Insurance carriers often require a threshold number of employees (usually some percentage of the total number of employees) to elect coverage for the group to qualify for insurance. This is called a participation requirement. However, depending on the reason an employee declines coverage, some employees that decline insurance won’t be considered at all when calculating […]
Yes. If an employee wants to enroll dependents, such as siblings, under their insurance, they can do so by enrolling them as a “qualifying child” during the enrollment process. Parents as Dependents Depending on specific carrier rules, parents can also be enrolled as dependents, but they must share the same address as the employee, be […]
Allowing dogs into the workplace is quickly growing trend in offices across America. Although pro-pet policies are generally appreciated by pet and animal loving employees, there are certainly some pros and cons to carefully consider before deciding if such a policy is right for your company. Pros It’s worth noting that the pros to allowing […]
In-state rules mainly concern insurance carriers’ requirement that a certain percentage of your employees who enroll in your group health plan live in the state where your coverage is written (usually where your company is headquartered). For example, if you have 100 employees, your insurance carrier may require 80% to live and work in California. […]
Most dental plans have an annual dollar maximum (max coverage). Max coverage is the most your insurance company will pay for dental costs incurred during your plan year. Example If you have a root canal for $750 and your dental plan covers 90% of the cost, your insurance company will pay $675, and you’ll pay […]
Can an employee participate in the FSA if he declined medical insurance because they are on their spouse’s plan?
According to the IRS , there’s no law prohibiting an employee from participating in a Flexible Spending Account if they’re not on their company’s health insurance plan. FSA Eligibility As the IRS notes, health FSAs are employer-established benefit plans. As an employer, you may choose to offer this in conjunction with other provided benefits (such […]
Do you know if the impact of the ACA, Affordable Healthcare Act, will impact companies with less than 50 employees in the near future?
It depends on a couple of factors, including if additional amendments are added over the next few years or if your state opts for a single-payer plan in the year 2017. All employers, large and small, will be impacted by implementation of a single-payer plan. The ACA: A Detailed Long-term Plan The ACA is 1,990 […]
For a company that has between 25 and 50 employees, what is a typical amount of plans to offer during open enrollment?
While there isnt really a typical number of plans, employers often offer anywhere from one to three plans. Location Matters If you choose to offer one plan, itll be one that all employees can access. If all employees are located in the same state or area, an HMO can work. Since HMOs can only be […]
For medical insurance, is it ok to offer one plan, such as an HMO, at no cost to the employee and other plans, such as PPO ones, at an employee contribution rate?
Yes, employers can set contributions using a base plan and a buy-up plan (or multiple buy-up plans). For example, if an employer offers an HMO plan and two PPO plans, the employer can elect to pay 100% of the HMO premium for an employee and require the employee to pay the difference to elect either […]
The easiest way for employees to find information on their co-pay, deductible, and insurance provider is through a Summary of Benefits & Coverage (SBC) and a Uniform Glossary of Terms. Where Employees Can Find This Information Your employees may request either of these documents from their issuer or group plan; a link will be found […]