Talking about small business health insurance benefits with employees is important to your company's ecosystem. When done effectively, employees better understand group health insurance and how it impacts their lives. That understanding leads to proactive use of health benefits, keeping your workplace safe, healthy, and happy.
But when does this process need to take place? As a small business owner, ensuring a thorough explanation of health benefits is your responsibility. But don't worry. We're here to guide you through the process.
When to Review Offerings and Benefits
Annual Review
There should be a company-wide meeting to review current health insurance benefits every year. The annual meeting should take place even if no personnel or health coverage changes occur. Reaffirming what the plan contains and providing an explanation for associated costs helps limit employee confusion or frustration.
Changes to the Health Insurance
On the anniversary of the policy’s start date, open enrollment arrives, allowing business owners to change plans and add employees. Keep in mind, not only are some changes legally required to be communicated, but it's a good practice to stay ahead of questions employees may have. Show good intentions for your small business employees by outlining what is changing and why. If there are costs associated, expect questions, and make sure to explain why the changes must occur.
Onboarding Employees
New employees already have a learning curve when joining a new small business. Reduce the stress by creating a clear and complete benefits guide. It's also important to keep it accessible. Using a presentation is a great way to share the benefits and costs of group health insurance.
Putting Policies in Place
Preparing for these moments will become easier after putting policies in place. Once you create a presentation, file the proper documents, and organize forms, the work becomes maintenance oriented. Whether it is HR or a leadership team, having someone in your small business dedicated to health insurance will be helpful in the long run.
How to Effectively Communicate Health Insurance Benefits to Employees
Now comes the matter of distributing complex health care material. It's important to explain how to enroll, when to enroll, available insurance options, eligibility, and other health care-related terms (premiums, deductibles, out-of-pocket, etc.).
When to Sign Employees Up for Health Insurance
There are only certain times when small business owners can add employees to the group plan. Ensure clear communication with employees when discussing enrollment windows, dependents, and changing plans.
Waiver of Coverage
- An employee may waive their right to join the group health insurance plan. If they do, they will only be able to opt-in during a once-a-year period or if a qualified status change occurs.
Existing employees can opt-in for health care coverage:
- During the once-a-year open enrollment period
- For many small businesses, the open enrollment period for employees to sign up for coverage is typically one month before the policy renewal date with a one-to-two-week window for them to change their coverage.
- If they experience a qualifying status change such as:
- Having a baby/adoption
- Getting married/divorced or legal separation
- Death of a dependent or spouse
- Change of spouse’s employment/benefits
Employees can be removed from the health insurance plan:
- When the employee is terminated, or
- If they experience a reduction in hours or classification
Documents Needed
To sign employees up for health insurance, you'll need them to provide the proper documentation. They can either present a U.S. passport, a Certificate of Naturalization (DHS Forms N-550 or N-570), or a Certificate of U.S. Citizenship (DHS Forms N-560 or N-561).
If those are not available, view our Special Enrollment Period: Valid Documents Chart resource.
Legally required information by the Affordable Care Act
Specific laws in the Affordable Care Act (ACA) require employers to provide certain information to employees enrolling in health care. This includes:
- Exchange Notices
- Summary of Benefits and Coverage
- Summary Plan Description
- W-2 Reporting of Health Costs
- IRS Form 1095
- COBRA Notice (if applicable)
Frequently Asked Questions Employees have about Health Insurance
- Is it better to get health insurance through work?
- While not always the case, it may be cheaper for employees to enroll in health insurance coverage through work than to purchase through the open marketplace.
- What are the benefits of health insurance?
- While no longer federally required, ensuring coverage is a proven means of protecting an individual from potentially expensive health care costs.
- Can I opt out of health insurance?
- Employees do not need to enroll in work-provided health insurance. Individuals can explore the marketplace for a health care plan best suited for their needs.
- How do I choose between plan options?
- Different plans from different insurance companies offer vastly different coverage. Be sure to read up on HMOs (Health Maintenance Organization) and PPOs (Preferred Provider Organization) to help your employees choose which insurance plan is best for them.
