​Health care costs aren’t just affecting individual people–businesses are struggling to cover their employees. Trying to find affordable health insurance for your small business can seem like an impossible mission. Not only are the costs unmanageable, but sometimes the employee benefits that are supposed to work for “all” don’t really do that. 
 
Thankfully, there are health insurance alternatives for small business groups like yours. In order to help you make the right decision for your small business, we’ve decided to lay out your different options. You’ll find the benefits and drawbacks of each so you can choose the one that best fulfills your needs.
 
1. Standard Group Health Insurance
 
Do you have less than 50 employees? If so, a traditional policy from the SHOP Marketplace may be a good option for you. These policies are offered by federal and state-run exchanges and come with tax credits. However, you must meet the eligibility requirements, so you’ll want to contact us Sackett & Associates Insurance Services to ensure this is the way to go for your company.
 
2. The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)
 
Thanks to a bipartisan bill that was passed in December 2016, the QSEHRA is now an option for companies with fewer than 50 workers. Here’s how this program works: 

• Your business offers a tax-free monthly allowance to your employees
• Your employees select and pay for their health care, including personal insurance, copays, premiums, and prescription medications
• Your business reimburses your employees up to the allowance you provided them

 
You set the allowance and your workers make their own purchases. If personalization and freedom are priorities, then consider going with QSEHRA.
 
3. Co-Op
 
Entering a co-op is one method that many business owners have seen to be tried-and-true. Joining a co-op spreads risk to a bigger group and increases buying power. However, not every co-op is created equal. Before you join one, make sure you determine whether it offers a better rate than something you can get elsewhere. 
 
4. Private Health Exchange
 
In a private exchange, your small group provides employees with a contribution they can use for plan options. These plans may be group- or individual-based. Brokers may offer this type of option by partnering with a private exchange provider or defined contribution.
 
5. Private Small Group Plan
 
You always have the option to buy a private plan. If you want more carriers and options than what’s provided by the SHOP Marketplace, then this may be something to consider.
 
If you need help finding affordable health insurance that makes sense for your business, call us at ​707-823-3689 for a quote.

​Some decisions are easy. When you need a haircut, you go to the barber or hair salon. If you need to fix your car, you see a mechanic. But making choices regarding your health care can be a lot murkier. When you’re hurt or feeling sick, you may wonder whether you should go to the emergency room, an urgent care facility, or schedule an appointment with your primary physician. 
 
Knowing where to go can be difficult. It all depends on your specific ailment, timeframe, budget, and health insurance. Here’s a guide to assist you.
 
Emergency Room
 
If you have a health emergency that requires immediate treatment, you should go to the emergency room. Some serious conditions that warrant an emergency room visit include:
 

• Potentially life-threatening symptoms, such as chest pains, stomach pains, high fevers for longer then a few days, difficulty breathing, sudden and severe headaches, or seizures.
• Acute trauma, including broken bones, head injuries, car accidents, uncontrollable bleeding, 

 
Whether you suffer a serious injury or are experiencing symptoms of a stroke or heart attack, you should get emergency treatment. 
 
Urgent Care
 
Urgent care centers and walk-in clinics are great options if you can’t wait for your primary doctor. Sometimes your doctor may be booked for days, weeks, or months at a time. Perhaps you need to get medical care on the weekend or after-hours. Certain symptoms and conditions simply can’t wait but don’t necessarily justify a trip to the emergency room. Potential reasons for getting urgent care include:
 

• Cold or flu symptoms, such as a cough, sore throat, ear pain, and nasal drainage.
• Sprains and strains.
• Minor cuts.
• Minor burns.
• Nausea or vomiting.
• Rashes.

 
An urgent care facility can also provide X-rays and stitches if necessary. In most instances, the cost of going to an urgent care center will be less than an emergency room visit, but you should always determine whether the center accepts your health insurance plan before going.
 
Primary Care Doctor
 
You should always contact your doctor’s office first if you’re in a non-emergency situation. Your doctor knows your in-depth medical history and will be able to assist you with everything listed above in the Urgent Care section. Plus, your doctor will promote your health and conduct preventive screenings. This is the most cost-effective option, so if you can wait to see your primary physician, you should do this instead of going to urgent care. 
 
You can receive health care in various places, but it’s ideal to get it from your primary doctor when possible. This usually costs less and takes less time than urgent care or the emergency room. For more health tips from Sackett Insurance, like our Facebook page.

​Deductibles, co-pays, coinsurance and cost sharing are all words that come up in the insurance industry. Lay people can often get these terms confused. Let’s discuss them to understand the portion of the bill you’ll be responsible for after insurance pays. 

Cost sharing is simply the share of the healthcare bill you pay out of your own pocket. It includes the deductible, coinsurance and copayments, but not the premium or cost of non-covered services. Cost sharing is a general term that you may see when buying insurance to give you a good idea of your overall cost. 

The deductible is the amount of money you pay before insurance will pay a claim. If you have a $1,000 deductible, you have to pay 100 percent of that amount before your insurance will pay anything. Make sure your healthcare provider files claims with the insurance company to give you credit for meeting your deductible. 

Coinsurance 

Once you have met your deductible, if you have coinsurance, your insurance company will typically pay for a percentage of further charges. A typical coinsurance is 20 percent. Let’s say you go into the hospital for surgery. Your final bill is $10,000. You have a $1,000 deductible, and 20 percent coinsurance. You would have to pay the $1,000 deductible first, leaving a bill of $9,000. Then, you would be responsible for 20 percent of that $9,000 or $1,800. Your total bill would be $2,800. The insurance would pay $7,200. 

A lower coinsurance is a good option when you have a chronic condition where you know you’ll need a lot of care each year. 

Copay 

With a copay, you pay a fixed amount for healthcare. Typically, you pay this amount at the time of service. Here’s where it can get confusing. Your plan will determine your copay, say $25, for a doctor’s appointment. The copay may be applied before you pay the deductible, but it may not go toward the deductible. Some plans have copays for certain types of care, but have coinsurance for other services. 

If your insurance lists a $25 copay to go to the doctor, you would pay your copay. Some insurance plans may have a coinsurance for x-rays or lab work you receive at the doctor. Generally, the insurance company receives the claim from the doctor and applies the terms of your plan according to the codes billed by the doctor. 

With a copay, you know exactly how much you’ll pay when you go to the doctor, even for a minor issue. 

Insurance doesn’t have to be difficult, but if you don’t understand the verbiage, it can be confusing. Follow Sackett Insurance Services on Facebook to get more industry information.

Whether you seek to acquire an individual or group health insurance plan, you want to have a good idea before you sign up which doctors you can see. Perhaps there is a doctor you have seen for years, and you want to continue seeing him or her on this new plan. Always make informed decisions when it comes to securing the best plan for your needs. 

Verify a Doctor With the Insurance Provider

One option you have to check which network a doctor is in is to acquire the doctor’s tax ID number. You can get this easily by contacting the doctor’s front office. After that, you can get in touch with the prospective insurance carrier. Provide the agency with the tax ID number, and a representative will be able to tell you whether the doctor accepts the plan in question. 

Verify Through the Doctor’s Office

If you have the information for a specific health insurance plan, then you can see if a doctor would accept it by contacting the doctor’s front office. Generally, you simply need to ask the question like this, “Does Dr. Stevens accept the Blue Shield Bronze 60 PPO plan?” Don't worry If you receive government subsidies through a Covered California plan, there is no need to ask if the doctor accepts those marketplace plans. 

Browse Through the Insurance Carrier’s Online Directory

One way to learn this information without having to speak to anyone is to go to the insurance provider’s online directory. You should be able to readily find this on the insurance carriers website. You will be able to search for the doctor’s name and see whether he or she is within your network. However, it's still wize to double check with your doctors office to verify they still accept your insurance plan.

You can learn about an array of health insurance policies with the aid of Sackett & Associates Insurance Services. Request a quote through our online form. Stay informed of the latest insurance news in California by subscribing to our blog. 

It’s easy to get confused by the various health insurance plans available to individuals and groups in California. Many people become overwhelmed by the wide variety of coverage and premium options and don’t know how to find a plan that best meets their unique health needs. 
​
Fortunately, everyone has access to the services of an insurance broker whose primary responsibility is to help individuals and groups find the right insurance plan. Here are a few of the top ways you can benefit by using a health insurance broker to find the ideal plan for yourself, your family or your employees. 
​
1. Free Services
​
Broker services are free, so there’s no need to worry about incurring any extra costs when shopping for a health insurance plan. Why sift through dozens of potential insurance plans yourself when someone else can do it for you, free of charge? Even though you don’t have to pay them, brokers work for you and keep your best interests in mind when narrowing down your policy options. 

2. Plans That Fit Your Needs

The experienced brokers at Sackett Insurance Services are intimately familiar with the many different health plans from which you can choose. They are able to shop all the health plans available to find the best fit for each client. They’ll ask about your coverage preferences and requirements and your budgetary restraints. Then, they’ll use the information you provide to help you select the ideal plan or group of plans that fit your needs. 

3. Privacy Protection

The California Insurance Code (Sections 791-791.27) states that your personally identifiable information must be protected, including information given to insurance brokers and companies. In all cases, brokers must provide you with a printed or written notice describing their policies and practices regarding privacy and how your personally identifiable information will be shared. The intent of privacy laws is to ensure that your personal information is protected as much as possible. 

Contact Us
​
Finding a broker in California is easy. The California Department of Insurance recommends calling a health insurance broker company directly. If you’re ready to find the ideal health insurance plan without spending hours sifting through hundreds of options, Sackett Insurance Services can help. For more information about our free services, contact us at 707-823-3689. We also encourage you to like us on Facebook, find us on Google+ and subscribe to our blog. We’d love to show you firsthand how easy it can be to find the perfect health insurance plan.

The Affordable Care Act experienced a lot of ups and downs this year. Congress attempted to repeal and replace the act over the summer but was unable to assemble enough votes. However, many in Congress, especially those in the Republican party, still want to repeal at least some areas of the ACA. One area of contention in this law is the individual mandate, which might become obsolete with the passing of the tax reform bill.

What Is the Individual Mandate?

The ACA's individual mandate requires everyone to obtain some type of qualifying healthcare coverage through their job or on their own. Otherwise, you face paying a penalty with your income taxes for every month for which there was no coverage, which can be as high as over $2,000 per person or the total yearly premium of the average national price of a Bronze plan. Businesses that employ more than 50 employees must also provide qualifying health insurance for their employees as part of the individual mandate. 

Does the Individual Mandate Remain Valid?

The Republicans in the Senate tried one more time to do away with this part of the ACA by adding a repeal of the individual mandate in their tax reform bill. Because this bill passed, there are many questions as to what this means for individuals around the country. 

Although the tax reform bill includes a repeal of the individual mandate, the bill is not yet law. Therefore, the individual mandate remains applicable. Starting this tax season, the IRS plans to reject tax returns that omit the information regarding health coverage. 

What About the New Tax Reform Bill?

Currently, the tax reform bill has passed through both the House of Representatives and the Senate. Only the Senate bill includes a repeal of the individual mandate. As of publication, the two bills must undergo a conference committee during which leaders of both parties debate the differences in the bills, including the repeal of the individual mandate, and create a single bill. Then, both parties voted on the conference bill with a simple majority to pass it. After that, President Trump signs the bill into law. 

Although the new tax reform passed into law, whether the repeal of the individual mandate remains is unknown. However, it will most likely not impact 2018, since the change would not begin until 2019. Therefore, for the time being, it is important to remain compliant with the current law, which includes the ACA and the individual mandate.

For more information on securing health insurance for individuals or for groups including employee benefits to remain compliant, contact us at 707-823-3689. To remain up to date on the latest health coverage news, like us on Facebook, find us on Google+, and subscribe to our blog.