Employee Benefits

BASIC TYPES OF GROUP HEALTH PLANS:

A Health Maintenance Organization (HMO) requires group members to obtain their health care services from doctors and hospitals affiliated with the HMO. Generally with an HMO members generally are required to designate a primary care physician who treats and directs health care decisions and who coordinates referrals to specialties within the HMO network. HMOs offer access to a comprehensive package of covered health care services in return for a prepaid monthly amount (or “premium”). Most HMOs charge a small co-payment depending upon the type of service provided.

A Preferred Provider Organization (PPO) does not require group members to designate a particular provider, however, if they use providers within their network, they will save the most money on their healthcare services. If providers outside of the network are used, it is possible that those services may not be covered at all, so it is a good idea to check first with your PPO. Keep in mind that deductibles must be met on this plan before some services will be covered. PPOs generally require a co-pay for physician visits.

A Health Reimbursement Account (HRA) combines high deductible/low premium health insurance with a tax favored savings account. Employers contribute to the savings account. Money in the savings account can help fund co-pays and other qualified expenses prior to the deductible being met. Money left in the savings account earns interest and can be carried to the next year.

A Health Savings Account (HSA) combines high deductible/lower premium health insurance with a tax favored savings account. Both employer and employee can contribute, tax-free to the savings account. Money in the savings account can help fund the deductible and other qualified medical expenses. Once the deductible is met, the insurance starts paying. Money left in the savings account earns interest and is yours to keep.

Along with health insurance, Life Insurance is considered one of the most important parts of the benefit package for employees. Whether employer paid or voluntary, a good life insurance policy provides for an employee’s final expenses, taxes, mortgage and even their children’s education as well as offering additional added benefits. We can help employers protect their employees and their employees’ families with a variety of different life insurance products.

Please read below for some brief information to learn about the various types of life insurance available:

Cash Value Life Insurance Policies tie premiums to various types of investment accounts (stocks, bonds, money market, etc.) in which the savings can be tax deferred and/or borrowed against, if needed. These policies are known as: whole life, universal life and variable life insurance.

Term Life Insurance Policies do not build cash value, however, they will pay a set amount to the named beneficiary upon the death of insured within the stated term. Some policies may also make payments upon terminal or critical illness.

Accidental Death and Dismemberment benefits are frequently offered with Health Insurance. These policies can be purchased with or without a Term Life Insurance benefit. If the employee incurs a loss of limb, sight and or hearing, the policy will pay out a lump sum or payments to the insured. In the event of accidental death, the policy would pay out a set amount to a named beneficiary.

National surveys have shown that Short Term Disability and Long Term Disability remain of high importance for most employees. Thus, savvy employers attract and retain top talent by offering both STD and LTD insurance as part of the employer paid benefit package or as a voluntary (worksite) benefit.

Here’s how Disability plans typically work:

Short Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), STD generally allows for income payments to the employee to begin after about a two-week waiting period and will continue to pay the employee until he/she recovers or maxes out the benefits–usually anywhere between one month to two years, depending on the policy.

Long Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), LTD generally allows for income payments to the employee to begin after about a 90-day waiting period. However, it could be much longer depending on the policy. The policy will pay the employee far longer than STD–for a few years, up to age 65, or even for life.

Employees always appreciate dental & vision coverage as part of their Employee Benefits Package. We offer individual, group or voluntary Dental & Vision through many of our major insurance carriers.

Dental Plans
Studies have shown that regular dental exams help employees to stay healthier and more productive in the work place. Additionally, you can detect serious underlying conditions such as heart disease and diabetes, through regular dental exams. In fact, the National Association of Dental Plans and the Centers for Disease Control have performed studies that show that employees with dental insurance have better attitudes and are less likely to suffer from depression, a common condition in today’s fast-paced world.

Dental insurance offers a variety of diagnostic, preventative care and corrective services. This includes cleanings, exams, x-rays, fillings, root canals, orthodontia for children, and emergency care while traveling.

Vision Plans
Similar to dental policies, vision plans are inexpensive and save employees money on routine eye care. Examples of care include exams, eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK. Additionally, monitoring your eye health with regular exams helps to prevent serious eye diseases like glaucoma and cataracts. In addition, regular eye exams help to detect early stages of diabetes, high blood pressure, and high cholesterol.

Overview

Designed under Section 125 of the Tax Code, Cafeteria Plans are employee benefit plans that offer tax incentives to both employers and employees, saving them thousands in premiums and other healthcare costs. Employees appreciate how Cafeteria Plans allow them to save money they are already spending. Also, looking at in another way, participating in a cafeteria plan reduces an employee’s taxable salary and increases the percentage of their take-home pay, thus increasing their spendable income. They receive a greater deduction on dependent care expenses than what’s offered by a traditional tax credit at the end of year. There are two common basic types of Cafeteria Plans:

A Flexible Spending Account (FSA) allows an employee to fund certain medical and dependent care expenses on a pre-tax basis through salary reduction to pay for out-of-pocket expenses that aren’t covered by insurance (for example, annual deductibles, office co-payments, prescriptions, over-the-counter drugs and orthodontia). The average working employee in America spends more than $1,000 annually on these types of benefits. By participating in a FSA, an employee’s taxable income is reduced, which increases the percentage of take home pay.

A Premium Only Plan (POP), also known as Premium Reimbursement Arrangement (PRA), allows employers to offer employees good health coverage virtually hassle-free with almost no expenses. It is designed to let employees purchase their own individual insurance with pre-tax dollars. This potentially saves both the employer and employee thousands annually in taxes and premiums combined. Specifically, on Federal, FICA, and sometimes State taxes, as well as Workers’ Compensation. Many consider this plan a simple bookkeeping function as no claims process is required and it requires little other maintenance once it’s been set up through your payroll.

Employee Voluntary Benefits (sometimes referred to as ancillary or secondary benefits) help employers offset rising benefit costs, while simultaneously enhancing the benefit offering. Often referred to as worksite benefits, voluntary benefits are insurance policies that add additional coverage (both traditional and non-traditional benefits) to the employer sponsored benefits, but are paid for by the employee. Even though these benefits are paid for by the employee, our clients are often surprised by how much employees still appreciate them. That’s because when designed and communicated properly, employees realize a sense of financial security and overall well-being with access to additional individual coverages they can obtain at low group rates, and through convenient pre-taxed payroll deductions.

Following are types of Voluntary Benefits offered:

• Dental & Vision
• Life Insurance
• Disability Insurance
• Critical Care Insurance
• Accident Insurance
• Telehealth & Doctors Online Support
• Identity & Legal Services
• Petcare Savings
• Caregiver Support