Looking to purchase group health insurance for your Oregon business?
Choosing the right group health plan for your Oregon company can be considered a significant financial investment in your employees. For many companies, health insurance is one of the highest expenses after payroll. It is essential to work with a broker that understands the immense financial responsibility. As a Portland Oregon Group Health Insurance / Employee Benefit Broker I offer a broad selection of Oregon group health insurance plans to design group benefits for businesses from the leading Oregon health insurance companies which include:
- Aetna Health Insurance
- Heath Net of Oregon
- Kaiser Permanente
- Providence Health Plan
- PacificSource Health Plans
- Regence BlueCross BlueShield of Oregon
- United Healthcare
- MODA Insurance
- Samaritan Health Plans
Oregon and Federal Requirements
Under the Affordable Care Act (ACA), an employer with at least 50 full-time (working more than 30 hours per week) employees must offer health insurance coverage for full-time employees and their dependents. Dependent children must be offered coverage up until age 26. If insurance is not offered, is not affordable, or is substandard, and any employee uses a tax credit to purchase individual insurance via the Oregon Health Insurance Marketplace, you can be subject to fines. Employers must report subsidized health care costs on the employee’s W-2 form to promote transparency.
Oregon Group Health Insurance Options
When purchasing group health coverage, a variety of options are presented to you for consideration. Most plans fall into one of two categories:
- HMO Plans (Health Maintenance Organization) provide services through contracted providers. Members are only covered for services from these providers.
- PPO Plans (Preferred Provider Organization) contracts with certain providers. Members receive lower-cost treatment from these providers, and pay higher fees with others.
An HMO has more restrictions such as a limited network although may be more affordable. A PPO may provide your employees more flexibility in choosing their health providers, but may also incur more cost to your company and employees.
The premiums for these plans might vary based on a number of factors including deductibles, co-insurance, and co-payments. These have the ability to be tailored to fit your budget and to meet the affordability provisions of the ACA.
Creating Group Health Insurance Plans That Meet Your Needs
I design health insurance plans that are competitive and attract and retain employees while balancing your budget needs. Employee benefits discussed and designed for your business include the following:
- Group Health Insurance
- Group Dental Insurance
- Group Short Term Disability Insurance
- Long Term Disability Insurance
- Health Savings Accounts (HSA)
- Health Reimbursement Accounts (HRA)
- Group Vision Insurance
- Group Term Life Insurance
- Employee Assistance Programs
- Flexible Spending Accounts (FSA)
- Key Person
- Individual Plans
HB 2002 expanded the definition of an Oregon Small Employer Groups from 2-25 to 2-50 employees. “Small Employer” means an employer that employed an average of at least 2 but not more than 50 employees on business days during the preceding calendar year, the majority of whom are employed within this state, and who employs at least 2 eligible employees on the date on which coverage takes effect.
Dependent or Spouse and Dependent ages (not just employees)
Percentage of employees & dependents participating in the insurance plan
Premium contribution by the employer and employee
Expected claims experience (min or max of 5%)
How many years group has had their plan with their current carrier
Health promotion engagement by employees and dependents
Each carrier has the ability to file different combinations of the above criteria.
Waiting periods for coverage for new hires cannot be longer than 90 days.
All categories of employees, management, non-management, etc, must have the same hours per week and probationary period for eligibility.
Employers may not ‘class out’ employees for the purpose of denying eligibility for health coverage.