GROUP HEALTH PLANS
2 - 250 EMPLOYEES
Designed to fit all types of businesses and all sizes of groups
We’ll find out what’s important to you and your employees, and we’ll dig deep to understand what is driving your costs to make sure your design and funding strategies are optimal.
An HMO (Health Maintenance Organization) requires employees to appoint a primary care physician who directs treatment utilizing service providers affiliated with the HMO. A small co-payment is often required for services, depending upon the type provided.
PPO (Preferred Provider Organization) plans offer a vast network of quality healthcare providers and facilities. Employees save the most money on healthcare if they use providers within the network. Some services require a deductible be met first, however, the plan includes important wellness and preventative services provided outside of the deductible with a small co-pay.
Self-funded employers benefit from a significant savings in the overall cost of their benefit programs. For example, savings may be in premiums, increased cash flow and certain tax advantages. Additionally, employers have more control over the benefits that the plan offers.
How it works. Most often, employers will partner with a PPO to provide services for the plan. A third party administrator (a TPA) is engaged to handle claims and processing. Self-insured employers run the risk of large catastrophic claims. As a result, they need to purchase stop-loss insurance to protect themselves in such an event. Even with the additional expense, employers save a significant amount of money on premiums and other advantages.
Partially-Funded Plans (aka Level-Funded) are a variation of a Self-Funding and allows small employers to take advantage of all the cost saving and benefit design features of a fully self-insured plan, however, they share the risk with one of our top national carriers.
How it works. An employer will select any of the fully insured plans that the carrier offers. Then rates will be determined by the group’s claim history. Next, stop-loss insurance is added to protect against catastrophic claims. The carrier will handle the administration of the plan.
An HSA (Health Savings Account) combines a high deductible, lower premium group health insurance plan (PPO) with an employee owned savings account. Both employer and employee can contribute, with pre-taxed dollars, to the savings account. The account is used directly by employee to help fund the deductible and other qualified medical expenses.
An FSA (Flexible Spending Account) is a tax-favored savings account funded solely by the employee through regular pre-tax payroll deductions. The funds can be withdrawn, tax-free, to pay for eligible medical, dental, vision, prescription and dependent daycare expenses. Employees elect how much they want withdrawn from each pay period. By participating in a FSA, an employee always has cash to pay for these expenses, and as an added benefit, their taxable income is reduced which also increases the percentage of pay they take home.
A POP (Premium-Only Plan) allows employees to select, purchase and pay monthly premiums for their own individual insurance plan with pre-tax dollars. Employees elect a set amount of wages to be deducted from each payroll to be used by the employer to reimburse the employee for the monthly premium.
Most insurers include wellness benefits in their comprehensive coverage, designed to improve lives and keep members healthy, ultimately reducing healthcare costs all the way around. Your group health plan will generally include the following services designed to promote a healthy lifestyle and identify and treat your most at-risk employees.
- Biometric screening, education and preventative programs.
- Gym and nutrition memberships at no or low cost
- Access to additional resources such as fitness trackers, blogs, subscriptions and more.
- Access to telehealth solutions
- Access to programs such as smoking cessation, substance abuse help, financial wellness seminars and more.
- Preventative medicine such as flu shots, mammograms, colonoscopy, heart and cancer screenings and more at no or low cost.
Smart employers consider life insurance a key part of the benefit package, and a valuable tool in attracting top talent.
Permanent Life Insurance builds cash value, which is sometimes used as collateral for loans, if needed. However, most employers only offer basic term life but also offer permanent life insurance on a voluntary basis.
Term Life Insurance will pay a set amount to the named beneficiary upon the death of insured within the stated term. Additionally, some policies may also make payments upon terminal or critical illness.
Employees always appreciate dental coverage as part of the basic benefit package. Studies have shown that regular dental exams help employees to stay healthier and more productive in the workplace. 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.
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.
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.
Savvy employers attract and retain top talent by offering highly desired short and long term disability as part of the employer paid benefit package or as a voluntary (worksite) benefit.
How it works.
When an employee is unable to work due to a qualifying disability, Short Term Disability (STD) 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 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.
When purchased at low group rates, voluntary benefits are an affordable way for employees to alleviate financial worries with benefits that go beyond traditional employer paid benefits. They can be set up at little or no cost to the employer, and lower payroll taxes for both employer and employee. In today’s economy, voluntary benefits rank high for employees must haves in a job. Typical voluntary benefits include separate or wrap-around life policies, disability plans, dental insurance, critical care or accident plans, and more.