Your partner in small group health insurance

“Small group health insurance” generally describes health care and coverage for businesses with 50 or fewer employees. The exact definition of a small group depends on state law.

Most of our plans offer national network coverage, so your employees can be located anywhere in the United States. But your business must be headquartered in Minnesota, Wisconsin, North Dakota, South Dakota or Iowa.

• Some of our plans may depend on exactly how many employees you have or which county your business is headquartered in. We can help you understand your options.
• Does your business have more than 50 employees? See our large group plan options instead.

Small group insurance plans can be either fully insured or self-insured:

• Fully insured plans – With these plans, you pay an insurance carrier fixed premiums based on the number of your employees, while your carrier administers your company’s plan and pays out all claims. We offer fully insured plans for small groups in Minnesota, Wisconsin and South Dakota.
• Self-insured plans– These are plans that an insurance carrier administers and that your organization manages. Your organization will structure the plan, enroll employees, and process and pay out medical claims. Many employers with self-insured plans also opt for stop-loss insurance, which helps protect against unexpected large losses.
  • Level funded plans – These are a special form of self-insured plans where you pay an insurer a set payment each month toward a reserve fund for unexpected costs. If there aren’t as many claims as expected, some or all surplus payments are refunded. We offer self-insured level funded plans for small groups in Minnesota, Wisconsin, North Dakota, South Dakota and Iowa.

Generally, self-insured plans can mean lower employer costs. But they can also come with more risks. Many small businesses choose fully insured plans for several reasons:

• Fixed rates that generally mean fewer cost variances from month to month, making budgets easier to manage

• Less financial exposure for the employer, as the insurer assumes responsibility for all claims
• Simpler claims management and fully integrated benefit plans
• Access to a wide variety of additional features and services designed to engage employees and improve their well-being, included at no extra cost

Choose from our wide variety of plans and health account options for your employees, including:

• Traditional copay and coinsurance plans – These plans charge a set fee for a specific service, like a clinic visit. These fees are usually listed on a member’s insurance card and can help members decide whether to make a doctor appointment or head to urgent care. Some plans also include a deductible.
• “Three for Free” plans – With these plans, the first three office or urgent care visits each year are at no extra cost. Employees also have access to a wide range of care and well-being resources through coinsurance with varying deductible amounts.
• High-deductible health plans (HDHPs) – These plans usually have lower premiums and higher deductibles, meaning employees pay less each month for insurance and more out of pocket when they receive care. They also typically cost less for employers.
  • Employees with an HDHP are also eligible to open a Health Savings Account (HSA), a special pretax bank account for eligible health care expenses which both the employee and the employer can contribute to.
• Health Reimbursement Account (HRA) plans – In these plans, an employer offers a predetermined amount of money to its employees, which is then used for eligible health care expenses.
• Flexible Spending Accounts (FSAs) – With an FSA, employees and employers can put pretax money into a special account for eligible employee medical expenses. An FSA can typically be offered alongside any other group medical plan.

Depending on the size of your group, you may have the option to select multiple plan designs. No matter which plan you choose, you’ll have access to everyday health support, programs and resources to support physical and mental health, and more.

Based on your funding model and business location, choose from a variety of provider networks to fit your company’s budget and your employees’ needs. All our networks are designed to put high-quality care first.

In addition, most of our networks include national 50-state coverage through our alliance with Cigna. That means straightforward, seamless access to over 1 million providers and 6,300 hospitals – with no referrals or separate insurance card needed.

All our group plans for small businesses offer high-quality health insurance options that have comprehensive benefits and coverage. We’ll be there every step of the way to make sure you get the most out of your plan.

Specific benefits and coverage levels vary by plan, but all plans include:

• 100% preventive care coverage, including routine checkups, immunizations, screening and counseling
• Prescription drug coverage with an actively managed, cost-effective formulary (drug list)
  • Formulary insulin covered with no member cost-sharing after a $25 benefit cap per fill
• Coverage for telemedicine services such as Teledoc and Doctor on Demand, with many plans offering access to Virtuwell , our 24/7 online clinic
• Out-of-network coverage, with urgent care and emergency care covered at in-network levels

Our teams are dedicated to collaborating closely with you to understand your company’s and your employees’ unique needs. Many of our plans include value-added services such as virtual health support, well-being resources, pharmacy navigation and more – available at no extra cost.

We’ll work together to discover which services and resources may be a good fit, and we’ll help your employees take charge of their plan so they can work to stay healthy and happy. Some of our services and resources include:

• Award-winning, locally based member and employer support teams
• Employee Assistance Programs (EAP) to help employees manage stress, be more productive at work and live healthier every day
  
• Omada Mind digital program for stress, anxiety and depression
• Living Well comprehensive well-being resources, including digital assessments, personalized action plans and discounts
• Comprehensive disease and case management support
• Medication Therapy Management (MTM) that helps ensure medications are working together correctly
• Assist America 24/7 coverage, helping your employees find a doctor, fill a prescription and more when traveling
• Digital and in-person decision support tools, making managing care easy anytime, anywhere
• Communications toolkits to drive employee engagement and help your employees get the most out of their plan
• Easy-to-use plan administration tools that save you time and money so you can focus on growing your business