Small businesses in California often need help to provide their employees with adequate healthcare coverage because of the high costs involved. However, Covered California for Small Business (CCSB) is a program that offers a range of health plans specifically designed for small businesses. Formerly known as the Small Business Health Options (SHOP), CCSB allows small businesses throughout California to take advantage of a competitive marketplace, enabling employees to choose the coverage they prefer and giving them access to the doctors and hospitals they need when purchasing insurance for their employees.
While it is mandatory for businesses with more than 50 employees to offer health insurance to their employees, CCSB offers health and dental coverage options for small businesses with one to 100 employees. This way, CCSB provides valuable advantages to small businesses in California.
Moreover, these plans comply with the ACA’s regulations, meaning they provide essential health benefits, such as preventive care, prescription drug coverage, and mental health services.
2024 Covered California for small business HMO Health Plans
An HMO (Health Maintenance Organization) plan is a great option if you want a consistent healthcare cost and prefer having the same doctor manage your healthcare. With an HMO plan, you must choose a primary care physician (PCP) to manage your healthcare. Your PCP is responsible for referring you to specialists within the HMO network. It’s important to note that this plan only covers in-network services unless it’s an emergency.
The premiums, copays, and coinsurance for an HMO plan are lower than those for a PPO or EPO plan.
2024 Covered California for small business PPO Health Plans
If you value the freedom to choose your healthcare provider while controlling costs, then PPO (Preferred Provider Organization) plans are the ideal option for you. With a PPO plan, you can select your primary care physician from their network and receive care from specialists without requiring a referral from your PCP. The network is designed to meet your specific needs.
2024 Covered California for small business EPO Health Plans
An EPO (Exclusive Provider Organization) plan is a type of health insurance that combines elements of an HMO plan and a PPO plan. It may not be as well-known as other options. With an EPO plan, you are required to get healthcare services from a doctor, specialist, or hospital that is part of the EPO network, just like an HMO. However, like a PPO plan, you can see a specialist without a referral if they are in the EPO network.
EPO plans usually have lower premiums than PPO plans but may be higher than HMO plans. You don’t have to pay a copay when you visit a healthcare provider within the EPO network.
Metal Tier Health Plans for Covered California for Small Business
Covered California for Small Business offers four tiers of coverage – Bronze, Silver, Gold, and Platinum. Employers can offer plans in a single metal tier or up to all four metal tiers. This provides your employees with multiple health plan options, allowing them to find one that fits their needs and budget.
Bronze Plans: If you don’t go to the doctor often but want coverage in case of a medical emergency, Bronze Plans usually have lower monthly premiums. However, you may have to pay more out of pocket when getting medical care.
Silver Plans: Silver Plans have reasonable premiums, deductibles, copays, and copayments – making them an excellent choice for those who need medical attention from time to time and want a good balance between monthly premiums and the cost of care.
Platinum and Gold Plans: These plans offer various options if you require frequent medical care. The Platinum and Gold Plans are excellent choices due to their high monthly premiums, low copays, and no deductibles – all of which make them stand out.
When can I enroll for Covered California for small business Health Plans?
Enrollment Period Dates: You can enroll in Covered California for Small Business at any time of the year. However, you must ensure that at least 70% of your employees are enrolled in a health plan, and you should contribute at least 50% of the total cost towards your employees’ premiums.
Employer Effective Dates: Group coverage begins on the 1st of each month. Applications must be submitted five calendar days before the effective date to ensure coverage starts on the 1st of the following month.
Special Enrollment: Covered California for small businesses offers an Annual Special Enrollment Period every year from November 15 to December 15. During this period, eligible employers can enroll for health coverage starting January 1.
What are the Requirements to be eligible for Covered California for small business Health Plans?
To be eligible for Covered California for small business Health Plans
- You must have 100 or fewer Full-Time Equivalent (FTE) Employees.
- The employer’s principal business address must be in California, or the employer must offer coverage to each eligible employee serving that employee’s primary worksite.
- At least one employee must receive a W-2; the employee cannot be an owner or spouse of an owner.
- Employers must offer Covered California for small business coverage to all eligible employees.
- The majority of employees are within California.
- Employers must contribute at least 50 percent of the lowest cost employee-only plan in your selected metal tier of eligible employees’ premiums.
Takeaway
Covered California for Small Business is an excellent program that offers a range of health plans specifically designed for small businesses. It enables small business owners to provide their employees with adequate healthcare coverage while controlling costs. Whether you prefer an HMO, PPO, or EPO plan Covered California for Small Business has got you covered. Plus, with its flexible enrollment period, eligibility requirements, and annual special enrollment period, you can enroll your business at any time of the year. So, if you are a small business owner in California, take advantage of this program and offer your employees the healthcare coverage they deserve.
Need Help with Group Health Insurance
Skyline Benefit is an independent health insurance broker in Fullerton, CA that offers affordable and flexible group health insurance options. Selecting the best group health insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112