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eHealth can help with health reimbursement arrangements
Individual Contribution Health Reimbursement Arrangement, also known as ICHRA, offers many advantages over traditional group plans. ICHRA may be right for you if you want greater control of costs while giving your employees more flexibility in choosing their ideal health plan.
| ICHRA | Group Health Insurance | |
|---|---|---|
| Reimbursement model | Employers choose contribution amounts based on employee class and family size. | Employers offer a plan, or a selection of plans to employees - and if the employer chooses - their employees' families. |
| Is minimum participation required? | No | Yes |
| Employer contribution limits | No minimums or maximums | No. However, in order to be eligible for the Small Business Health Care Tax Credit, employers must contribute 50% or more of the cost of premiums for all full-time employees. |
| Employer eligibility | Employers of any size with at least one other employer (other than their spouse). | Generally, small employers with 1-50 employees are eligible for SHOP. Employers of any size can offer group coverage. |
| Employee eligibility | Any employee classes of the employers' choosing, including part-time and seasonal workers, so long as they have minimum essential coverage. | Any employee classes of the employers' choosing |
| Coverage flexibility | Employees choose their health insurance plan and what healthcare purchases they make so long as they are qualifying expenses. If they choose to leave the company, they can keep their current plan. | Employees have a plan or selection of plans to choose from that offer minimum essential coverage based on what the employer chooses to offer. |
| Enrollment | Employers can enroll any time of the year. Employees with an ICHRA election will be offered a special enrollment period. | Small businesses can generally enroll during any time of the year. |
| Tax information | ICHRA reimbursements are not taxed to the employee. However, if an employee accepts an ICHRA offer they cannot receive premium tax credits. | Group health plan contributions are generally not taxed to the employee. However, in order to offer a SHOP plan the employer must be eligible for the Small Business Health Care Tax Credit - which means they must contribute 50% or more of full time employees' premiums. |
| ICHRA |
|---|
Reimbursement modelEmployers choose contribution amounts based on employee class and family size. |
Is minimum participation required?No |
Employer contribution limitsNo minimums or maximums |
Employer eligibilityEmployers of any size with at least one other employer (other than their spouse). |
Employee eligibilityAny employee classes of the employers' choosing, including part-time and seasonal workers, so long as they have minimum essential coverage. |
Coverage flexibilityEmployees choose their health insurance plan and what healthcare purchases they make so long as they are qualifying expenses. If they choose to leave the company, they can keep their current plan. |
EnrollmentEmployers can enroll any time of the year. Employees with an ICHRA election will be offered a special enrollment period. |
Tax informationICHRA reimbursements are not taxed to the employee. However, if an employee accepts an ICHRA offer they cannot receive premium tax credits. |
| Group Health Insurance |
Reimbursement modelEmployers offer a plan, or a selection of plans to employees - and if the employer chooses - their employees' families. |
Is minimum participation required?Yes |
Employer contribution limitsNo. However, in order to be eligible for the Small Business Health Care Tax Credit, employers must contribute 50% or more of the cost of premiums for all full-time employees. |
Employer eligibilityGenerally, small employers with 1-50 employees are eligible for SHOP. Employers of any size can offer group coverage. |
Employee eligibilityAny employee classes of the employers' choosing |
Coverage flexibilityEmployees have a plan or selection of plans to choose from that offer minimum essential coverage based on what the employer chooses to offer. |
EnrollmentSmall businesses can generally enroll during any time of the year. |
Tax informationGroup health plan contributions are generally not taxed to the employee. However, in order to offer a SHOP plan the employer must be eligible for the Small Business Health Care Tax Credit - which means they must contribute 50% or more of full time employees' premiums. |
To learn more about your options, call 1-, or click here to get a quote.
Does your small business qualify for California health tax credit?
If you're a small business owner in California, you may qualify for a tax credit that could cover some of the costs you pay for employees' premiums. If you qualify, eHealth can help you obtain your tax credit and find a small business health insurance plan that works best for you and your employees.
Number of full-time workers the company employs is within
25
Average annual wage per worker must be less than
$50,000
Minimum employer contribution toward employee coverage is
50%
If you are a small business owner with 25 full-time employees or less, and pay an average salary less than or equal to $50,000 a year, you might be eligible for a tax credit.* This tax credit was created under the Patient Protection and Affordable Care Act (PPACA) in order to give small businesses and tax-exempt organizations a break on the cost of group health insurance for their employees.
The federal tax credit will reimburse qualifying small businesses for up to 50% of the premiums they pay towards employee medical, vision and dental insurance. Tax-exempt organizations may qualify for a tax credit of up to 35% of premium expenses.
*In some states, the tax credit only applies to Qualifying Health Plans (QHPs) bought through government exchanges. Other restrictions may apply.
Small businesses with fewer than 10 full-time employees that pay average annual wages of $25,000 or less may qualify for the full credit. The amount of the credit is reduced for companies with more full-time workers and higher wages, until it is phased out entirely for those with 25 or more full-time workers and average annual wages over $50,000.
Because eligibility rules are based in part on the number of full-time employees, not the total number of all employees, businesses that use part-time help may qualify even if they employ more than 25 individuals.
This article is for general information and is not tax, accounting, or legal advice. Please consult a tax, accounting, or legal advisor for advice on your specific situation.
Frequently asked questions
How much does Small Business Health Insurance cost in California?
California group health insurance starts for as little as about $216 per employee.* Actual prices will vary based on age, gender, and a number of other factors. Get a free quote and compare coverage options to find a plan that suits your needs.
* This is based on the lowest-price plan available from eHealth in California, but actual prices available depend on zip code, age, gender, and other factors. Get a personalized quote to see what may be available for you.
What types of small business health insurance plans are available in California?
In California, small businesses have access to various types of small business health insurance plans to provide coverage for their employees. These include Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Exclusive Provider Organization (EPO) plans, High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs), and traditional group health insurance plans. HMO plans typically require employees to select a primary care physician and obtain referrals for specialist care, while PPO plans offer more flexibility in choosing healthcare providers. EPO plans combine elements of HMO and PPO plans, providing coverage within a network of providers without requiring referrals. HDHPs with HSAs offer lower premiums and tax benefits, but employees must meet higher deductibles before coverage kicks in. Understanding these options allows small businesses to tailor health insurance benefits to the needs of their employees while managing costs effectively.
What are the California-specific regulations for Small Business Health Insurance?
California has several state-specific regulations governing small business health insurance. These regulations include the requirement for insurance carriers to offer guaranteed issue small group health plans, ensuring that coverage cannot be denied based on the health status of employees or their dependents. Additionally, small group health plans in California must cover essential health benefits mandated by the Affordable Care Act (ACA), including preventive care, maternity care, mental health services, and prescription drug coverage. California also has regulations concerning the size of small businesses eligible for certain health insurance options, such as the California Small Business Health Options Program (SHOP) Marketplace, which caters to businesses with 1-100 employees. Furthermore, California offers tax credits and subsidies to small businesses to help offset the cost of providing health insurance to employees.
How does the Affordable Care Act (ACA) impact Small Business Health Insurance in California?
The ACA has significant implications for small business health insurance in California. Under the ACA, applicable large employers (businesses with 50 or more full-time equivalent employees) are required to offer affordable health insurance coverage that meets minimum essential coverage requirements to full-time employees and their dependents. The ACA also established the Small Business Health Options Program (SHOP) Marketplace, which provides a platform for small businesses with up to 100 employees to shop for and compare health insurance plans. Additionally, the ACA mandates certain protections for employees, such as prohibiting insurance carriers from denying coverage based on pre-existing conditions and capping annual out-of-pocket expenses for covered services. Overall, the ACA aims to improve access to affordable health insurance options for small businesses and their employees in California.
What is the California Small Business Health Options Program (SHOP) and how does it work?
The California Small Business Health Options Program (SHOP) is a marketplace designed to assist small businesses in providing health insurance coverage to their employees. It works by offering a platform where businesses with 1-100 employees can compare and purchase health insurance plans from different carriers. SHOP also provides potential tax credits and subsidies to qualifying small businesses to help offset the cost of providing health insurance coverage. Employers can offer their employees a range of health insurance plan options, empowering them to select coverage that aligns with their needs and preferences. Overall, SHOP facilitates access to affordable health insurance options, assists with tax credits, and offers flexibility in plan selection for small businesses in California.
Can small businesses in California offer different health insurance plans to different employees?
Yes, small businesses in California generally have the flexibility to offer different health insurance plans to different employees. Employers can choose to provide multiple health insurance plan options from various carriers through the California Small Business Health Options Program (SHOP) Marketplace or private insurance providers. This flexibility allows businesses to cater to the diverse needs and preferences of their workforce. Employees can then select the plan that best suits their individual healthcare needs, budget, and preferences. However, it's essential for employers to ensure compliance with any applicable federal and state regulations regarding health insurance offerings and employee benefits.
What are the consequences of not providing health insurance for employees in California?
In California, businesses that do not provide health insurance to their employees may face several potential consequences. While California does not mandate small businesses to offer health insurance, applicable large employers (ALEs) under the Affordable Care Act (ACA) may face penalties if they fail to offer affordable coverage that meets minimum essential coverage requirements to full-time employees and their dependents. Additionally, businesses may experience challenges in attracting and retaining top talent without offering health insurance benefits. Employees without access to affordable healthcare coverage may experience financial stress and reduced job satisfaction, impacting overall morale and productivity within the workforce. It's essential for businesses to carefully evaluate the impact of health insurance offerings on their workforce and ensure compliance with relevant regulations to mitigate potential penalties and risks.
Are there resources or assistance programs available to help small businesses navigate health insurance in California?
Yes, several resources and assistance programs are available to help small businesses navigate health insurance in California. These include Covered California for Small Business, which serves as the state's official health insurance marketplace where small businesses can compare and purchase health insurance plans. Additionally, Small Business Development Centers (SBDCs) offer free or low-cost consulting services, including guidance on health insurance options and compliance with state and federal regulations. Covered California for Small Business also offers a certified insurance agent program to provide personalized assistance and help businesses navigate the health insurance marketplace effectively. Small businesses can also seek assistance from insurance brokers, agents, and nonprofit organizations specializing in healthcare to understand their options and make informed decisions about health insurance offerings for their employees. These resources provide valuable support and guidance to help small businesses navigate the complex landscape of health insurance in California.
California Resources for Small Businesses
Business owners in California can expand their health insurance offerings to include group dental insurance and group vision insurance. California small business owners can also refer to the following resources about owning and operating a small business in California:
What people are saying
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"Before working with eHealth I thought buying group health insurance would be difficult. I didn't expect it to be as EASY as eHealth made it. My advice, work with eHealth - it's easy."
- MS Glass LLC, Texas
"As a busy business owner, I needed eHealth to advise me and handle my group health insurance details. eHealth is an invaluable resource. Health insurance doesn't have to be complicated. Need help? call eHealth!"
- Tabatha, Nevada
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