Blue Cross Blue Shield of Illinois Medical Indemnity Plans
FAQs
Frequently Asked Questions
If you're considering providing health care coverage for your employees, we're here to help. We've shared answers to some of the most common questions small business owners have about health insurance coverage below.
How many employees do I need to qualify for small business health insurance?
To qualify for group coverage as a small business, your company needs between two and 50 full-time employees (including the owner). A full-time employee is defined as someone that works at least 30 hours per week. Some states have additional guidelines as to who qualifies as a full-time employee, and have minimum participation requirements. For guidance on other qualifiers, call 833-923-1784.
If you purchase insurance between November 1 and December 15 for a January 1 or January 15 effective date, this participation requirement is waived.
What is health insurance?
Health insurance is a contract between a policy holder and a health insurance company that requires the insurance company to pay or reimburse some or all of a member's health care costs for covered services. Learn more about how insurance works.
How do deductibles, coinsurance, premiums, and copays work?
Deductibles, coinsurance, and copays are all mechanisms that allow health insurance companies and individuals to share costs. Deductible is a fixed amount an employee is required to pay before reimbursement by the health plan (coinsurance) begins. Coinsurance is the percentage of the cost of a covered health care service the employee is responsible for paying after they've met their deductible. Premium is the monthly amount that must be paid for a health insurance plan. Copay is the fixed dollar amount a member is required to pay for covered services or prescriptions at the time you receive them. Learn more about how insurance works.
What's the difference between in-network and out-of-network benefits?
Doctors, hospitals, or other providers who accept your employees' health insurance plans are "in-network," also known as participating providers. Doctors who do not take these plans are "out-of-network." In-network provider services are paid at a higher benefit level. Learn more about how insurance works.
What's the difference between HMO and PPO plans?
HMO (Health Maintenance Organization) plans typically require members to select a primary care physician (PCP) to coordinate care within the network. In order to see a specialist, members may need a referral from their PCP. Having care coordinated by a PCP may result in lower overall costs for the member. PPO (Participating Provider Option) plans do not require members to select a primary care physician, and in most cases, members can go to any provider within the network without a referral. This increase in flexibility may result in a higher overall cost for the member. Learn more about how insurance works.
How does my deductible impact my premium?
Generally, the higher a plan's deductible, the lower its premium. Plans with higher deductibles have lower monthly costs but may make expenses less predictable if medical bills accumulate suddenly. If you choose a plan with a lower deductible, it will generally have a higher premium. Plans with lower deductibles allow employees to better control unpredictable costs when they need their insurance.
Why are there different network options?
Our network plan offerings are built to create health insurance coverage options that fit any budget across different metallic coverage tiers. For more detail on the networks available to you, visit our Plan Options page.
What are Smart networks?
A Smart network is a group of providers that encompass a specific geographical area, and is less broad than a standard PPO network. Plans with a smaller network typically have lower premiums. Learn more about how insurance works.
What are essential health benefits?
Essential health benefits are included in every health plan, no matter which plan you choose. The Affordable Care Act requires these benefits to be included in all individual, family, and employer-sponsored plans. Visit our Plan Options page to see all essential health benefits included in our plans.
What Plans do we cover?
BCBSIL plans provide comprehensive benefits with options to fit your employees' needs and your organization's budget. For more detail on the plans available to you, visit our Plan Options page.
How much should I contribute?
Employers offering group coverage are required to pay at least 25% of their employees' premiums. You may pay a higher percentage if you choose; making insurance more affordable for your employees can increase participation. If you purchase group coverage between November 1 and December 15 for a January 1 or January 15 effective date, the minimum contribution requirement is waived. Learn more about the benefits of offering health insurance.
When can I apply for health coverage for my business?
You can apply for health coverage at any time throughout the year. If you purchase group coverage between November 1 and December 15 for a January 1 or January 15 effective date, the minimum amount you are required to contribute towards your employees' premium, as well as the number of employees required to participate - are waived.
How much will it cost me to provide health insurance for my employees?
The cost of health insurance for your small business will depend on the type of plan you choose as well as your contribution strategy. Most states require a minimum contribution for group coverage.
If you purchase group coverage between November 1 and December 15 for a January 1 or January 15 effective date, your contribution requirements are waived.
When I purchase health insurance for my employees, how long does the policy last?
Each policy has a 12-month contract term. We will reach out to you before the contract term expires to discuss your options for renewing your policy.
When can I purchase health insurance for my business and when does it become effective?
You can buy coverage any time during the year and indicate a desired coverage start date. Once your business is approved for coverage, you will receive a notice confirming the date on which your coverage will begin. It will be effective for all enrolled employees starting on that date.
As a small business, do I qualify for tax advantages for offering health insurance for my employees?
Yes, you may be eligible to take a deduction on the amount you contribute towards the premium cost on your employees behalf. Please contact your tax professional for more details on the tax advantages you may qualify for by offering your employees health insurance.
Do my employees enjoy tax benefits for enrolling in the coverage I sponsor?
It is possible. You can take a pre-tax deduction from employees' paychecks to cover the portion of the total premium that they are required to pay. This deduction reduces their taxable income and the amount of income taxes owed.
Through the Affordable Care Act, individuals may be eligible for subsidies for purchasing coverage through the individual market place if they meet income requirements. If you have additional questions, please contact your tax professional for more information.
How would a group policy I offer my employees differ from an individual policy that they purchase through the market place?
Group insurance policies allow employers to offer their employees and their dependents a wider choice of options, with access to more robust plans and larger networks. Monthly premium costs are shared between the employer and the employee.
In the individual market place, there may be fewer options to choose from, plans typically have a higher deductible and smaller networks, and employees are responsible for 100% of the monthly premium.
Can I extend the offer of coverage to my employee's spouses and/or children?
Yes, coverage can be extended to spouses and/or children of any employees who enroll in coverage. You can decide if you want to contribute to the cost of their coverage.
What if I have employees who reside out of state?
We offer plans that include out-of-state coverage. If you have employees that reside out of state, you should consider including one of these plans. To find out which plans offer out-of-state coverage, review our 2022 Small Group Plans. 
Is there someone I can call if I have additional questions?
Our insurance specialists can answer any additional questions you may have as you consider your group health insurance options. Call us at 833-923-1784.
How is dental insurance different from health insurance?
Health insurance includes coverage for a wide range of medical care. However, health care plans only include pediatric dental coverage. Dental insurance can help you and your employees access quality dental care.
Dental insurance includes coverage for oral care, such as regular check-ups, orthodontics, oral surgery, and other dental services. Like health insurance, dental insurance includes networks, coinsurance, deductibles, and annual out-of-pocket maximums.
Is any dental care covered by health care coverage?
All health care plans include pediatric dental coverage. However, coverage for adults is only available through a dental insurance plan.
What are the advantages of offering dental Insurance?
Combining health and dental coverage through BCBSIL streamlines the administration of both programs, helping you manage your overall benefit costs. Employees with both BCBSIL health and dental plans have access to BlueCare Dental ConnectionSM, which includes educational information and outreach to help your employees make important decisions about their dental care.
Members who have health and dental insurance have experienced:
• 24% reduction in medical costs
• 41% fewer hospital admissions
• 34% fewer ER visits
How much do I have to contribute to my employees' dental insurance premiums?
You can choose to offer a contributory or voluntary dental plan to your employees. If you choose a contributory dental plan, you must contribute at least 50% towards your employees' dental insurance premiums. For voluntary plans, you are not required to contribute towards your employees' premiums, but you have the option to contribute up to 49%.
Can I purchase dental insurance without health insurance?
To purchase BCBSIL dental insurance, you must purchase BCBSIL health insurance.
Healthier Employees. Healthier Business.
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833-923-1784
Source: https://www.bcbsilcommunications.com/shopsmallbusiness/faqs.html
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