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Tom Schrette and Alan Cash

Tom Schrette and Alan Cash

Dear Tom and Alan:

I read your last column with interest because I know people who don’t have health insurance and have no plans to get it. Maybe that $695 penalty will get a few motivated!

What about those who own a business? Will they be required to provide coverage to their employees to avoid a fine?

Tom: Excellent question — especially since we’re right in the middle of open enrollment for individuals and families. The short answer is no, there is no obligation for a business owner to provide coverage.

Of course, beyond motivating workers, there are good reasons for offering it through the company. The website points out that an employer could receive a tax credit for up to 50 percent for two consecutive years. This is for a company with 10 or fewer full-time employees with an average pay of less than $26,000 annually.

Here’s the example they give: 10 employees; $260,000 total annual payroll (works out to an average of $26,000 per employee); $70,000 total premium for group; $35,000 tax credit for employer for years 1 and 2, none after that.

For a little larger business, with 25 or fewer full-time employees, with an average salary of less than $54,000 per year, there is a tax credit, but not the maximum of 50 percent.

Al: Covered California defines small business as under 100 employees, at least one employee who receives a W-2, and the majority of employees live in California.

Similar to the individual and family plans, there are metal tiers: bronze, silver, gold and platinum. Within each tier can be more than one option. An employer can offer two adjoining levels of coverage.

For example, an employer could choose to offer silver and gold plans, while contributing the mandatory 50 percent for the silver plan. If the employee wanted to move up to the gold, he/she would make up the difference.

Tom: Unlike the individual and family plans whose open enrollment this year is Oct. 15 to Jan. 15, enrollment for small groups is available all year round.

For 2020, there are six companies offering insurance through Covered California: Blue Shield, Kaiser, Health Net, CCHP, Oscar and Sharp.

Only the first three are available in Napa. In addition, Delta Dental, Liberty Dental Plan of California, Dental Health Services, and California Dental Network offer dental plans for companies.

The Sharp Health Plan is in San Diego, and the Oscar Health Plan of California will be available for groups in Los Angeles and Orange counties.

Al: Covered California for Small Business reports that for the approximately 55,000 covered under a group plan the rates for 2020 will be increasing by 4.1 percent. The years 2019 through 2015 saw increases of 4.6, 5.6, 5.9, 7.9, and 5.2 percent respectively. Enrollment has increased by 7,000 individuals over the past year, which is a gain of about 15 percent.

Happy Thanksgiving everyone!

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

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