Group Health Insurance
Group health insurance provides employers with choices in products, benefit designs and alternate funding arrangements. Benefit plan designs can include Preferred Provider Organizations (PPO) as well as Health Maintenance Organizations (HMO) companies with multiple locations across the county need health care coverage and processes that blend smoothly into a single efficient system. Stop-loss coverage can also be provided for companies who would like to insure more of their own risk. We are able to serve the diverse needs of large and small companies by matching networks and plan designs that simplify a company’s task if administering employee benefits.
Flexible Spending Account (FSA)
A Flexible Spending Account (FSA), is one of a number of tax-advantaged financial accounts that can be set up through a cafeteria plan. An FSA allows an employee to set aside a portion of his or her earnings to pay for qualified expenses as established in the cafeteria plan, most commonly for medical expenses but often for dependent care or other expenses. Money deducted from an employee’s pay into an FSA is not subject to payroll taxes, resulting in substantial payroll tax savings.
Health Savings Account
A Health Savings Account (HSA) is a tax-deductible savings account that an employee can contribute to for health care expenses that are not paid through health insurance or any other health reimbursement source. Any interest and investment earnings are not taxable, so the money in HSAs grows tax-free. When paired with a compatible high-deductible health benefit plan, HSA enables your employees to:
- Lower their insurance premiums,
- Pay routine medical bills from their HSA and have the security of comprehensive insurance coverage in the event of an unexpected hospitalization or major illness,
- Save taxes on the amount they spend each year for health care expenses,
- Have the potential to build savings for future qualified medical expenses, and;
- Maintain the account year-to-year, even if they change jobs or move to another state.
Health Reimbursement Arrangement (HRA)
A Health Reimbursement Arrangement (HRA) is an account to which the employer makes contributions that are not taxable to the employee. These can be used to pay for certain medical care expenses. The IRS first recognized the HRA in 2002 in two rulings that include the following provisions:
- Only an employer can contribute to an HRA. An employee cannot contribute to an HRA.
- Generally an employee can use an HRA to pay for medical care that would go toward funding a high deductible plan.
- If in a plan year the money that is in an HRA is not all used, the unused funds can remain in your HRA and you can use the to pay for medical expenses you incur in a subsequent year or years.
- Any contribution an employer makes to an HRA is not taxable and payments made from the HRA are also not taxable.
Section 125 Cafeteria Plan
Employees benefit from a cafeteria plan by choosing and paying for benefits with pre-tax dollars. Employers benefit from the plan by reducing payroll taxes and adding benefit choices for employees.
Group Life Insurance
Basic Group Term Life insurance enables employers to provide their employees with valuable term life insurance protection while giving them the convenience of guaranteed amounts of coverage sponsored in whole, or in part, by the employer. Many plans permit voluntary employee contributions to increase insurance protection.
We can customize these insurance plans according to each employer’s specifications. Usual plan designs are flat dollar amounts or multiple of employees’ annual base earnings. We work with prospective clients to establish guaranteed issue levels that will provide significant levels of insurance with no medical questions. Many of our clients also include a Supplemental Group Life Insurance plan in their benefits package. This program allows employees to purchase additional coverage to meet their needs and the premium can be payroll deducted.
Group Dependent Life Insurance
Available as an option to the supplemental term life plan, group dependent life insurance offers employees the opportunity to elect life insurance coverage for their spouses and / or dependent children. An employee cannot have dependent group life coverage unless he or she also participates in their supplemental group life plan. This coverage can be term or universal life insurance. The insurance laws of many states regulate the amount of group dependent life coverage an employee can elect.
Group Dental Insurance is designed to cover the costs associated with normal dental maintenance, oral surgery, root canal therapy and orthodontia. The coverage may be on a “reasonable and customary charge” basis or on a dollar-per-service schedule approach. Deductibles and coinsurance features are typical with maximum yearly benefit amounts. Most plans cover routine cleaning and exams at 100%. A wide range of plan designs are available so we can tailor a program to meet the specific needs of any organization – including employee-pay-all-plans. Family members are also eligible for coverage, but must be enrolled in the same plan as the employee.
Group Short (STD) and Long Term Disability (LTD)
Short Term Disability (STD) programs provide coverage for income lost when employees are unable to work because of non-occupational accident, illness or pregnancy. After reviewing disability trends, we can structure a plan to provide benefits and create incentives for employees to return to work, thus reducing the overall cost of the programs to the employer. We offer voluntary and employer sponsored plans.
Standard Plan Provisions:
- Weekly benefits up to 67% of an employee’s lost income or flat amounts
- Waiting periods ranging from 1-30 days
- Maximum benefit duration to coordinate with an LTD program – 13, 26 or 52 weeks.
- Disability definitions which allow an employee to be totally or partially disabled to qualify
Group Long Term Disability insurance (LTD) provides for the payment of a percentage of income should an insured be unable to work due to a disabling illness or accident. Our programs are designed to manage employer risks and reduce lost-time costs. They include a wide variety of standard benefits, features and innovative options, all of which can be tailored to meet an employer’s unique needs.
Standard Plan Provisions:
- Monthly benefits from 40% – 67% of income
- Elimination periods of 90 and 180 days
- Definition of disability: “own occupation” to age 65; 24-month “own occupation” definitions
- Residual and Partial disability
- 100% return-to-work incentive
- Normal retirement age benefit durations (Age 65)
- 24-month mental illness, drug and alcohol, self reported disabilities limitations
- Pre-existing conditions limitation
Integrated Benefits: STD / LTD provides both Short Term (STD) and Long Term Disability (LTD) coverages. The administration and claim management components of both STD and LTD can be combined, giving employers and employee’s additional benefits and opportunities. By integrating disability coverages, employers can achieve optimal time, cost and resource efficiencies while enhancing employee satisfaction.
Integrated STD/LTD offers a number of distinctive advantages:
- No delays when transitioning from STD to LTD benefits
- Early intervention, with an opportunity to manage claims faster
- A single claim team for consistent decisions
- Improved outcomes through a return-to-work focus and immediate concentration on cost savings
Group vision care usually pays for reasonable and customary charges incurred during eye exams by ophthalmologists and optometrists. Some plans often include discounts for Lasik surgery. The design of the vision plan can be a simple discount plan or a fully-insured plan with co-payments.
Group Long Term Care (LTC)
Group long-term care insurance is a cost-effective way to help protect against the high costs of a long term illness or accident. Since people are living longer and medical expenses are steadily increasing, personal finances often prove to be inadequate to meet the challenge. This product pays a benefit so an insured can get needed help in the case of severe cognitive impairment or inability to perform without substantial assistance two or more of the six activities of daily living (ADL):
Long-term care insurance plans are designed to cover active, eligible employees, spouses, retirees, spouses of retirees, parents, parents-in-law and grandparents. Plans are typically offered on a voluntary basis, but co-pay arrangements with employers are easily designed especially for executive care-outs. The high emotional and financial toll of caring for a spouse or family member who needs help with Activities of Daily Living (ADLs) have made long-term care insurance a highly valuable employee benefit.
SUPPLEMENTAL VOLUNTARY BENEFITS (Accident, Cancer, Specified Illness, Etc)