Insurance

Health Insurance Q&A

September 7, 2022

1. In the current situation of severe inflation in the United States, many employers have increased operating costs. Is there any way for employers to reduce expenses in insurance?

  • It is not easy to be a employer in California. We recommend that employers check your insurance plans when you renew insurance every year. If you are now offering a PPO plan for employees, you can consider whether add the HMO plan, the premium of the HMO plan will be much cheaper than the PPO.
  • If it is already an HMO plan, check to see if the plan level needs to be changed. If it is a platinum plan, consider downgrading to a gold plan, or to a cheaper silver/bronze plan, the cost of employer will also be much lower.

2. The California government stipulates that as long as the company has more than 5 employees, the employer must provide the option of employee retirement plan. Is there any way to provide employee retirement plan, without increase costs?

  • Don’t worry. Although the government requires employers to provide employee retirement plans, such as the 401k. But employers can also choose a retirement plan provided by the government, called CalSaver, which costs less to set up.
  • In addition, employers can also choose a retirement plan called SIMPLE IRA. SIMPLE IRA is like an employee’s own retirement plan, but it is set by the company. There is no cost for the company, so for the employer SIMPLE IRA might be a pretty good choice.

3. Health insurance premiums are rising every year. If employees want to reduce their expenses, how can they do?

  • We often call on employees to choose the health insurance that suits them. For example, some employees may rarely see a doctor, but choose the expensive PPO plan or the HMO plan of the big network.
  • We would suggest that if the doctor you are used to seeing has a plan that accepts a smaller network, you can choose it. The premium can be saved by 10% to 15%. If you don’t often see a doctor, you can choose a basic plan. For example, a bronze plan or a silver plan is enough.

4. If employees enroll health insurance from the company, are there any benefits that individual health insurance does not have?

  • If the company provides health insurance to employees, the California government stipulates that employer should help employees pay part of the premium, which may be 50% or a fixed amount. So, employees enroll health insurance from the company will usually be more cheaper.
  • The company can also set up the service of Section 125, in which the Premium Only Plan can make the employee’s insurance premium into Pre-Tax, so that the employee’s health insurance premiums can be paid without paying taxes.

5. At the beginning of August, the US Senate passed the “Inflation Reduction Act”, of which 352 billion dollars will be used for medical care. What impacts reflect on health insurance?

  • We know that can be expected to reduce drug costs for Medicare insurance. The out-of-pocket maximum of drugs will from no limit to $2000, which is an important benefit.
  • The bill will reduce the premiums of ACA health insurance. It will benefit many people, but the detailed premium reduction rate may not be known until the Open Enrollment at the end of this year.

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