Group Health Insurance in Florida

The Harbor Financial Group has specialized in providing group health insurance to companies in Melbourne and the greater Brevard County, Florida area for over twenty-five years. In that time, health insurance has transformed into one of the most regulated and contested industries in the country. But what has always remained constant is our deep commitment to customer service, attention to detail, and helping our clients implement benefits that change their employees’ lives.

What we do

From the beginning, we’ve practiced as independent insurance brokers. Our independence gives us the flexibility to represent a broad range of insurance carriers and products. Additionally, it gives our clients access to the lowest rates available.

We offer the following products as part of a client’s employee benefits package:

Major medical group health plans
Dental, vision, life and disability insurance
Health savings accounts (HSA’s)
401(k) Plans
Section 125 plans
Accident, hospital and cancer plans
Legal insurance
Identity theft protection
Long-term care insurance

We like to tell our clients to think of us as an offsite human resources department. That’s because we keep track of things that office managers and controllers don’t have time to: government compliance and regulations, individual employee effective dates and enrollments, COBRA deadlines, and many other benefits-related issues. We also provide annual health insurance market analyses of available plans and rates, oversee annual open enrollment meetings, and offer our business cards and direct lines to employees for individual concerns.

Why employee benefits?

First of all, large companies are required by federal law to provide benefits. Under the Affordable Care Act, applicable large employers (referred to as ALEs, companies with more than 50 full-time employees) must offer affordable, minimum value health coverage to their full-time employees (and dependent children). If an ALE fails to offer health coverage, they risk paying a penalty.

If you have questions about whether your company is considered an ALE, or how to fund a plan that meets minimum health value coverage, don’t hesitate to reach out to us. The ACA penalty is a hefty fine, and it is often more cost-effective to offer health benefits.

Additionally, every company has one unique advantage: the employees. The knowledge, skills, and hard work that employees offer their company each day are the key to its success. And although our world is rapidly advancing as a global economy, with technology marvels led by industry giants, it is human enthusiasm and vision that grounds every company.

Here are three great reasons to consider offering benefits to your employees:

Relieve stress, and offer peace of mind: Stress affects over 80% of American workers. The causes vary: unstable personal relationships, finances, workload, or home responsibilities. And under the finance category, healthcare is often an unexpected aggressor that burdens families with ongoing expenses and sometimes overwhelming debt. By providing quality healthcare that pays at least 50% of employee premiums, employers can relieve the financial burden of healthcare, and alleviate a chunk of the stress employees endure. The situation is a win-win for employers too, because employees are more productive, creative, and engaged when their stress is minimized.
Invest in your workforce: The employer-employee relationship has the potential to transform your company. When employers offer a quality benefits package, employees take on a sense of gratitude that is reflected in their work. They are less bitter, less likely to complain, and more purposeful in their jobs. It is, of course, true that you can’t please everyone, and some employees will always be disgruntled. But benefits are a great place to start, as they add value to your employees’ lives.
Attract top talent: when potential employees are entertaining multiple job offers, they evaluate the value of the benefits packages in addition to the salary. Potential employees want to know that their next company will take care of them so that they can take care of their family and loved ones.

How to get started

If you are a business owner, office manager, HR manager, or anyone looking to implement group health insurance plans for your company, the Harbor Financial Group would be grateful and excited for the opportunity to give you a quote.

If you need individual health insurance (including tax credit-eligible individuals) or Medicare, our agency also offers those plans.

The quoting process differs for small companies and large companies, so we want to give a good idea of what to expect:

Small group health insurance

The quoting process is more straightforward for small business health insurance (less than 50 full-time employees) because the premium rates are determined monthly or quarterly by the state of Florida. Every year, insurance companies submit their group plan designs to the state. Based on the benefits and actuarial value of each plan, the state approves a rate that health insurance companies can charge for the plan. The rates increase based on age, county, and the effective date, but not based on gender or pre-existing conditions.

As a Florida small business owner, you will be asked to submit an employee census to us. The census is a list of all full-time employees, and the dependents interested in coverage. It also contains each individual’s date of birth, zip code, and date of hire if applicable.

We submit the census, and some basic company information, to all carriers who offer health insurance coverage in your company’s state and county. The carriers will return quotes for the plans offered based on the content of your census, as well as the effective date. Our agency will then help you find the right health plan.

After open enrollment, we submit all employee applications back to the carrier. Sometimes the final rates differ because some employees or dependents on the census decided to waive coverage. Based on the age of the employees, this can cause premium rates to increase or decrease.

Large group health insurance

If your company employs more than 50 individuals full-time, it is what the industry calls a ‘large group’. The good news is that you have the potential to acquire much lower rates for you and your employees. With many employees, your business will inevitably exhibit more normalized health trends, and the insurance carriers can afford to offer you lower rates.

However, the bad news is that you are subject to more government regulations. You are not only required to offer benefits as a large group employer but the employee share of the monthly premium, after the employer contribution, cannot exceed 9.86% of the lowest-paid employee’s income (see healthcare.gov).

The large group quoting process is somewhat similar to that of small groups. Employers send us a census along with basic company information, and we submit it to every insurance carrier eligible to quote. However, the process differs in large group quoting because insurance carriers can customize the quote if they are interested in the business.

Sometimes carriers quote with competitive, low premium rates, and it is apparent they want the group. Other times, carriers quote high premium rates, demonstrating that the group is welcome to enroll, but the carrier is not highly interested. And, carriers can decline to quote at all.

Once all carriers have responded with quotes or declined to quote, we present the information to the decision-makers. We will work closely with you to select a carrier and benefit package that suits your company’s needs and assist you in enrolling your employees at annual open enrollments.

One large-group issue to be aware of is the unpredictability of premium rates. Insurance carriers use a measurement tool called the medical-loss ratio (MLR) to determine rates for a group. On average, carriers expect to pay 85% of every premium dollar back in claims.

If a large group runs a carrier below an 85% MLR, they may get lower rates. But, if a large group runs a carrier above an 85% MLR, especially if the MLR is over 100% and the insurance carrier has experienced a significant loss, the carrier can potentially respond with rates that would exceed what small groups pay in premiums.

To avoid unfavorable MLRs, companies often implement wellness programs, weight loss initiatives, smoking cessation programs, and substance-addiction support. These offerings can be quite effective, and even boost morale and encourage teamwork.

But it is important to remember that ultimately, it is inappropriate for an employer to know which individuals are behind high claims, which drive high MLRs. That knowledge is a severe HIPAA violation. And if an employer ever acts against an employee based on that knowledge, they expose the company to a litany of lawsuit risk.