Blue Cross Blue Shield Want to Leave Group Insurance
FAQs
Frequently Asked Questions
If you're considering providing wellness care coverage for your employees, we're here to assistance. Nosotros've shared answers to some of the most mutual questions pocket-size business organization owners have about wellness insurance coverage below.
How many employees do I need to authorize for small-scale business organization wellness insurance?
To authorize for grouping coverage equally a modest business, your company needs between two and l full-time employees (including the possessor). A full-fourth dimension employee is defined as someone that works at least 30 hours per week. Some states accept boosted guidelines every bit to who qualifies equally a full-time employee, and have minimum participation requirements. For guidance on other qualifiers, telephone call 833-923-1785.
If you purchase insurance between November 1 and Dec 15 for a January 1 or January 15 constructive engagement, this participation requirement is waived.
What is health insurance?
Health insurance is a contract between a policy holder and a health insurance company that requires the insurance company to pay or reimburse some or all of a member'due south health care costs for covered services. Larn more well-nigh how insurance works.
How practise deductibles, coinsurance, premiums, and copays work?
Deductibles, coinsurance, and copays are all mechanisms that allow wellness insurance companies and individuals to share costs. Deductible is a fixed amount an employee is required to pay earlier reimbursement by the health plan (coinsurance) begins. Coinsurance is the per centum of the cost of a covered health care service the employee is responsible for paying after they've met their deductible. Premium is the monthly amount that must be paid for a health insurance programme. Copay is the fixed dollar amount a member is required to pay for covered services or prescriptions at the time you receive them. Learn more about how insurance works.
What'south the divergence betwixt in-network and out-of-network benefits?
Doctors, hospitals, or other providers who accept your employees' health insurance plans are "in-network," also known as participating providers. Doctors who do not take these plans are "out-of-network." In-network provider services are paid at a higher benefit level. Larn more than about how insurance works.
What's the difference betwixt HMO and PPO plans?
HMO (Health Maintenance System) plans typically require members to select a main intendance doctor (PCP) to coordinate care within the network. In guild to meet a specialist, members may need a referral from their PCP. Having care coordinated by a PCP may result in lower overall costs for the fellow member. PPO (Participating Provider Option) plans do not require members to select a primary care physician, and in most cases, members tin can go to whatever provider within the network without a referral. This increase in flexibility may result in a higher overall cost for the member. Learn more near how insurance works.
How does my deductible impact my premium?
By and large, the college a plan's deductible, the lower its premium. Plans with college deductibles have lower monthly costs but may make expenses less predictable if medical bills accumulate suddenly. If you choose a program with a lower deductible, it will generally have a higher premium. Plans with lower deductibles permit employees to better control unpredictable costs when they need their insurance.
Why are in that location different network options?
Our network programme offerings are congenital to create wellness insurance coverage options that fit whatever budget beyond different metal coverage tiers. For more than particular on the networks available to you, visit our Plan Options page.
What are Smart networks?
A Smart network is a group of providers that encompass a specific geographical expanse, and is less broad than a standard PPO network. Plans with a smaller network typically accept lower premiums. Larn more most how insurance works.
What are essential health benefits?
Essential wellness benefits are included in every health plan, no matter which program you choose. The Affordable Intendance Act requires these benefits to be included in all private, family, and employer-sponsored plans. Visit our Plan Options page to see all essential wellness benefits included in our plans.
What Plans do we encompass?
BCBSTX plans provide comprehensive benefits with options to fit your employees' needs and your organization'southward budget. For more than detail on the plans available to you, visit our Program Options folio.
How much should I contribute?
Employers offer group coverage are required to pay at least 50% of their employees' premiums. You lot may pay a higher percentage if y'all choose; making insurance more affordable for your employees can increment participation. If you lot are new to BCBSTX and buy small-scale group coverage between November i and Dec 15 for a January 1 or January 15 effective date, the minimum contribution requirement is waived. Learn more about the benefits of offering health insurance.
When tin I apply for wellness coverage for my business?
You can use for health coverage at any time throughout the twelvemonth. If yous purchase group coverage between November i and December fifteen for a January i or January 15 constructive date, the minimum amount you are required to contribute towards your employees' premium, besides as the number of employees required to participate - are waived.
How much will it cost me to provide health insurance for my employees?
The cost of health insurance for your pocket-sized business will depend on the type of plan you choose as well equally your contribution strategy. Almost states require a minimum contribution for grouping coverage.
If you purchase group coverage between November one and December xv for a January i or Jan 15 effective date, your contribution requirements are waived.
When I buy health insurance for my employees, how long does the policy last?
Each policy has a 12-month contract term. We volition achieve out to yous before the contract term expires to discuss your options for renewing your policy.
When tin I purchase health insurance for my business and when does it become effective?
You can purchase coverage any time during the year and indicate a desired coverage start date. In one case your business is approved for coverage, you will receive a notice confirming the engagement on which your coverage volition begin. It will be effective for all enrolled employees starting on that date.
As a small business organisation, practice I qualify for tax advantages for offering wellness insurance for my employees?
Yes, you may be eligible to take a deduction on the corporeality you contribute towards the premium cost on your employees behalf. Please contact your tax professional for more details on the tax advantages you may qualify for by offer your employees wellness insurance.
Do my employees enjoy taxation benefits for enrolling in the coverage I sponsor?
It is possible. Yous can accept a pre-taxation deduction from employees' paychecks to cover the portion of the total premium that they are required to pay. This deduction reduces their taxable income and the corporeality of income taxes owed.
Through the Affordable Care Act, individuals may be eligible for subsidies for purchasing coverage through the individual marketplace place if they meet income requirements. If you take boosted questions, delight contact your tax professional for more information.
How would a group policy I offer my employees differ from an individual policy that they purchase through the market place?
Group insurance policies permit employers to offer their employees and their dependents a wider choice of options, with admission to more than robust plans and larger networks. Monthly premium costs are shared between the employer and the employee.
In the individual market identify, there may exist fewer options to choose from, plans typically have a higher deductible and smaller networks, and employees are responsible for 100% of the monthly premium.
Can I extend the offer of coverage to my employee'south spouses and/or children?
Yes, coverage can be extended to spouses and/or children of any employees who enroll in coverage. You can decide if yous desire to contribute to the toll of their coverage.
What if I have employees who reside out of country?
Nosotros offer plans that include out-of-state coverage. If you accept employees that reside out of state, you should consider including one of these plans. To observe out which plans offering out-of-state coverage, review our 2022 Small Group Plans. 
Is there someone I can call if I take boosted questions?
Our insurance specialists tin respond any additional questions you may have equally you consider your group wellness insurance options. Call us at 833-923-1785.
How is dental insurance different from wellness insurance?
Wellness insurance includes coverage for a wide range of medical intendance. Nevertheless, health intendance plans only include pediatric dental coverage. Dental insurance can aid yous and your employees access quality dental care.
Dental insurance includes coverage for oral care, such equally regular cheque-ups, orthodontics, oral surgery, and other dental services. Like wellness insurance, dental insurance includes networks, coinsurance, deductibles, and almanac out-of-pocket maximums.
Is any dental care covered by health intendance coverage?
All health care plans include pediatric dental coverage. Still, coverage for adults is only available through a dental insurance plan.
What are the advantages of offering dental Insurance?
Combining health and dental coverage through BCBSTX streamlines the administration of both programs, helping you manage your overall benefit costs. Employees with both BCBSTX health and dental plans have admission to BlueCare Dental ConnectionSM, which includes educational information and outreach to assistance your employees brand important decisions about their dental care.
Members who accept wellness and dental insurance accept experienced:
• 24% reduction in medical costs
• 41% fewer hospital admissions
• 34% fewer ER visits
How much do I have to contribute to my employees' dental insurance premiums?
You can cull to offering a contributory or voluntary dental plan to your employees. If you choose a contributory dental plan, you must contribute at least fifty% towards your employees' dental insurance premiums. For voluntary plans, yous are not required to contribute towards your employees' premiums, only you take the option to contribute upwards to 49%.
Tin I purchase dental insurance without health insurance?
To purchase BCBSTX dental insurance, you must purchase BCBSTX health insurance.
Healthier Employees. Healthier Business.
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Source: https://www.bcbstxcommunications.com/shopsmallbusiness/faqs.html