall sick. As a first-time insurance buyer, therefore, you must master the discipline of paying premiums diligently.

A good practice is to prioritize critical payments such as health insurance premiums on your monthly budget. If your bank allows it, set up automatic monthly recurring payments so you never miss paying a premium.

How to Use Company Health Insurance Plans

Your job may come with a company health insurance plan. Company plans cut down on the health costs you have to shoulder yourself.

With employer-provided health insurance, your company will pay some or all of the cost. You need to be aware, however, that you might still be on the hook for a portion of the monthly premiums.

To use company insurance, make sure you submit all paperwork that your employer asks for. While the insurer agreement will be signed by your employer, you also need to sign the necessary paperwork to opt in. Once you are actively enrolled, you can now access doctors and medical services under the plan.

How to Buy Family Health Insurance Plans

Buying your first family health insurance plan is more complex than selecting an individual health plan. Family health insurance plans are necessarily more expensive than comparable individual insurance plans. This is because they cover your entire immediate family or other dependents.

An easy way to buy family insurance is to upgrade your individual plan to a family plan. Your insurance company may be willing to incentivize the upgrade.

Even though family health insurance costs more, the additional cost may not be as much as it would take to insure everyone individually. This means purchasing family plans can save you money if you and your spouse both need insurance.

Comparison of Health Insurance Plans

In the American insurance industry, a handful of insurance providers have gained a widespread following. Chances are, one of these will work for your insurance needs as well. Below, we give you a handy comparison of popular health insurance plans based on the insurer’s reputation.

• Blue Cross Blue Shield – This plan is offered by a group of independent agencies nationwide that give the greatest variety. It is best if you have highly specific care needs.
• Humana – This company’s plans are available in fewer states. However, it has some of the cheapest plans, making it the best for low-budget shoppers.
• Kaiser Permanente – This insurer is not active in all states and has limited options for seeing doctors outside the network. It will be more suitable for the elderly, for whom its lower premiums make for good savings.

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• Self-Employed Health Insurance

What’s the best option for self-employed health insurance?   If you live in Virginia or some parts of Maryland, the answer may be a group health plan .

Why Group Health Insurance?

What makes a group health plan a better option?

The non-group / individual health insurance market has been tumultuous.  This has translated into less favorable options if you don’t work for a company that offers you health insurance and you are not eligible for a subsidy based on income.

On the other hand, the group health insurance market has been more stable.  Under a group plan, you have access to:

• A broader range of doctors and hospitals — both locally and nationwide
• More options – for example, lower deductibles, HSA-compatible plans, etc.
• More favorable pricing in many cases

Small group health plans are Affordable Care Act compliant .  This means there is no medical underwriting, and they include all of the consumer protections mandated by law.

In addition, we can start a small group health plan on the first of any given month (and in some cases the 15th).  This means you are not subject to the chaotic annual open enrollment period each fall.

We believe a small group health insurance plan is a win-win if you are self-employed and not subsidy-eligible!

Self-Employed Health Insurance in Virginia

Virginia law ( SB 672 ) requires insurance carriers to offer group health plans to self-employed individuals.  SB 672 became effective July 1, 2018.

Who is eligible?

Certain sole proprietors, single member LLCs, partnerships, or corporations.

What is required?

You must work full time in your business, and you must have filed a tax return for the previous tax year.  Depending on how your business is structured, you must be able to provide a copy of the following from the previous tax year:

• Sole proprietorship :  Schedule C or F (from 1040)
• Partnership, S corporation : Schedule K-1 for all partners/members
• Single Member LLC :  Schedule C or F (from 1040)
• C corporation: most recently filed Virginia Employment Commission’s Employer’s Quarterly Tax Report (VEC) or W-2

What if I just became self-employed and haven’t yet filed the appropriate tax return?

There may be another option for you, depending where you live/work. Please be in touch with us right away!

(Note – final approval of your eligibility for a group health plan lies with the health insurance carrier. Do not cancel any existing coverage until you have formal approval.)

Self-Employed Health Insurance in Maryland

Contact us to find out if you are eligible for a group health plan.

Tell Me How!

At Virginia Medical Plans, a OneDigital Company, we have helped hundreds of small business owners and self-employed people with their health insurance.  Contact us at 703-707-8270 to learn how we can help you.  Or follow the instructions below to request a free quote.

To request a free quote for self-employed group health insurance, please click here to download a census form. Complete and return to us securely using this link or via secure fax at 888-514-4258.  We know you are the only employee — be sure to let us know the nature of your business, and include any of your dependents (spouse or children) who need coverage as well.

Attention: This website is operated by Virginia Medical Plans|a OneDigital Company, and is not the Health Insurance Marketplace website. In offering this website, Virginia Medical Plans|a OneDigital Company is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at healthcare.gov.

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Virginia Small Business Health Insurance Information

The purpose of this guide is to provide a general overview of virginia small business health insurance. the guide reviews small business health insurance options for virginia small businesses..

Building a successful business is hard work. Finding affordable small business health insurance doesn’t have to be. All small businesses face special challenges when it comes to finding and getting health insurance coverage. Luckily, recent health care reform legislation provides small businesses with special opportunities to secure affordable health insurance.

Virginia Core Small Business Health Insurance Options

When evaluating your small business health insurance options in Virginia, you should immediately compare the costs and benefits of the following three options:

Offering Traditional Small Business Health Insurance Coverage,

Offering a Defined Contribution Health Plan that Reimburses Employees for Individual Health Insurance Coverage, and

Offering Nothing

Virginia Small Business Health Insurance Overview

There are two primary categories of health insurance for small businesses to choose from:

Individual health insurance, 

Group health insurance. 

1) Individual Health Insurance

Individual health insurance plans are health insurance plans purchased by individuals to cover themselves or their families. Anyone can apply for individual health insurance. Small business owners who can’t offer group coverage due minimum contribution (or minimum participation) requirements typically purchase individual and family plans for themselves and their families. In 2014, insurance companies will no longer be able to decline individuals for individual health insurance based on a pre-existing medical condition. Also, starting in 2014, there are new special tax incentives available to businesses and employees when employees purchase individual health insurance. In some cases, self-employed persons who purchase their own health insurance may be able to deduct the cost of their monthly premiums. When small businesses decide on the individual health insurance route, they often create a "Pure" Defined Contribution Health Plan to  reimburse employees tax-free for individual premiums .

2) Group Health Insurance

Group health insurance plans are a form of employer-sponsored health coverage. Costs are typically shared between the employer and the employee, and coverage may also be extended to dependents. In certain states, self-employed persons without other employees may qualify for group health insurance plans.

Four Types of Virginia Small Business Health Insurance Plans

Whether you’re looking at individual health insurance or group health insurance, there are several different types of health plans available. The four you should absolutely know are:

PPO Health Insurance Plans,

HMO Health Insurance Plans,

HSA-Qualified Health Insurance Plans, and

Indemnity Health Insurance Plans.

The plan type that is best for you and your employees depends on what you and your employees want, and how much you are willing to spend. Here’s a brief review of the four popular types of health insurance plans:

1) PPO Health Insurance Plans

PPO or “Preferred Provider Organization” plans are the most common. Employees covered under a PPO plan need to get their medical care from doctors or hospitals on the insurance company’s list of preferred providers in order for claims to be paid at the highest level.

2) HMO Health Insurance Plans

HMO stands for “Health Maintenance Organization.” HMO plans offer a wide range of health care services through a network of providers that contract exclusively with the HMO, or who agree to provide services to members. Employees participating in HMO plans will typically need to select a primary care physician (“PCP”) to provide most of their health care and refer them on to HMO specialists as needed.

3) HSA-Qualified Health Insurance Plans

HSA-qualified plans are typically PPO plans designed specifically for use with  Health Savings Accounts  (HSAs). An HSA is a special bank account that allows participants to save money – pre-tax – to be used specifically for medical expenses in the future. Section 105 Healthcare Reimbursement Plans (HRPs) are often used in place of HSAs due to their advantages for employers.

4) Indemnity Health Insurance Plans

Indemnity plans allow members to direct their own health care and generally visit any doctor or hospital. The insurance company then pays a set portion of the total charges. Employees may be required to pay for some services up front and then apply to the insurance company for reimbursement. 

Virginia Small Business Resources*

Virginia Health Insurance Coverage:

Group Plans: Benefits will vary depending on the chosen plan.  Pre-existing health conditions covered.  

Individual Plans: Assorted plans depending on medical needs.   Pre-existing health conditions covered.

COBRA: Coverage available for 18-36 months depending on qualifying events. Benefits are what you had with your previous employer.  Pre-existing health conditions covered.

HIPAA: Benefits are based on program selected. There is no expiration of coverage.  Pre-existing health conditions covered.

HIPAA: Premium assistance that pays employer-sponsored health insurance or Cobra premium available.  Pre-existing health conditions covered.

 Virginia Health Insurance Eligibility:

Group Plans: Guaranteed coverage for companies with 2-50 employees. Eligible employees must work at least 30 hours a week. Owner can count as an employee. Owner name on business license must draw wages from the company.  

Individual Plans: Eligibility is subject to medical underwriting. If you are denied coverage for a medical condition, you may be eligible for AHIP, or PCIP.  

COBRA: Guaranteed coverage available for employees who work for businesses with 20 or more employees. Employees have 60 days from date of termination to sign-up.  

HIPAA: Must have had 18 months of continuous coverage and completely exhausted Cobra or state continuation coverage. Must not have lost coverage due to fraud or non-payment of premiums. You have 63 days to enroll.  

HIPAA: Must qualify for Medicaid and have access to Employer-Sponsored Insurance or Cobra.

Virginia Health Insurance Monthly Cost:

Group Plans: Costs depend on employer contribution and the  +  20% of the Insurance company’s Index rate.  

Individual Plans: Costs for Individual coverage vary. There are no rate caps.  

COBRA: Costs vary between 102% to 150% of group health rates.  

HIPAA: Premiums will depend on plan chosen.  

HIPAA: Reimburses the full employer-sponsored insurance premium amount by check monthly. Pays the insurance company directly for people on COBRA or eligible small businesses.  

*Source: www.coverageforall.org

Virginia : Average “Single” Premium per Enrolled Employee for Employer-Based Health Insurance, 2011*

Virginia : Average “Family” Premium per Enrolled Employee for Employer-Based Health Insurance, 2011*

Virginia : Average “Employee-Plus-One” Premium per Enrolled Employee for Employer-Based Health Insurance, 2011*

Virginia : Average Per Person Monthly Premiums in the Individual Market, 2010*

*Source: statehealthfacts.org

Small Business Health Insurance Reform

Are you ready for health care reform ("ACA") in 2014?

Today, employers are more stressed than ever. Here’s why:

The business environment is uncertain,

Employer-sponsored health insurance costs increase annually, and

New fees and penalties take effect next year, and most employers don’t fully understand how this will affect their financials.

It is time for employers to examine the specifics of healthcare reform, and start thinking strategically vs. emotionally. Change is hard. However, employers that educate themselves and plan ahead can avoid severe financial impacts.

The more change and disruption your business can embrace, the more cost savings (for both the company and your employees) you will be able to realize over the long term. In order to embrace this change, you must be familiar with the key aspects of ACA. For many small businesses, the solution to healthcare reform is simple: Offer a “Business Expense Account” for Healthcare. A new vehicle, called a Healthcare Reimbursement Plan (HRP), allows employers to get out of the health insurance business, and simply give select employees monthly allowances to spend on their own health insurance policy in a state health insurance exchange.

Listed below are key ACA components to consider when choosing small business health insurance. 

Individual Health Insurance Tax Subsidies

Beginning 2014, individuals will have access to tax subsidies to buy private health insurance through the public exchange. These subsidies will be for those who enroll in a silver plan through the exchange. The subsidy caps the cost of individual health insurance at 2% - 9.5% of their household income if their household income is less than 400% above the federal poverty line. This equates to roughly $90,000 per year for a family of four.

Click here for more information on the premium subsidies.

Individual Health Insurance Tax Penalties

The  Individual Mandate  requires most individuals to purchase health insurance, or else pay a penalty on their tax return each year. The intention of the individual penalty is to reduce the "Free Riding" effect in the health insurance market (a free rider is someone who is healthy and does not purchase health insurance until they need it.

Click here for more information on individual tax penalties.

Small Business Health Insurance Tax Credits    

Small businesses with up to 25 full-time equivalent employees may qualify for a tax credit for offering employee health benefits. The credit is broken in to two phases. Phase 1 (2010-2013) includes a tax credit worth up to 35% of a small business’s health insurance costs.  Phase 2 (2014 and beyond) includes a tax credit up to 50% of a small business’s health insurance costs.

Click here for more information the tax credits.

Small Business Health Insurance Tax Penalties

Starting January 1, 2015, Employers  with 50 or more  full-time equivalents who do not offer minimum essential coverage can face monthly penalties if at least one employee uses a premium tax credit to obtain health insurance through the state health exchange. If you do not have more than 50 employees, you are not subject to these penalties.

Click here for more information on the business tax penalty.

The Future of Small Business Health Insurance - Defined Contribution Plans

Defined Contribution Plans  allow employers to offer health benefits without offering a traditional group health insurance plan. Instead of paying costs for a specific group health plan, employers allocate tax-deductible monthly allowances for their employees to spend on private health insurance and other medical expenses tax-free.

Features of defined contribution plans include the following:

Employee Choice – employees choose a health insurance plan that best fits their needs.

Fixed Cost – employers control health care costs by allocating fixed monthly allowances for their employees.

Savings – employers using Defined Contribution Plans typically cost less than group health plans which results in saving for both the employer and employee.

Next Steps – Evaluate Your 3 Core Options

Immediately compare the costs and benefits of the following three options:

Offering a Defined Contribution Health Plan that Reimburses Employees for Individual Health Insurance Coverage, and

Offering Nothing.

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Virginia Health Insurance for Small Businesses

Nasro virginia employee benefit services include group health insurance & self-funded options:.

Own or operate a small business in Virginia?  NASRO Administrators is a socially responsible employee benefits consultant working to help small businesses and non-profits manage their health care and employee benefits by providing a range of options at the most affordable rates possible.

If you are studying your Affordable Care Act health coverage requirements and options, starting a new business. expanding operations in Virginia, or just need to lower your monthly health insurance costs, you need to meet NASRO.  You are not alone, and NASRO can help you. We have worked for decades to help establish the more humane health care system that Virginia is known for in our region. NASRO is helping to make sure all the health plan options available in the state are communicated clearly, completely, and professionally. If you have a question or a problem please call us for advice on a wide range of health care topics, including coverage options, network availabilities, provider quality, insurance rates, and more.

NASRO will help you with every step of the process until your enrollment is accepted. If you have questions about how to determine the best benefit plan, how to answer the questions concerning your medical history or how to coordinate your new coverage with the ending of your old coverage please call NASRO at  617-875-5140 or e-mail us at [email protected] . Information on other group health plans are listed below.

NASRO’s Clients Includes of Professional Corporations, Partnerships, LLC’s, S Corporations, and C Corporations, Non-Profits, and Co-ops, 

Health and Dental Rate Information

NASRO is a non-profit, socially responsible employee benefit consultant. We provide both the information and the interpretation of what the various benefit plan levels and prices are actually buying. NASRO Administrators is staffed by Virginia health and dental insurance experts who are available to assist any company with direct answers to questions about benefit choices, cost, which Virginia health or dental insurance provider network is best for you or your employees.

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Any individual in the tri-state area is eligible to participate in our dental plan regardless of medical pre-existing conditions. Call 617-875-5140 to find out the rates, benefits and enrollment information from the top dental carrier in the state.

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Small Business Plans in Virginia, Maryland and Washington D.C.

Find a health care plan for your small business

Choosing the right health care partner can help you achieve a healthier workforce, a healthier business, and a healthier future. Together, we can tailor a solution that meets the needs of your business and your employees.

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Your employees see doctors who are motivated by outcomes, not profits — so you get the most value for your health care dollars.

Of the 1,600+ health plans surveyed in 2022 by the National Committee for Quality Assurance, ours is the only commercial plan in the nation to be rated 5 out of 5.*

Access to more than 1,700 Kaiser Permanente doctors in the Mid-Atlantic, plus a network of providers and specialists.

Explore our Plans

Find health coverage that supports your workforce and fits your budget..

The following types of plans are available in Virginia, Maryland and Washington D.C. Each health plan meets the requirements of the Affordable Care Act (ACA).

Copayment HMO plans

Predictable copays and out-of-pocket maximums with a focus on prevention

Deductible HMO plans

Once the out-of-pocket-maximum is met, most services are 100% covered the rest of the year

HRA and HSA-qualified plans

Lower premiums plus tax savings †

Point-of-service (POS) plans

Employees can take advantage of our integrated network or see any licensed provider of their choice

Supplemental benefit plans

Add acupuncture, chiropractic, dental, and vision to your employee health care plans

Virtual plans

Offer convenience of virtual care with unlimited $0 virtual visits and keeps premiums low.

Flexible choice plans

Balance cost and provider choice with three network options allowing employees to choose when and how they get care.

Download plan information

The metal naming system was created as part of the ACA to make it easier for you to shop and compare plans. In general, the higher the metal value, the greater the coverage.

*NCQA Commercial Health Plan Ratings 2022. †The tax references in this website are provided for informational purposes only. Consult with your financial or tax advisor or attorney for advice about federal and state income tax laws. Some plan options, products, and riders not available in all areas.

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Kaiser Permanente health plans around the country: Kaiser Foundation Health Plan, Inc., in Northern and Southern California and Hawaii • Kaiser Foundation Health Plan of Colorado • Kaiser Foundation Health Plan of Georgia, Inc., Nine Piedmont Center, 3495 Piedmont Road NE, Atlanta, GA 30305 • Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., in Maryland, Virginia, and Washington, D.C., 2101 E. Jefferson St., Rockville, MD 20852 • Kaiser Foundation Health Plan of the Northwest, 500 NE Multnomah St., Suite 100, Portland, OR 97232 • Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc., 1300 SW 27th St., Renton, WA 98057

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