Group Health Insurance
Although group health insurance is a crucial component of your employee benefits package, signing a contract with a certain provider can be a significant commitment. The choices you make have an impact on the wellbeing of your employees, who are your most precious asset. Employers must balance cost control with offering worthwhile perks to entice and keep top employees in light of the escalating expense of healthcare. We specialize in insurance at Kent Lu Insurance Services. We can help you with your needs for group insurance and make your health plan RFP as effective as possible.
Request a Quote
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Once your application has been accepted, the insurance provider will evaluate your group based on factors including your company's size, location, and employee age to determine a final premium. Employee health and pre-existing diseases have no longer an impact on group health insurance costs since the Affordable Care Act was established.
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Small business owners may be eligible for tax credits up to 50% of employer contributions to employee health insurance premiums. Under the Affordable Care Act, businesses with fewer than 50 full-time employees are not required to provide group health benefits and will not face any tax consequences if they do not offer these benefits. However, companies that employ 25 or fewer employees who earn an average annual wage under $50,000 are eligible for special tax credits, provided the employer contributes a minimum of 50% of employee insurance premiums.
As of 2016, under the Act, employers with 50 or more full-time employees are required to provide affordable health insurance to employees or pay a tax penalty. Our agents can help you select the right group health insurance plan for your needs.
Our Services
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Insurance Policy Assistance
Questions about your insurance policy? Feel free to reach out to us and we’ll help you navigate your healthcare options.
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Free Quotes
We’ll help you narrow down a selection of relevant plans for you to compare.
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Medical Bill Tracking Support
We can help you address any issues with Tracking Medical Bills
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Update Insurance Information
We can help you update your infromation and change your Primary Care Physician and Medical Network
Insurance Carriers
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Anthem Blue Cross
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Blue Shield
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Health Net
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Kaiser Permanente
FAQs
Why do I need health insurance?
The United States is a country with the most expensive medical expenses in the world. A general outpatient, surgery or emergency charge can cost hundreds to thousands of dollars. Health insurance protects you from unexpected high medical costs.
Is there a penalty for not having health insurance in 2023?
The penalty for not having coverage the entire year will be at least $850 per adult and $425 per dependent child under 18 in the household when you file your state income tax return.
What is open enrollment?
After the implementation of Affordable Care Act (Obamacare), major insurance companies can only accept the purchase and change of health insurance plans during the open enrollment period which from November 1st of each year to the end of January 31st of the following year. The enrollment end period can be varies if there is a special circumstance.
What is special enrollment?
You can apply for a health plan outside open enrollment (or make changes to your current plan) if you’ve experienced one of these qualifying life events, usually within the last 60 days. The effective date of the insurance is the 1st of the following month after submitting the application.
Gained U.S. citizenship or lawful presence
Had a baby or adopted a child
Moved to/within California
Lost existing health coverage, including job-based individual plans
Got married or divorced
Turned 26 and lost coverage through a parent’s plan
Death in the family
Lost eligibility for Medicaid/Medi-Cal
Returned from active-duty military service
Released from incarceration
What documents are required to apply for the subsidized health insurance?
Only California taxpayer residents are eligible to apply for the subsidized health insurance through Covered California. For new immigrants, a social security number and legal immigration status documents are required (Employment Card, Permanent Resident Card, Certification of Naturalization, or passport). Your pay stub or tax return is required as proof of income.
Why there are different premiums for the same coverage plan among different insurance companies?
Different insurance companies have different contracted medical network. Usually, a larger medical network will have relatively higher premiums. The premiums in different regions are also different due to medical claim ratio.
What is Medic-aid / Medi-Cal?
Medi-Cal is California's Medicaid program. Medi-Cal gives people with low incomes access to health services without paying insurance premiums and medical expenses. However, the contracted medical network is very limited and usually the waiting period of the medical appointment is longer.
*In some cases, monthly premium for children under 18 yrs old may required.
How can I change my Medi-Cal plan to a subsidized health insurance?
Subsidized health insurance and Medi-Cal insurance cannot exist at the same time. If you currently hold a Medi-Cal insurance, you need to contact the Department of Social Services to cancel your Medi-Cal insurance, even if it is not during the open enrollment period of health insurance. After the Medi-Cal insurance is cancelled, then it is eligible as special enrollment period. You can apply for the subsidized health insurance within 60 days. After the application is submitted, it will be effective on the 1st of the following month.
How much Subsidy you can get from Covered California?
Covered California refers to the standards in the Federal Poverty Level to provide premium subsidies according to different household sizes and adjusted gross income on the 1040 tax form. The variety Silver plans are depend on the income ranges.
View the chart here
What are the differences among HMO/PPO/EPO plans?
HMO plan requires you to designate a Primary physician and a medical network. Except for emergency medical treatment, you need to make an appointment with a Primary physician first, and the Primary physician will determine whether it is necessary to refer you to a specialist or make an appointment for surgery. The medical costs will not be covered outside the contracted medical network.
PPO plan allows you to directly make an appointment with a Specialist doctor without a referral from a Primary physician, and larger contracted medical network. Some of the medical costs will be covered under non-contracted medical network.
EPO is between HMO and PPO. EPO is easier to make an appointment with a Specialist doctor without referral from a Primary physician. It is more convenient than HMO, but there is no coverage for non-contracted medical network, and contracted medical network is smaller than PPO plans.