Florida Group Insurance
Give Your Group Health Policy Another Look
Are you paying too much for your group health insurance? You might be.
If so, is this the time to be doing that? What if you could offer your employees the same or better coverage for less money?
With the current economy, it might be time to reassess your provider. Are you receiving the best for your employees and your business? The group health insurance professionals at Harbor Insurance will procure several plan options for you. From deductibles to the physician network to coverages offered, we will help you sort out the programs that work best for your situation.
In these turbulent times and on this changing health insurance landscape, you need to review your group health policy every year. So, complete the Protection Saver Form below, today—before the next open enrollment period. We will then contact you to discuss your needs and provide you with enough viable group health quotes to select from.
Group Plans Available in Florida
In order to be considered for group health insurance coverage, a carrier will require a minimum of two employees. An eligible employee is one who works on a full time basis with 25 or more hours per week. The employer is responsibile for verifying that their group meets the eligibility requirements on an annual bases. A health insurance company reviews the application for complaiance when a group starts a new plan and an audit may be completed each year at renewal.
- 75% or more of the company employees must be employed in Florida
- Coverage can only be waived without having coverage elsewhere by 25% or fewer employees
- At least 10% of the premium cost must be paid by the employer
- The employer has authority to declare the waiting period timeline for enrollment for new employees
Types of Group Health Plans
- HMO: This managed Care plan gives your employees the security of lower out-of-pocket expenses, comprehensive coverage and virtually no claim forms to fill out. Employees choose a primary care physician who will manage medical care and refer employees to specialists and hospitals within the network.
- POS: Your employees have the freedom to use the managed care network of physicians or choose doctors and hospitals outside the network. In network, the employees select a primary care physician (PCP) to coordinate their needs and to refer them to in-network specialists. By going out-of-network employees may encounter higher out-of- pocket expense and more paperwork.
- Direct Access: This open access plan provides employees with direct access to all primary care and specialists within the network without a referral. They do not need to select one primary care doctor. While employees have the freedom to choose from doctors and hospitals within the network, they may also go outside the network. By going out- of-network, they will encounter higher out-of-pocket expenses. Employers can choose from various plan designs to meet their budget and benefit needs.
- PPO: This preferred provider organization gives the employees the largest selections of network doctors and hospitals. If the employee uses the network, he receives a higher level of coverage; if he chooses out-of-network physicians or hospitals, he pays a higher share of the cost. Various plan designs are available.
- HSA: A Health Savings Account is like a 401K for healthcare. It is a tax advantaged personal savings or investment account that individuals can use to save and pay for their qualified healthcare expenses, now or in the future. Paired with a qualified high deductible plan, the HSA is a powerful tool that empowers consumers to be more actively involved in their health care decisions. Harbor Insurance has the necessary knowledge and expertise to assist both employers and employees who are considering Health Savings Accounts.
- Dental Coverage: May be purchased as a standalone plan or as a rider (an add-on) to a group health plan.
- Vision Coverage: May also be purchase as a rider (an add-on) to group health plans.
Important Employer Considerations
Coverage must be offered to all eligible employees. When the employer pays 100% of coverage costs, all employees must enroll unless they sign a waiver that they have other coverage. In plans where employees are asked to contribute, employees may waive coverage if they have other coverage or cannot afford coverage. However, if 25% of the employee group declines coverage without other health insurance elsewhere, the entire group is then ineligible and the group is not in compliance to receive benefits.
COBRA or Insurance After Work: In Florida, companies with two to nineteen employees must continue to provide coverage for twelve months after termination. The coverage must also be offered to the employee's spouse and child. All potential beneficiaries must apply for continued coverage within 30 days of termination.
In reference to Guaranteed Issue; in Florida, no one can be declined due to a pre-existing condition. They may however, be subject to a pre-existing condition exclusion for six months if they have had a lapse in coverage of over two months.
Today, more than ever before, employers need to understand the requirements in offering a group plan. Health insurance is becoming more complicated every day. At Harbor Insurance, we are committed to educating employers and helping you to streamline your plans during these difficult economic times.