You are trying to keep good people and you cannot compete with a corporate benefits package on price alone. The good news is that you do not have to. Small employers have three legitimate structures available and most owners have only ever been pitched one of them.
Small group coverage generally has open enrollment windows set by the carrier and the state, and some structures allow enrollment year round. Individual coverage arrangements can start the first of any month.
This is the exact sequence we run. No portal maze, no call-center roulette, no quote and vanish.
Full time equivalents, not headcount. Part timers, seasonal workers and 1099 contractors are treated differently, and the count determines which structures are even available to you.
Retention, recruiting, owner coverage, or a genuine benefit for everyone. These lead to different plans. An owner buying coverage for themselves and two employees has different math than a shop trying to win against a national competitor for skilled labor.
Traditional small group, level funded, and reimbursing employees for individual coverage. Each has real advantages and real drawbacks depending on your headcount and your workforce health profile.
The best plan fails if nobody understands it. We run the enrollment meeting, answer the questions, and handle the paperwork so it does not land on your desk or your office manager.
Most small business owners have been pitched exactly one thing, traditional small group coverage, and they either bought it or decided benefits were out of reach. There are two other legitimate paths. Level funded plans let a healthier than average workforce keep some of the savings rather than handing them to the pool, with stop loss protection so a bad year does not become a catastrophe. Individual coverage arrangements let you give employees a defined, tax advantaged amount to spend on their own plan, which caps your cost and lets each person choose the network that fits their family.
Which one wins depends on things you already know. How many employees. How healthy the group skews. Whether your people live in one metro or spread across three states. Whether you want a predictable line item or you are willing to take some variability in exchange for upside. That is a thirty minute conversation, not a form.
One call. Licensed producer, not a call center. If your current plan is still the better deal, I will tell you that.
In a lot of small businesses the owner is the person with the most at stake, and the owner is often the one who could be covered far more efficiently on a separate track. There is nothing improper about pricing owner coverage and employee coverage as two questions. It frequently produces a better answer for everyone than forcing one plan to serve both.
The most common failure is not price, it is renewal. A group gets quoted attractively in year one and takes a hard increase in year two, and by then switching is disruptive. Ask what the plan looks like at renewal before you sign, not after. The second most common failure is a network that looks fine on paper and does not include the hospital your people actually drive to.
We ask for a census, roughly what you want to spend, and what problem you are trying to solve. Then we price all three structures and show you the comparison including the renewal risk on each. If your best answer is to reimburse employees rather than sponsor a plan, we will tell you that even though it is the smaller sale.
Requirements vary by state and carrier, but many small group markets start at two enrolling employees. Participation minimums also apply, meaning a certain share of eligible employees must enroll for the group to be issued.
Generally you must offer coverage to all similarly situated eligible employees, though you can define classes such as full time versus part time. You cannot pick and choose individuals.
A structure where the employer pays a fixed monthly amount that covers expected claims, administration and stop loss insurance. If claims come in lower than expected, the employer may receive a portion back. If they run high, stop loss coverage limits the exposure.
There are tax advantaged arrangements that let employers reimburse employees for individual coverage instead of sponsoring a group plan. Rules on classes, notice and integration are specific, so this needs to be set up correctly.
Employers below the applicable large employer threshold generally are not required to offer coverage. Many do anyway because it is one of the few benefits that moves the needle on retention for skilled workers.
Under-65 coverage only. We do not sell Medicare.