Group Benefits

Whether your business size is 2 or 2000, we will create a benefits plan for your employees aligned with your business or organization’s goals and philosophies.

We take a step back, listen, and learn, before we customize a plan with the proper industry benchmarks and data. This ensures that the process put into motion starts off right.  We feel that this is better approach than simply just shopping the prices or taking a “one-size fits all” attitude.  

We offer all lines of group benefits:

Speak with one of our Benefit Consultants today.

Individual Health Benefits

We provide quality health insurance coverage for individuals between the ages of 1 and 64.  Using some of the same providers we use for commercial coverage, we bring peace of mind to individuals looking for quality health insurance for themselves and their families. 

We work with Exchange (Marketplace) based plans and Off-exchange (Marketplace) based plans. As your benefits consultant, we will make sure you have access to helpful tools and resources you need to manage your plan.

Speak with one of our Benefit Consultants today.

Voluntary Benefits

Voluntary benefits enhance core benefit packages and deliver added incentive without employers spending more on insurance. A solid voluntary benefit platform offers your employees the ability to purchase competitively-priced coverage, and in most cases without underwriting questions. Voluntary Benefits complement your core benefit strategy while reducing company costs and employee financial risk.

Voluntary Benefits may include:

Speak with one of our Benefit Consultants today.

Health Savings Accounts

Health Savings Accounts (HSA) were formed in January, 2004 as part of the Medicare Prescription Drug and Modernization Act. These programs replace Medical Savings Accounts (MSA). In essence, HSA have removed all of the negative requirements of an MSA and retained the positives.

Health Savings Accounts are established on a non-taxable basis to reimburse individuals for out of pocket liabilities. By purchasing a high deductible health insurance plan, an employer reduces his/her premiums. From these premium savings, monies can be set aside to help offset some or all of an employee’s additional out-of-pocket liability.

Guidelines for a Health Savings Account

Speak with one of our Benefit Consultants today.

Healthcare Reimbursement Arrangements

By purchasing a high deductible health insurance plan, an employer reduces his/her premiums. From these premium savings, monies can be set aside to help offset some or all of an employee’s additional out-of-pocket liability.

Healthcare Reimbursement Arrangements (HRAs) are part of the IRS code section 105 “defined contribution plans”. Final regulations were released in June of 2002 allowing for HRAs to be allowed on a tax favorable basis.

IRS guidelines allow for the following

• There are no plan design requirements to qualify for an HRA plan
• HRA accounts must be funded with employer dollars
• Monies reimbursed to an employee for eligible out of pocket medical expenses are deductible to the employer (monies are not deductible until actual reimbursements are made)
• Monies are received by the employee as non-taxable income

Employers can elect to have the entire fund assigned to the employee, or only reimburse for actual eligible expenses incurred

Speak with one of our Benefit Consultants today.

ASO | Self-Funded

Under a self-funded approach, the employer assumes the risk for claims incurred and paid on its employees and their covered dependents.  The employer would pay a fixed cost for the administration of the plan using a Third Party Administrator (TPA), or through an Administrative Services Only (ASO) arrangement with a major insurance carrier. 

Self-funding is especially beneficial for an organization that expects to grow.  When a new employee is hired the minimum amount of time before that person or his/her family member to generate a paid claim is usually 3-4 months.  While under a fully insured program, the entire premium is paid to the insurer from day one, with a self-insured plan, only the minimal fixed costs are paid until such time as a claim is actually generated.

Finally, it should be noted that in the event of a high claims year, the reinsurer will increase the following year’s maximum liability. However, unlike under a fully insured plan when premiums are also be increased for the upcoming year, for a self-funded approach, the increased potential cost is not paid unless warranted by the actual claims.

Disadvantages to self-funding include:

• Inability to predict exactly when claims will actually be incurred
• Although an employer maintains his own reserve fund, he is also responsible for the Run Off Claims, should the plan be terminated.

Advantages to self-funding include:

• Increased cash flow
• Potentially significantly lower costs, depending on actual claims
• Lower administrative costs
• Flexibility in plan design
• Ability to control “Reserve” dollars normally held by the insurance company. 

Reinsurance coverage can be purchased to protect the company against an extremely large claim or a multitude of lesser claims.  Premiums for this protection would provide two forms of insurance:

1. Specific Stop-Loss Protection. An insurance policy is purchased through a reinsurance company to protect against any individual claims.  The employer would accept the risk on any one individual during the plan year up to this amount (typically $60,000, $70,000 or $80,000).  The reinsurer immediately reimburses claims that exceed this amount, during the plan year.
   
2. Aggregate Stop-Loss Protection. An additional insurance policy is purchased to protect the Company against the total number of claims that may be incurred and paid during the plan year. The reinsurer establishes monthly claim factors for single and family coverage.   Similar to fully insured premiums, these are multiplied by each month’s actual enrollment to establish a year-end maximum amount.  Should all claims under the Specific Stop-Loss level exceed this amount the reinsurer accepts the responsibility for the balance.

Speak with one of our Benefit Consultants today.