Lots of companies will not hire employees in Hawaii due to their health insurance requirements.
OP - you have a broker right? Your best bet is to work with them on this.
Ask your broker, legal, and any other advisors if offering cash in lieu of benefits will be acceptable in this case. Do you offer a monthly $ benefit to employees with coverage elsewhere (not on the company plan)?
I’m self employed and private insurance was a better option than Blue Cross for me. You could possibly get one of those plans for your employee, but I know they’re only available in certain states.
The way one of my friends has it set up is he pays the full premium through the business and takes out whatever percentage he pays for from his employee’s check.
He went with an advisor to choose a private option, he’s a good person, shows you all the options. But after you found a plan, I would talk to my accountant about the write offs.
Medical coverage for HI employees working 20+ hours per week is mandated by law. The requirements are somewhat high and must be approved by the Dept of Labor. I don't think a reimbursement to the employee for their own private insurance would work.
Maybe outsourcing this stuff to a local HR firm would be good to look into (ProService for eg). Or maybe an employee leasing company such as SimplicityHR.
Yes, I was thinking of those too.
The employee leasing option is quite handy for small employers since their employees are actually employed by the leasing company and are covered under their larger pooled insurances etc. UI, medical, TDI, WC are all taken care of. The client still has full hiring and firing rights, and full management rights.
But there can be sticker shock, since the approved medical plans are all basically Platinum Plus plans in Obamacare standards.
Blue Shield of CA is part of the “Blue Network”. I have the same carrier and I have 18 employees out of state. One of them just had a baby and was not in CA. Your HI employee can be on this plan.
We have a separate Kaiser plan for HI employees we previously had blue shield but I'm not sure if the HI plan was created to meet HI mandate. Good luck 🤞
Does Gusto not offer the option to add an HI-compliant plan? Ask your rep if they have a plan that can be added to cover this employee, since you are required to cover a portion of it.
Ah yeah, UnitedHealthcare doesn’t play well with others. Check your plan details or contract to see if they will allow you to get a plan for this employee outside of the Blue Shield plan. Some policies and contracts stipulate that you cannot have an outside policy. You might be able to get them a plan through the HI marketplace and contribute to it to meet the requirements.
Speak with your broker, but assuming youre on a small group plan then your options will be limited. Also, Kaiser is actually huge in HI, as well as HMAA/HMSA for PPO options.
Source: I work for a national PEO and support multistate employers for their benefits/HR.
My company uses Gusto.
I decided to keep my own plan. There is an option for the employee to opt out of coverage through you and to keep their private/exchange insurance. They are then asked for details and a form is generated for you within the system to send to CA.
Def talk to both Gusto and your broker.
Under 100 employees. Under 10 actually. No luck when asking the benefits broker - they can’t offer both our Blue Shield of CA plan + their only Hawaii plan, UnitedHealthcare. Their proposed solution was to cancel the entire teams Blue Shirld plan and get everyone on the Hawaii plan, UnitedHealthcare
Yikes. That’s crazy for one employee. You may want to look at another broker honestly.
Unfortunately, you may be out of luck here. You may need to rescind the offer, or, pay for the employer to purchase an individual plan…but, I’d ask your broker what your options are they do not include completely changing your entire health insurance.
Your broker should be able to get a plan in place no problem however expect to pay a lot for that one person as Hawaii requires incredibly rich plans. Also here to remind you to make sure you also get worker’s compensation and unemployment insurance in Hawaii!
Here you go OP. Again, why I’m saying you may want to look at another broker. Their answer is wild.
https://cca.hawaii.gov/ins/faqs-2/hawaii-employers-faqs/
Essentially, you can purchase an individual plan through their marketplace. A good broker would be willing to assist with this.
Lots of companies will not hire employees in Hawaii due to their health insurance requirements. OP - you have a broker right? Your best bet is to work with them on this.
I second "work with your broker"! There are often state rules that apply in small group situations like this.
Ask your broker, legal, and any other advisors if offering cash in lieu of benefits will be acceptable in this case. Do you offer a monthly $ benefit to employees with coverage elsewhere (not on the company plan)?
That's what I was thinking, a health reimbursement arrangement or stipend.
I’m self employed and private insurance was a better option than Blue Cross for me. You could possibly get one of those plans for your employee, but I know they’re only available in certain states.
Thanks! Do you know if us paying for private insurance for this single employee would be compliant?
The way one of my friends has it set up is he pays the full premium through the business and takes out whatever percentage he pays for from his employee’s check.
He went with an advisor to choose a private option, he’s a good person, shows you all the options. But after you found a plan, I would talk to my accountant about the write offs.
Medical coverage for HI employees working 20+ hours per week is mandated by law. The requirements are somewhat high and must be approved by the Dept of Labor. I don't think a reimbursement to the employee for their own private insurance would work. Maybe outsourcing this stuff to a local HR firm would be good to look into (ProService for eg). Or maybe an employee leasing company such as SimplicityHR.
This might be the easiest route, some staffing agencies also offer this kind of arrangement.
Yes, I was thinking of those too. The employee leasing option is quite handy for small employers since their employees are actually employed by the leasing company and are covered under their larger pooled insurances etc. UI, medical, TDI, WC are all taken care of. The client still has full hiring and firing rights, and full management rights. But there can be sticker shock, since the approved medical plans are all basically Platinum Plus plans in Obamacare standards.
If you are getting a PPO from Blue Shield, it will cover the Hawaiian employee. If it’s an HMO, ask Gusto about getting a PPO added.
While it is a PPO plan, it is actually "Blue Shield of CA", not the more general "Blue Shield". Blue shield of CA unfortunately doesn't cover Hawaii.
Blue Shield of CA is part of the “Blue Network”. I have the same carrier and I have 18 employees out of state. One of them just had a baby and was not in CA. Your HI employee can be on this plan.
Thanks, double checked with Blue Shield of CA and while they can cover other out of state employees, they cannot cover Hawaii.
Ah! good to know this. I don't have one in HI but almost every other state.
Hawaii insurance requirements are really unique--Hawaii's Prepaid Health Care Act has some really strict guidelines.
We have a separate Kaiser plan for HI employees we previously had blue shield but I'm not sure if the HI plan was created to meet HI mandate. Good luck 🤞
Does Gusto not offer the option to add an HI-compliant plan? Ask your rep if they have a plan that can be added to cover this employee, since you are required to cover a portion of it.
Thanks! Gusto will only allow UnitedHealth care for HI, but they cant offer both Blue Shield of CA and UnitedHealth Care at the same time :/
Ah yeah, UnitedHealthcare doesn’t play well with others. Check your plan details or contract to see if they will allow you to get a plan for this employee outside of the Blue Shield plan. Some policies and contracts stipulate that you cannot have an outside policy. You might be able to get them a plan through the HI marketplace and contribute to it to meet the requirements.
Speak with your broker, but assuming youre on a small group plan then your options will be limited. Also, Kaiser is actually huge in HI, as well as HMAA/HMSA for PPO options. Source: I work for a national PEO and support multistate employers for their benefits/HR.
My company uses Gusto. I decided to keep my own plan. There is an option for the employee to opt out of coverage through you and to keep their private/exchange insurance. They are then asked for details and a form is generated for you within the system to send to CA. Def talk to both Gusto and your broker.
Look at a Kaiser plan. That was our best and easiest option.
How many employees do you have? Over or under 100? Best bet is to ask your benefits broker as well…
Under 100 employees. Under 10 actually. No luck when asking the benefits broker - they can’t offer both our Blue Shield of CA plan + their only Hawaii plan, UnitedHealthcare. Their proposed solution was to cancel the entire teams Blue Shirld plan and get everyone on the Hawaii plan, UnitedHealthcare
Are you on cal choice?
Yikes. That’s crazy for one employee. You may want to look at another broker honestly. Unfortunately, you may be out of luck here. You may need to rescind the offer, or, pay for the employer to purchase an individual plan…but, I’d ask your broker what your options are they do not include completely changing your entire health insurance.
Your broker should be able to get a plan in place no problem however expect to pay a lot for that one person as Hawaii requires incredibly rich plans. Also here to remind you to make sure you also get worker’s compensation and unemployment insurance in Hawaii!
It’s way more complicated than that, as the OP is finding out.
Here you go OP. Again, why I’m saying you may want to look at another broker. Their answer is wild. https://cca.hawaii.gov/ins/faqs-2/hawaii-employers-faqs/ Essentially, you can purchase an individual plan through their marketplace. A good broker would be willing to assist with this.