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California health insurance - Health plan basics in California - Health plans for Family Business

What is the right health insurance for a family business?

With all the talk of large corporations and their employment, most people are surprised to find the average company size in California is overwhelmingly between two and five people.

The so-called "mom and pop" business is more the norm and this allows for important considerations when choosing California health insurance for a family business.

Individual Family health insurance versus Small Group health insurance

The first real question to ask is whether you should look at Individual Family health coverage or a Small Group insurance plan.

There are pro's and con's to both.

First, the ACA law has impacted this consideration.

A family business must have a non-spouse on payroll to qualify for group health.

For a true family business, this rule may force individual family coverage.

Now with the new ACA law, the big difference is the network of providers available to you.

The individual family networks are about 1/3 smaller than group plans. This is true for Covered Ca or off-exchange plans as well.

Small Group California health insurance is useful in a few different situations.

There requirements to qualify for Group coverage but the three main ones are:

  1. At least one person formally tied to the company for more than 1/2 of prior calendar quarter (owner and/or payroll).
  2. At least 75% of the eligible participants must go with the plan. There can be some flexibility on this requirement.
  3. The company must pay at least 50% of the employee's health insurance premium.

These are the main stumbling blocks for small or new companies looking to purchase California Small Group health insurance.

Secondly, if you plan to offer health benefits to current or future employees, you want to do so with a group plan and not individual plans.

There can be liability in a company paying for individual insurance plans and the State frowns on such practices. If the coverage is really just for your family, this becomes less of an issue.

What type of California health insurance plan works with Family business?

Try to go with the lowest cost, comprehensive plan.

You are buying coverage for yourself so the premium savings with such a plan will usually outweigh higher deductibles, etc.

If you are offering employees coverage, this may not work as well. Employees view health plans as a fringe type of benefit.

If you offer high deductible plans, it may not be well received depending on the type of industry you are in.

If your employees are frustrated with their out-of-pocket expenses with such a plan, you are paying for a benefit with no tangible benefit to retaining or attracting good employees.

The big difference is that purchasing health insurance benefits for employees is viewed as "carrot" as opposed to health insurance for you and your family.

Employee Elect has allowed the best of both worlds in that they employer determine a fixed contribution (either dollar amount or percentage of a given plan) and then allows the employees to pick and choose from any of the plans.

The employee would pay the difference for a richer plan but this allows each employees to pick a plan that meets his/her needs.

This also works for family only plans where each spouse might have different needs or requirements.

You can run your Group Health Plan Quote here to view rates and plans side by side from the major carriers...Free.

Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!

Frequently Asked Questions
▸ Can a California family business get group health insurance?
Yes, California small group health insurance is generally available to family businesses, typically starting with two eligible employees. Whether a spouse, family member, or co-owner qualifies as an employee depends on how the business is structured, so speaking with a licensed agent helps clarify eligibility.
▸ What is the difference between individual/family and small group health insurance for a family business?
Individual/family plans (including Covered California) cover people based on personal income and household size, while small group plans are employer-sponsored and may allow the business to contribute to premiums. The right fit depends on your business structure, number of employees, and budget. Get a small business quote to compare options.
▸ Can a California employer pay health insurance premiums for a family member on an individual plan?
Generally, employers cannot pay premiums on behalf of an individual or family member enrolled in an individual/family plan - this is an important distinction from group coverage. If premium contributions are a priority, a small group plan may be the more appropriate route.
▸ Is it cheaper to get health insurance through a family business or buy it individually?
Cost depends on factors like group size, ages, location, and available subsidies, so there is no single answer. Individual plans may qualify for income-based subsidies through Covered California, while group plans allow employer tax deductions on premium contributions - a licensed agent can help you compare both scenarios for your situation.
▸ Does CalHealth.net help family businesses across all of California?
Yes, CalHealth.net (operated by Goodacre Insurance Services, licensed since 1994) serves family businesses and individuals in every county and region statewide - from Southern California and the Bay Area to the Central Valley and Northern California. Assistance is at no cost to you; you pay the same premium as going directly to the carrier. Learn more about the agency.
The answers above are general information about California health insurance and may change as rates, plans, and rules are updated each year. They are not a substitute for personalized advice. For current, personalized guidance, please contact us, email help@calhealth.net, or call 800-320-6269. Serving California since 1994.
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