Health Insurance

Available "on exchange" or "off exchange" means through a government website or directly through a carrier.  Most plans are available on the government exchanges where you can apply an advanced premium tax credit or cost sharing reductions if you qualify.  These are the standardized and regulated plans available to all who fit the criteria.  Also referred to as "Obamacare", this is the majority of insurance available today.  Your rate is determined by age, gender, and location alone.  Some of the great things the Act did was force insurance carriers to cover preexisting conditions, pay for preventive care, & standardize what plans cover.  This also drove up costs significantly for these plans making it more important than ever to work with a broker who will make sure you get all the assistance you might qualify for.

Small groups are employers with less than 50 or 100 employees based on your state.  Your rate is determined by age and location alone.  You must have at least one non-related employee on payroll and contribute to some of your employees premium costs.  You can enroll in these plans any time and cancel any time.  There is no negotiating the rates for these plans or customizing the benefits.  However, depending on where the business is located, there may be hundreds of plans to choose from.  Choosing the right carrier, offering different network options, and educating employees is crucial to controlling costs when offering these plans.

For groups of over 50 or 100 employees based on your state.  Different from Small Group plans in many ways.  Examples include custom rates vs shelf rated age-banded ones in a small group.  Plans start to become more customizable and rates are negotiable.  If you own multiple small businesses, the employee count for all of your entities should be combined which could qualify you for Large Group plans.  Plans offered by an employer must meet affordability guidelines for your lowest paid eligible employee.

These are for groups who qualify by size, location, and are a member of the Association the plan is connected to.  Smaller employers are able to pool together to form a larger population.  In turn, you are granted access to plans insurance companies reserve for large employers and you are rated differently.  Most companies see significant savings of 25-50% over ACA plans and receive richer benefits.

These are underwritten plans for businesses.  Meaning the health and demographic of your employee population has a huge impact on costs.  Putting together your own plan leads to more control and access to information which may be affecting your costs.  These plans require more time, participation, and education but can lead to long term improvements for an employers healthcare spend.

This is a more advanced type of Self-funded insurance.  Typically a group of companies join together to form their own insurance company.  This requires the most time and startup costs, but results in the most control over your costs as an employer.  There are many large captives active today.  Companies are required to apply, interview, be underwritten, and buy-in to these established captives.

Most health insurance doesn't work outside of the country.  Travel insurance exists for temporary coverage during a single or multiple trips.  Some long term plans exist for individuals who regularly travel or live abroad.  These long term plans can also provide domestic coverage.