Group health insurance, more commonly known as an employee benefit program, is established and maintained by a business entity.
The employer provides access to medical care for employees and their family members through a contractual relationship with a private insurance carrier.
Group health insurance plans are designed to be more cost-effective as premiums are typically less expensive than an individual health plan. In most cases, an employer contributes to the employee and/or their dependents' monthly premium. A defined contribution can be in the form of a defined dollar amount or a flat percentage.
Premiums are payroll deducted which allows the employee’s premium portion to be tax-free.
Employers pay lower payroll taxes and can deduct their annual contributions on their business tax returns.
There are a variety of different plan and premium funding available to employers, depending on a company’s size.
Pays lump cash sums for a cancer diagnosis and per day for hospital stays, cancer specific medications, imaging, experimental treatment, and many other services related to cancer treatments.
Offers payment for a wide range of medical care services that could occur with an unexpected injury.
Provides financial peace of mind if you experience a serious health event such as heart attack, stroke, coma, paralysis, major organ transplant, third-degree burns, and many others. Payments will be in the form of lump-sum cash payments for the health event and subsequent per day payments for recommended hospital stays and/or care.
Policyholder is entitled to a lump sum for being confined to a hospital for 23 or more hours; additional claims may be eligible to be submitted for direct payment for rehab, emergency room care, doctor visits, ambulance, etc.
Supplemental insurance is advantageous when the unexpected happens, but consumers should consider these policies when they have a planned surgery/procedure.
Supplemental insurance has grown in popularity due to the significant shift in member/consumer cost share. More families are burdened with higher out-of-pocket costs forcing them to dig into their savings or delaying much-needed medical care. Supplement insurance pays policyholders directly, not the medical insurance carrier, so those funds can be used however they choose. Some examples of the different types available are:
Oral health can tell a lot about a person’s overall health.
Dental coverage is an important coverage to have and can include the following:
Preventive care like routine cleanings, exams, and fluoride treatments
Basic services like fillings, basic extractions, emergency dental pain, periodontal and endodontic treatment
Major services like root canals, crowns, and implants
Orthodontia services and retainers
Access to extensive dental networks of providers and specialists
Certain medical policies have preventive vision benefits included but for individuals that need comprehensive coverage due to poor eyesight or stigmatisms can access stand-alone vision insurance to significantly lower their costs.
Typical plan designs include coverage for:
Comprehensive eye exams
Contact lens fitting
Low copays for prescribed lenses
Benefit allowance for eyeglass frames and/or contacts lenses
Discounts on Lasik Eye Surgery
On average, consumers can save 50-60% off the total bill for exams and the purchase of lenses and frames/contact lenses.
Life insurance, group sponsored specifically, is a convenient and inexpensive way to provide financial support for beneficiaries in the event of death. Most employer sponsored policies will utilize a term life platform, but enhanced policies, like universal or whole life, can sometimes be offered as an employee benefit. Employers may pay all or a portion of the premium for a flat amount (ex. $50,000) and/or allow employees to purchase additional amounts with limited underwriting requirements.
Auto….home…life…health…..wages? Disability insurance is a way to insure an individual’s income. If an unexpected accident or severe medical diagnosis occurred making that person unable to work, disability insurance comes into play. Short Term Disability supplements a portion of missed income for a specific time period (12/13/26 weeks). If the claimant is still considered disabled, Long Term Disability takes over and typically supplements income through Social Security Normal Retirement Age (SSNRA). Please note, policy provisions differ by employer and industry.