PRODUCTS WE OFFER
We offer many solutions to your insurance needs. Select what kind of insurance you would like to know more about and we will help you find the perfect fit.
SMALL BUSINESS INSURANCE
At Nemetz Insurance Services, LLC we currently assist over 150 Small Business Group plans in the Austin area. We can quote and install both Fully Insured plans and Level Funded/Self-Funded plans with carriers such as Blue Cross and Blue Shield of Texas, United Healthcare, Aetna, Humana, Vista360 and National General.
We have specialized in helping those Small Business’ (1 to 50 employees) that have either never had a group health insurance plan in the past, or those that have had one, but have never had an agent/broker that could facilitate the implementation and administration of those plans.
Some key takeaways about a Small Group plan:
Affordability: For employees that are not eligible for subsidized plans on the individual market, some of the group plans are lower cost than the plans on the individual market. In the case of the Blue Cross HMO plans, they are, on average, about 40% cheaper than the individual market. An employer only needs to cover 50% of the employee only cost for the lowest cost plan in their options. This is usually a much lower cost than most employers realize. There is also a yearly Waiver Period** in which an employer is not required to contribute any cost.
Choice: Unlike the individual market, employees and owners would have access to PPO options in the group market. We are also able to set up a variety of plan options inside each group plan so that employees can pick a plan that best suits their specific needs.
Taxability: By running employee health and dental insurance contribution through your payroll with a Section 125 plan you are able to make the whole contribution tax deductible, not only are you saving the 7.65% SSN and Medicare contribution on your contribution, but also on the contributions your employees make.
Your employees would also save the same 7.65% contribution as well as the federal tax rate on their contribution. This is especially advantageous for any employer that currently pay their employees a stipend (without an HRA plan), as a straight stipend is considered Salary and fully taxable to both the employer and employee.
Employee Retention and Attraction: One of the key reasons to consider a Small Group Health insurance plan is the Retention of your key employees and the attraction of new employees you may like to hire. A recent Glassdoor survey of employees ranked insurance (40%) as the most important benefit they get, outranking things such as Vacation (37%) and bonuses (35%). That same survey showed 55% of employees say these benefits are an important reason they stay with their company.
**Wavier Period: There is a once a year waiver period that allows for Small Groups to institute a Small Group Health Insurance plan without having to either meet the 50% contribution requirement or the minimum participation requirement. In fact, the company can contribute 0% if they wish and make the plan completely employee funded. This waiver period happens for November 15th to December 15th each year for plans with a start date of January 1st.
The Internal Revenue Service released a final rule on the Small Business Health Tax Credit. The final rule generally adopts the language from the proposed rule.
Please keep in mind that small employers interested in the Small Business Health Care Tax Credit have to enroll in a Small Business Health Options Program (SHOP) plan (and meet other eligibility requirements) in order to qualify.
The Small Business Health Care Tax Credit is available to eligible small businesses and small tax-exempt employers for two consecutive tax years. For small businesses, the maximum tax credit is 50 percent of premiums paid; for tax-exempt employers, the maximum is 35 percent of premiums paid.
Small employers may qualify for the tax credit if they employ fewer than 25 full-time equivalent employees with an average annual wage of $50,000 or less. The tax credit amount is phased down for employers with between 11 and 25 full-time employees and average annual wages between $25,000 and $50,000.
Employers planning to claim the Small Business Health Care Tax Credit have to obtain an official eligibility determination notice from the federal government. Employers should call their financial advisers for additional information.
Like our other small group products, SHOP plans offer comprehensive coverage, from doctors to medications to hospital visits. Employers can compare options based on price, benefits and other features that may be important to their employees. Plans offered through SHOP have to meet all 2014 health market reform requirements mandated by the Affordable Care Act.
We are currently reviewing the rule and will provide more information once it is available.
With a business of this size you are not obligated to purchase insurance for your employees. There are subsidies available to assist you in purchasing insurance for them. You can find a tax credit calculator at the Small Business Majority. The tax credits are larger for the fewer amount of people you employ and the lower their wage scale.
Your employees though will still be required to purchase health insurance or face a tax penalty at the end of the year. Many studies have shown that the stronger the economy gets the more likely an employee is to leave his current position that doesn’t include a comprehensive benefits package (including medical). There may be some alternatives with HRA’s starting in 2014 that will allow an employer to assist their employees while at the same time keeping costs down, but we are still waiting for additional federal regulations on this. It should be a conversation you can have with your broker to examine these options, or you can Contact Us at any time so that we can do a comprehensive evaluation of your options for you.
Part of the healthcare law requires businesses that sell over $500,000 per annum of products or services to “inform” their employees of the new market place. You can do this, and we would suggest documenting this, by using the following Department of Labor Forms:
Employers with a health plan – English Employers with a health plan – Spanish Employers with no health plan – English Employers with no health plan – Spanish
Starting in 2015 (this has been delayed 1 year) you will have options through the new SHOP Exchange. This federal exchange will give business owners new options and allow them to pool their groups with other small businesses. Currently the smaller your group and the older your demographic then the higher your typical small group plans will be. We anticipate that the smaller your group the more cost effective these new plans will be for you.
One major difference will be new plan options moving forward. Parts of the law create restrictions on plan year deductibles for small group plans. One part of the law restricts this to $2000 for individual and $4000 per family. We are waiting for the release of new plans to get more detail on what types of insurance plans that will be offered, but we don’t anticipate that some of the higher deductible plans that are in place today will be compliant as of next year.
You enroll in SHOP coverage directly through an agent, broker, or insurance company.
Work with an agent, broker or insurance company to help you apply for SHOP eligibility and find and compare available SHOP plans. You can also use the PREMIUM ESTIMATION TOOL on HealthCare.gov to browse and compare plans and pricing information.
Your agent, broker, or insurance company will help enroll you and your employees. You don’t need to wait for SHOP eligibility confirmation to enroll. The deadline to enroll is always the 15th of the month for coverage to be effective the 1st of the following month.
Starting in 2014, small employers can claim the SMALL BUSINESS HEALTH CARE TAX CREDIT only for coverage purchased through the SHOP Marketplace.
HUMANA ONE
UNITED HEALTH ONE
BLUE CROSS/BLUE SHIELD
AETNA
VISTA 360
OSCAR