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Tom Schrette and Alan Cash

Tom Schrette and Alan Cash

J.L. Sousa

Dear Tom and Alan:I have a young man, 27, working for my company. He tried to get health insurance but evidently enrollment is closed until Nov. 1.

Anyway, I’m retired and on Medicare and only have one or two part-time workers in addition to the young guy who is full-time.

I seem to remember that a small group has to have at least two people or they can’t get covered. I’d like to offer him something in the way of benefits.

No, really, I’d like to provide him with an excellent plan for him and his fiancée.

Ideas?

Boss Man

Tom: Yes, indeed. More than 20 years ago California changed the law covering small group health insurance to prevent insurance companies from “cherry picking” which groups would be approved.

The law said that any group with five employees was guaranteed to be covered. Over a few years, the number went down to two employees.

Prior to that, a group with a few sick people could actually be declined health insurance.

In the years since then and before the Affordable Care Act (ACA), it was not unusual for a married couple to get a small group plan for the two of them.

The ACA changed the part that allowed an employer to put his/her spouse on the plan if it was just the two of them.

However, the good news for Boss Man is that he can have a small group plan with just one full-time employee.

Al: I ran a quote through one of our general agents asking for the numbers on Gold and Platinum plans for our reader’s employee.

Since he wanted an “excellent” plan, they skipped the Bronze and Silver quotes. They came back with Anthem, Blue Shield and Kaiser.

The Anthem Gold with zero deductible and $20 office visits is $954.66 per month for the employee plus domestic partner/spouse;the Anthem Platinum is $1,131.75.

The Blue Shield Gold with zero deductible and $20 office visits is $936.85 per month; the Blue Shield Platinum is $1,093.28.

Finally, Kaiser Gold with zero deductible and $25 office visits is $725.10; the Kaiser Platinum is $801.18.

Tom: The paperwork can be a bit daunting.

Along with the employer master application and the employee application, a copy of the DE 9C is required.

The DE 9C is filed quarterly with the California Employment Development Department and it shows the names and salaries of all employees during that period.

Sometimes, people are terminated or quit but their names are still on the form and there may be questions.

The insurance company will have a form for Boss Man to explain if he is sole proprietor, partner or corporate officer. Usually there’s a form to make automatic withdrawals from the company checking account.

Lastly, put the first month’s check in with it and you should be good to go for the first day of the next month!

Submit questions to schrette@gmail.com or alancash@gmail.com.

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