Group Benefits

GROUP BENEFITS

Your Expert Provider of Group Health Solutions

With more than 20 years of service to employers throughout Michigan, we have the experience and resources necessary to cater to the unique needs of any client, no matter size of company or complexity of their benefit issues.

Our team of certified benefit specialists, financial consultants and life underwriters utilize proven strategies to customize employee benefit packages that cut costs, while also reducing the time and stress related to managing employee benefits.

Click The Toggles Below To Learn More About the Types of Benefits Your Program May Include, Based On Your Needs.

We offer traditional health plans through most major carriers. Depending on your needs, we have plans that comply with the Affordable Care Act (ACA) to full packages that offer a variety of benefits.
Health Maintenance Organization (HMO)
A 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.
Preferred Provider Organization (PPO)
A PPO saves members 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.
Health Savings Account (HSA)
A HSA combines a high deductible/lower premium health insurance plan (PPO) with a savings account. Both employer and employee can contribute, tax-free to the savings account, which can help fund the deductible and other qualified medical expenses. Once the deductible is met, the insurance starts paying.

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Medical Reimbursement Plan Options

Medical reimbursement plan options includes a variety of affordable health coverage options for 2 man employer groups up to 50 full time equivalent employees. It depends on how your company is structured and how many employees you currently have, the video below will help you to determine what plan option best suits your situation and how you can begin lowering cost with greater tax advantages and benefit options.

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A Premium-Only Plan lets employees purchase their own individual insurance with pre-tax dollars, potentially saving employees thousands annually in taxes and premiums combined.

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A Flexible Spending Account (FSA) is a cafeteria plan under Section 125 of the tax code and allows for benefits to be paid with pre-tax dollars which results in tax savings to both the employee and the employer. The average working employee in America spends thousands of dollars annually on certain types of medical benefits, daycare expenses and transportation services. By participating in an FSA, an employee’s taxable income is reduced, which increases the percentage of pay they take home and allows them to pay for these benefits and services with the pre-taxed dollars, in essence giving them a discount on these services.

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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. Whether an employer paid or voluntary benefit, a good life insurance policy provides for an employee’s final expenses, taxes, mortgage and even their children’s education as well as offering additional added benefits. We 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 or as a voluntary (worksite) benefit.
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 will begin.  It generally allows for income payments to the employee to begin after about a two-week waiting period.  It will continue to pay the employee until he/she recovers or maxes out the benefits.  This is 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 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.  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.  This will increase the ability to attract and retain the very best talent.
Here’s How It Works:
Most LTC plans are designed to provide benefits for care through nursing homes or assisted living centers.  This also includes 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.
We offer Dental and Vision Plans through many of our major insurance carriers. These plans are offered on a stand-alone (voluntary or employer-sponsored) basis or incorporated into the group health plan offering. Whether as voluntary or paid benefit, employees appreciate both dental & vision coverage as part of their Employee Benefits Package.
Dental Plans
Regular dental exams help employees stay healthier and more productive in the work place. Simple routine visits to the dentist, which are usually covered 100% by insurers, help to detect serious underlying conditions.   The National Association of Dental Plans and the Centers for Disease Control have performed studies that show that employees with Dental Insurance plans have better attitudes and are less likely to suffer from depression, a common condition in today’s fast-paced world. Dental Plans offer a variety of diagnostic, preventative care and corrective services.  These include cleanings, exams, x-rays, fillings, root canals, orthodontia for children, and emergency care while traveling.
Vision Plans
Similar to dental policies, vision plans are inexpensive and save money on routine exams.  They provide eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK. Monitoring your eye health with regular exams also helps to prevent serious eye diseases like glaucoma and cataracts and also helps to detect early stages of diabetes, high blood pressure, and high cholesterol.
We help employers who provide medical benefits to their retirees tackle the challenges of ever increasing premiums and health care costs.  We offer a guaranteed issue “true group” approach.  Eligible employees (and spouse) receive all the benefits of Medicare and more with a Group Medicare Supplement. Here’s how it works:

Medicare Supplement Insurance policies complement your retiree’s original Medicare Parts A and B. They cover some or all of the expenses that Part A and B don’t, like co-pays, deductibles and other charges.  Dental, vision and hearing wellness benefits may be included.
Starting in January 2020, a new type of HRA will be available called an Excepted Benefit HRA. For background, a Health Reimbursement Arrangement (HRA) is a vehicle that allows employers to help employees pay for medical expenses with tax-advantaged dollars. The most common types of HRAs are called Section 105 HRAs, named after the Internal Revenue Code Section 105, which created and regulates most types of HRAs today. The Excepted Benefit HRA is a new flavor of Section 105 HRA with some unique benefits and applications. We'll keep this information up-to-date as we continue to learn more about it.

Where did the "Excepted Benefit HRA" come from?

In October 2018, the U.S. Departments of the Treasury, Health and Human Services, and Labor proposed new regulations to expand the usability of health reimbursement arrangements (HRAs). This is the 3rd and final part of President Trump's Executive Order from October 2017 (E.O. 13813) to reform the health system through regulatory changes. You can see the press releaseaccompanying fact sheet, and proposed rule itself here. The final rules were passed June 13, 2019 that outline EBHRA, ICHRA (Individual Coverage HRA), and QSEHRA (Qualified Small Employer HRA).

Why was it created?

Traditionally, HRAs have always been required to integrate with a group health plan unless they fit the narrow criteria to be considered a stand-alone HRA (like a QSEHRA). However, regulators have recognized that some employers may wish to offer tax-free reimbursement without regard to whether or not employees have qualified insurance coverage. The Excepted Benefit HRA offers reimbursement opportunities to employees that do not participate in the group health plan.

What are the requirements for an Excepted Benefit HRA?

There are four requirements for an HRA to qualify as an Excepted Benefit HRA:
  1. The HRA must not be an integral part of the plan;
  2. The HRA must provide benefits that are limited in amount;
  3. The HRA cannot provide reimbursement for premiums for certain health insurance coverage;
  4. The HRA must be made available under the same terms to all similarly situated individuals.

Do employers have to offer a group health plan to use an Excepted Benefit HRA?

Technically, yes, an employer must offer group health insurance in order to also offer an Excepted Benefit HRA. However, unlike traditional HRAs, employees do not have to participate in the group plan in order to receive reimbursements. This is really what separates this new HRA from traditional HRAs which required employees participate to receive reimbursements.

What can it pay for? What are "excepted benefits" anyway?

"Excepted Benefits" is insurance jargon to refer to insurance plans that are not primary health plans. Examples of excepted benefits include vision insurance, dental insurance, long-term care insurance, nursing home care, etc. Individual major medical premiums, coverage under a group health plan, and Medicare Parts B and D are not excepted benefits and would not be eligible. The proposed rules make exceptions that would allow for payment of COBRA premiums, short-term plans (STLDI), and individual or group plans that consist solely of excepted benefits.

What are the limits?

Employers can offer $1800 a year starting in 2020 to employees. While this does not sound like much, this works out to $150 a month which can go pretty far for non-major medical health insurance plans. The $1800 amount is tied to inflation, so it'll go up a little bit every year.

Can unused funds carry-over to the next year?

Yes, if an employee does not use all of his or her allowance in a given year, the unused balance can carry-forward to the next year. Presumably, the employer will be able to choose whether to allow this or not, but we'll see. According to the proposed rules, any carry-over amount will not count towards the annual maximum the following year.

Can an Excepted Benefits HRA work with other types of HRAs?

Because an Excepted Benefits HRA requires a group health plan be offered, it will not work with the newly proposed Individual Integrated HRAs or existing QSEHRAs. It is not clear if Excepted Benefit HRAs can also be offered alongside a traditional 105 HRA. However, the proposed rules do allow employers to offer different benefit solutions to different classes of employees (assuming the classes are defined in a fair manner). An employer could offer an Excepted Benefits HRA to one class (say, part-time employees) and a QSEHRA to full-time employees.

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In January 2020, employers will be able to offer a new type of HRA called an "Individual Integrated HRA". These are similar to Traditional HRAs except they integrate with individual health insurance coverage instead of group plans. Although the ink is still drying on the regulations, here's what we know so far about how these new HRAs will work. For background, a Health Reimbursement Arrangement (HRA) is a vehicle that allows employers to help employees pay for medical expenses with tax-advantaged dollars. The most common types of HRAs are called Section 105 HRAs, named after the Internal Revenue Code Section 105, which created and regulates most types of HRAs today. What we're calling an "Individual Integrated HRA" is a new flavor of Section 105 HRA with unique benefits and applications. We'll be keeping a close eye on the regulatory situation and keep this blog up-to-date as we continue to learn more about it. Here's what we know now:

Where did the "Individual Integrated HRA" come from?

In October 2018, the U.S. Departments of the Treasury, Health and Human Services, and Labor proposed new regulations to expand the usability of health reimbursement arrangements (HRAs). This is the 3rd and final part of President Trump's Executive Order from October 2017 (E.O. 13813) to reform the health system through regulatory changes. You can see the press release, accompanying fact sheet, and proposed rule itself here. Another type of HRA was also created from these proposed rules called an "Excepted Benefit HRA".

What are the requirements for an Individual Integrated HRA?

The proposed rules would require that several conditions be met for the Individual Integrated HRA to qualify:
  • Individual employees (and their dependents) must be covered by a health insurance plan
  • The design of the HRA does not intentionally or unintentionally discriminated (to prevent risk shifting)
  • Employees in the same "employee class" are offered an HRA on the "same terms"

What are the proposed "employee classes" and how do they work?

The proposed employee classes in regulations include:
  • Full-Time Employees
  • Part-Time Employees
  • Seasonal Employees
  • Employees covered by a collective bargaining agreement
  • Employees who have not satisfied a waiting period for coverage
  • Employees under age 25
  • Non-Resident aliens with no US-based income
  • Employees whose primary site of employment is in the same rating area
This means that employers could offer different reimbursement amounts or even different types of coverage to different classes of employees. This is a big upgrade over QSEHRA, which allows employers to choose whether to include or exclude classes of employees similar to the list above but not to offer different offerings. For example, under the proposed rules, employers could offer full-time employees a traditional group plan and part-time employees an Individual Integrated HRA. Or employers could offer an HRA with certain reimbursement rates to an office in one geography and a different HRA with different reimbursement amounts to an office in another location (based on the rating area criteria above).

What can it help pay for?

The Individual Integrated HRA is designed to help employees pay for individual health insurance premiums. In addition, it can also help pay for medical expenses provided that the employee has substantiated he or she has health insurance coverage. This is similar to the rules in effect governing QSEHRA.

Is there a minimum or maximum number of employees needed?

No, there are no minimums and no maximums. Employers over 50 full-time employees may have to meet a minimum contribution in order to avoid ACA corporate mandate penalties.

What are the contribution limits?

No limits have been provided and none were suggested in the initial rule. Traditional 105 HRAs are only limited by employee wages and the "fair terms" requirements.

Can large employers offer an Individual Integrated HRA to meet the corporate mandate?

Yes. The IRS is expected to provide calculations and benchmarks to help large employers (ALE) subject to the corporate mandate determine what their minimum HRA contributions will have to be in order to satisfy the mandate.

Can an Individual Integrated HRA work with other types of HRAs?

Because an Individual Integrated HRA requires no group health plan be offered to the same class of employees, we know it will not work with the new Excepted Benefits HRA or with traditional Section 105 HRAs integrated with a group health plan. It may be able to work with QSEHRA but the benefits would likely be redundant. However, the proposed rules do allow employers to offer different benefit solutions to different classes of employees (assuming the classes are defined in a fair manner). An employer could offer an Excepted Benefits HRA to one class (say, part-time employees) and a QSEHRA to full-time employees.

When will we learn more about the final rules?

Now that the proposed rules have been published, there is a 60 day public comment period. There are likely to be some minor tweaks and clarifications made to the rules. The IRS is expected to provide further guidance during 2019, although no timeframe has been provided.

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National studies continue to prove that one way to lower the cost of healthcare and healthcare claims is to encourage the population to lead a healthy lifestyle. As a result, many carriers, as well as employers, are offering wellness benefits to complement health benefits, in addition to offering incentives for using them.

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