West Virginia Large Group Health Insurance Benefits Plans

For large businesses in West Virginia, rising costs are an ongoing concern regarding offering health insurance that exceeds the needs of employees and follows the ACA guidelines. Premiums have increased by 23 percent over the last decade, with many companies implementing cost-saving mechanisms like increased deductibles. Even with the high inflation rate, large employers note that spending on health insurance has been increasing faster than overall inflation—with no apparent signs of slowing.

The ACA requires that insurance plans include coverage for ten essential benefits, which are defined as necessary for the patient protection act:

1. Ambulatory patient services (outpatient care)
2. Emergency room services
3. Hospitalization, including surgical and medical services
4. Maternity and newborn care for women, including baby delivery
5. Mental health and substance use disorder services
6. Prescription drugs
7. Rehabilitative services and devices
8. Laboratory services
9. Preventative and wellness benefits, including chronic disease management
10. Pediatric services that include dental and vision care for children under the age of 19

Many states, including West Virginia, have been added to that list. For example, West Virginia requires covered care for skilled nursing, clinical trials, diabetes treatment, and reconstructive surgery after a mastectomy. However, companies that self-fund their benefits (usually larger businesses) can avoid the state-specific requirements. For example, 69 percent of employers fully self-fund their health insurance in West Virginia.

West Virginia Small Business Health Insurance Plans

Small companies have undergone an even more significant negative impact from inflation on the cost of health insurance to their employees than large businesses. In just one year, prices for smaller businesses have shot up nearly ten percent. Still, the ACA requires that companies providing insurance meet the affordability standard of a premium that does not exceed 9.62 percent of the employee’s gross income. The insurance policy must also cover the ten essential benefits (West Virginia added benefit coverage mandates).

Small companies may find support through the SHOP marketplace (Small Business Health Options), which your Songer Benefits Insurance agent can help you explore to find programs that meet your company’s needs.

West Virginia Employee Benefit Plans and Employee Benefit Packages

West Virginia doesn’t require paid and unpaid time off for employees; this does not include public interest requirements like jury duty, military service, and time to vote, all of which may be taken without pay. However, many corporations offer time off to stay competitive and supply their employees with the ability to refresh and relax, seek personal interests, and seek a beneficial work-life balance.

In many cases, employers in West Virginia offer other benefits, including dental care, vision coverage, and wellness programs.

Contact Songer Benefits for the Right Group Health and Benefit Plan

Call us today to learn about our health and benefit options for employees. Our insurance brokers will help you implement a plan that meets everyone’s needs. Once you are satisfied, we will provide you with a FREE quote!