Benefits that reflect how you lead.

• Employers typically pay a share of employee premiums. Carriers often set minimum employer contribution and employee participation requirements, which vary by carrier and state.
• Common plan types include HMO, PPO, and EPO designs, plus high-deductible health plans (HDHPs) that can be paired with a Health Savings Account (HSA) when IRS requirements are met.
• Rules differ by group size. Under the Affordable Care Act, employers with 50 or more full-time-equivalent employees are generally subject to employer coverage requirements; smaller employers generally are not required to offer coverage.
• Premiums, networks, and plan options depend on your location, the carrier, and your group’s makeup, and can change at each renewal.

Worth askingWhat would our total cost look like at different contribution levels, and what participation do we need to qualify?

• Dental plans often group services into preventive, basic, and major care, with different cost-sharing for each.
• Annual benefit maximums and waiting periods for some services are common. Some group plans reduce or waive waiting periods, depending on the carrier and group.
• Vision plans typically help with routine eye exams and provide allowances toward glasses or contact lenses.
• These benefits can be employer-paid, shared, or offered as voluntary (employee-paid) coverage.

Worth askingDo our employees’ current dentists and eye doctors participate in the plan’s network?

• Basic group life is often employer-paid as a flat amount or a multiple of salary. Employees may be able to buy additional coverage for themselves and dependents.
• AD&D pays a benefit for certain covered accidental deaths or injuries, subject to the policy’s terms and exclusions.
• Employer-paid group term life above $50,000 may create taxable imputed income for the employee — confirm details with a tax professional.
• When an employee leaves, some policies allow them to keep coverage through portability or conversion options.

Worth askingHow much coverage is guaranteed without health questions, and what happens to coverage if someone leaves?

• Short-term disability typically covers a period of weeks to months; long-term disability can continue for years, depending on the policy.
• Benefits are usually a percentage of earnings, up to a monthly maximum, and begin after an elimination (waiting) period.
• Policies define “disability” differently, and pre-existing condition limitations may apply.
• A few states require employers to provide short-term disability or similar coverage. Requirements depend on where your employees work.

Worth askingHow does the policy define disability, and how long is the elimination period?

• These plans generally pay set cash benefits for covered events — such as an accidental injury, a covered diagnosis, or a hospital stay.
• Benefits are usually paid to the employee, who can use them for medical bills or everyday expenses.
• They are often offered as voluntary benefits, with employees paying through payroll deduction.
• They are not a replacement for major medical coverage. Exclusions and pre-existing condition limitations can apply.

Worth askingWhich events or diagnoses are covered, and are there pre-existing condition limitations?

• Benefits can be fully employer-paid, cost-shared, or voluntary — giving employees access to coverage at group rates with little or no employer cost.
• Some employee premiums can be paid pre-tax through a Section 125 cafeteria plan. Eligibility and tax treatment should be confirmed with a tax professional.
• Clear enrollment communication helps employees understand and value what you offer.
• Reviewing benefits before each renewal helps you respond to cost changes and a growing team.

Worth askingWhich benefits would our employees value most, and what can we realistically fund this year?