Help with Small Group Health

[justing]

I have a dentists office with one dentist and 3 employees. The Dentist does not want to get a group health plan that he has to take part in, but is willing to contribute for the employees.

Is there anything available to them?

I am new to this area of insurance.

Thanks

 

[DS4]

3 out of 4 should be ok for group coverage in your state.
What is the reason the dentist doesn't want to participate? Does he have group coverage through his spouse? Or, a group plan through a dental association? Or, he already has an individual health plan?
If the dentist agrees to contribute towards the employee cost, the hard part of the sale is over!

 

[justing]

He has his own individual and is scared to change it due to pre-existing conditions.

 

[Full Throttle]

Two ways to go:

1. Group plan: as already stated, most states only require 75% of eligible employees to apply. If the dentist is the owner, you can also exclude the owner from eligibility if desired and you have 100% participation.

2. Monthly Bonus Allowance: set-up a 105 or 125 plan that the business will contribute $X per month to help out the employees.

Both have advantages and drawbacks.

 

[Justin Bilyj]

Matt, you should right an e-book for small group business...

 

[Crabcake Johnny]

You need more information. How many of the 3 employees will participate and at what cost? Maybe 2 of the 3 are covered under their spouse's policy and the other 1 can't handle their portion of the group premium. More research.

 

[DS4]

He has his own individual and is scared to change it due to pre-existing conditions.

I'm sure his individual health plan is "Creditable", meaning, if the dentist enrolls in the group plan, he will not be exposed to a pre-existing condition clause. Provided he has been on the previous individual plan for 12 months or more.
You need to find out exactly how much the dentist is going to contribute towards the employee cost. This is key.
If the dentist "waives" coverage, and retains his current ind plan, you will in all likely hood need to have the all the eligible employees enroll to satisfy participation percentages.
I will expect to hear in the near future that this case has been sent to underwriting for approval.

 

[Justin Bilyj]

Would he be paying less as well, going to the small group plan?

 

[DS4]

Would he be paying less as well, going to the small group plan?

To answer this question, you would need more info about what the dentist currently has, and, how much he is paying.
Lets assume the dentist currently has Mega Life & Health. For little or no add'l premium, the dentist could greatly increase coverage.
The ind plan the dentist currently has probably doesn't have maternity. The group plan will. Of course, if the dentist is past the baby stage of life, don't bring this point up.