Employee Benefits for Texas Small Business


Top Mistakes Employers Make Regarding Employee Benefits

“Mistakes” is a tough word, but allow us to also use the words false assumptions or oversights.

First, allow me to state my affiliation…

I am an employee benefits specialist who works almost exclusively with small businesses in Texas.  Services include group health insurance, voluntary benefits, Cafeteria plans, etc.   I have visited with literally thousands of business owners in the past few years and have experienced a plethora of scenarios.

First, let us deal with employers who value employee benefits and try their best to offer plans that work for both the employer and the employee:

The number one oversight I see is that employers do not take advantage of tax savings for their group health insurance.  Sometimes it is lack of information and sometimes it is distrust of the system.  Regardless, employers can save money for themselves and their employees.  Say, for instance, an employee is paying $700 for family health insurance each month via deductions from their paycheck.  With a Section 125 or comparable plan in place, the employee can save on average 15% (or $105) a month on those premiums.  The employer further can save on average nearly 10% (or $70) a month in payroll taxes because the premium is removed from the payroll base.  I’m no tax adviser, but the math is fairly simple.

Second, I see many employers who feel they cannot afford the roller coaster ride of implementing a group health plan and instead figure they can make up the benefit by paying each employee an extra, say, $200 a month and tell the employee it is for their insurance.  This has a three-pronged disadvantage.  First, the employer is paying on average $20 additional a month in payroll taxes for the “raise” (in addition to the $200).  Second, the employee is paying income taxes on the $200,  so they net maybe $165.  So, to give an employee $200 for health insurance through income, over $55 is lost between employee and employer.  The final straw comes when inevitably the employee (through no fault of their own) starts to take the benefit for granted.  After a year or so, the connection to health insurance is lost in their minds.  And, in fact, most of the time when I see this scenario, the employees still don’t have health insurance. And this whole scenario assumes each employee is young and healthy and insurance costs only $200.  Go figure.

Now let us consider the employer who is disconnected from their employees in terms of projecting need.  I have had employers tell me that their employees cannot afford voluntary benefits such as short term disability or supplemental health.  In fact, one employer told me we would never get an employee interested because none of them was interested in the group life insurance that cost only $.75 a paycheck for $10,000 in coverage.  Luckily, we got the go-ahead to see the employees anyway. Well, turns out that $.75 a paycheck was not worth the little amount of life insurance for this group, but 18 of the 22 employees found value in other options we provided.  The average employee spent nearly $60 a month in voluntary benefits – because they fit their individual needs.  The employer typically speaks on behalf of the employee without truly understanding where the need is.  Of course, the employer typically is in a different tax bracket than the employees. My job as a benefits specialist is to address the need, but sometimes who have to fight through the false assumptions just to get the opportunity to speak to the individual.

I love when an employer tells me that they want to survey their employees and see if they are interested in voluntary benefits.   If they are, then the employer will get back to me.  Behind the scenes a conversation goes like this:

Employer:  Hey folks, do you want to talk to an insurance guy that stopped by about getting some more insurance.  He says its cheap.

Employees: No, not really.

In reality, there is a reason insurance agents need a license.  The license requires a minimum amount of expertise and ethics so that we can communicate to individuals not only what the options are, but how they work and why an individual might need them.   Nearly 70% of American workers either do not have life insurance or are under-insured.  A 10 minute conversation with a professional would go a long way toward reducing sleepless nights. 

Furthermore, the most important asset a working American has is his or her paycheck.  Without sufficient insurance, the paycheck is also their biggest risk.  Lose the paycheck due to accident or illness and watch the dominoes fall.

Survey the average American worker, and most would say their employee benefits are insufficient.  Certainly the increase in health care has a large part in this, but another aspect is an employer working on false assumptions without allowing a specialist to address the needs of the individual.



The Magic Bean for Group Health Insurance?

 

 

Offering employee benefit plans has become increasingly challenging and often cost prohibitive for small business owners.

The traditional process of requesting quotes and going with the lowest bidder simply does not work for most small businesses.  The time required to research and implement benefit plans is simply not available to the small business owner at the expense of managing their company.

Until now, the only alternatives were: offer no benefits or struggle with an ill-fitting benefit plan that stretches the financial tolerances of employer and employee alike. 

I‘d like to introduce you to a different approach.  We’re all looking for the magic bean in group health and employee benefit solutions.  This approach may not involve magic, but it certainly provides a solution to a question that seemingly had no good answer.  The solution is two-fold.

I. What if you could offer your employees a medical plan with:

  • $500 deductible
  • ID Card with access to Texas True Choice, the premier PPO network in Texas
  • 70/30 coinsurance with $3000 max out of pocket
  • $30 doctor visit co-pay
  • prescription plan
  • chiropractic coverage
  • dental coverage
  • $15000 Life Insurance per employee

And have it cost less* than $250 per employee and as low as $425 per family?

Comparable major medical plans would cost in excess of $700 per employee and $1800 per family for a $500 deductible.

How does this plan differ from the others than I have known and/or used?

The only key difference is how the total coverage is calculated.  This plan offers $100,000 of coverage per year (per covered individual) after which coverage ceases.  A traditional group health plan can offer $1 million in lifetime coverage.

Is that enough?

Statistically, this plan will cover all needs 98.2% of the time.  However, we have a solution for those who wish to buy up and have $1 million of lifetime coverage** in conjunction with this plan.  The cost of the buy-up depends upon the age of the individual, but is typically between $30 ~ $50 per person who opts for it. The nice aspect of the buy-up solution is that it is voluntary to the employee and legally does not require the employer to pay for even a portion of it.

Basically, these solutions provide each employee a $500 deductible with up to $1 million in coverage for typically less than $300 a month. 

 

 

* Rates are subject to medical underwriting and may be higher or lower depending upon the age, gender and medical history of applicants.  **  While the group medical solution is guaranteed issue, the buy-up requires that the applicant qualifies medically.  It is possible in some cases that an individual would not qualify for the buy-up coverage.