Finding the Right Insurance Plan at the Right Price

SHOP, Obamacare's small business insurance marketplace, won't become fully operational until the fall of 2014.

However, in the meantime small business owners who are trying to decide whether to offer health insurance coverage to their employees can preview available plans and get price estimates.

Under the provisions of the Affordable Care Act, small businesses -- those with 50 or fewer full-time equivalent employees, or FTEs -- are under no obligation to provide health coverage to their employees.

For those who do, however, SHOP, known officially as the Small Business Health Options Program, offers an array of plans designed to meet the needs of most small businesses.

Small business owners who would prefer to purchase group health coverage in advance of SHOP's full-fledged opening in the fall of 2014 have a couple of options.

They can purchase health plans that meet Obamacare standards from insurance brokers or buy coverage from ACA exchanges if they are based in states where such exchanges are operational.

 

 

Some May Get Tax Credits

Waiting for SHOP makes good business sense for companies with fewer than 25 FTEs. These businesses may qualify for tax credits worth up to 50 percent of their premium costs, but only if they purchase their coverage through SHOP.

SHOP health plans are available in four levels of coverage, Bronze, Silver, Gold, and Platinum, all of which cover essential health benefits as well as pre-existing conditions and some free preventive care.

The categories in no way define the quality of care a plan provides but rather describe the way in which your employees and the plan will share the costs of medical care.

In short, employees on a bronze plan will have the highest co-pays for health services, while those with platinum coverage will have lower out-of-pocket costs.

 

How to Preview Plans

To learn more about choosing a health insurance plan and what it will cost, head to https://www.healthcare.gov/how-do-i-choose-insurance-thats-right-for-my-.... Under Take Action, click on "See plans and prices right now."

This will take you to a web page where you can begin answering a few questions to learn what plans are available in your part of the country. Click on "I'm looking for coverage for a small business I own or operate."

Next, you'll be asked to identify what type of coverage you're interested in -- medical or dental.

Although some health plans may also include some level of dental coverage, at this point you'll be asked to pick one or the other to get specifics on stand-alone dental or medical coverage.

 

Select Your State

Now select the state in which your small business is located.

If you select a state in which a state marketplace is already operational -- California, for example -- you will be given a link to that marketplace -- Covered California -- and can proceed from there.

 

If the state in which your business is located has no health insurance exchange, you'll be asked to choose the county in which your business operates.

Next, you'll be asked to supply the age of each of the business's employees who are likely to accept your offer of coverage.

 

Review Available Plans

After inputting age information for each of your employees, click on "View Marketplace Plans" to see what types of coverage are available for your business and its employees.

For each plan that's available, you'll be given the total monthly premium for covering all of the employees for whom you've supplied relevant age information. Also supplied for each plan is the annual deductible per individual and per family, the out-of-pocket maximum per individual and per family, and the specifics of copayments required for various forms of care.

If as a small business owner you decide to offer health coverage to your employees, you can opt to pay anything from 0 to 100 percent of the plan's monthly premiums. The balance of premium due, if any, must be paid by your employees.

For both you as the employer and your employees, there's a tax benefit to purchasing a health plan through SHOP.

Premiums are paid with pre-tax dollars, which means that whoever contributes toward payment of the premium gets a nice tax break.

About the author

Don Amerman is a freelance author who writes extensively about a wide array of small business and personal finance topics.

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