Group Health Employee Benefits

A Health Maintenance Organization (HMO) requires group members to obtain their health care services from doctors and hospitals affiliated with the HMO. Members are required to designate a primary care physician who treats and directs health care decisions and who coordinates referrals to specialties within the HMO network. HMOs offer access to a comprehensive package of covered health care services in return for a prepaid monthly amount (or “premium”). Most HMOs charge a small co-payment depending upon the type of service provided.

With a Preferred Provider Organization (PPO) members save the most money on healthcare, if they use providers within their network. If providers outside of the network are used, it is possible that those services may not be covered at all. Deductibles must be met on this plan before some services will be covered. PPOs require a co-pay for physician visits.

Small businesses who purchase their employee health plans through the Government’s Small Business Health Options Program (SHOP) may qualify for a tax credit which could  reduce premiums by as much as 50%. To be eligible, you must cover at least 50 percent of the cost of employee-only (not family or dependent) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation beginning in 2014) per year.

Along with Health Insurance, Life Insurance is considered to be a key part of the benefit package for employees. Besides being a valuable tool in attracting top talent, employees are happier and more productive feeling secure that their loved ones will be taken care of in the event of illness or an untimely death.

Life insurance provides for an employee’s final expenses, taxes, mortgage and even their children’s education as well as offering additional added benefits. Toubin Insurance Agency can help employers protect their employees and their employees’ families with a variety of different life insurance products.

Permanent Life Insurance
Life insurance that builds cash value and the savings can be tax deferred and/or borrowed against, if needed. These policies are known as Permanent Life Insurance.

Term Policy
Life insurance that does not build cash value, however, it will pay a set amount to the named beneficiary upon the death of insured within the stated term. Some policies may also make payments upon terminal or critical illness.

National surveys have shown that Short Term Disability and Long Term Disability remain of high importance for most employees. Savvy employers attract and retain top talent by offering both STD and LTD insurance as part of the employer paid benefit package. Here’s how Disability plans typically work.

Short Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), STD generally 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
During the time an employee is unable to work due to a qualifying disability (illness or injury), LTD generally allows for income payments to the employee to begin after about a 90-day waiting period, although it could be much longer depending on the policy, but will continue to pay the employee far longer than STD–for a few years, up to age 65, or even for life.

Group Long-Term Care (LTC) plans are becoming an increasingly common voluntary benefit offered by employers today. The prospect of long-term care is one of the most important issues your employees may have to face. The cost of long-term care is expensive and generally not covered by other employee benefits, disability or even Medicare. If someone requires long-term care, it is not just an emotional strain but a financial one as well, impacting retirement savings and overall financial position.

Savvy employers know that access to additional resources can increase employee productivity when confronted with managing long-term care situations. Long-Term Care plans demonstrate to your current and prospective employees that your company cares about them–increasing the ability to attract and retain the very best talent.

Most LTC plans are designed to provide benefits for care through nursing homes, assisted living centers, home health care and adult day care. Employers can provide a base benefit while giving the employees the opportunity to “buy up” and obtain the level of coverage that they need for their families.