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.
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.
Medical Reimbursement Plan OptionsMedical 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.
Permanent Life InsuranceLife 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 PolicyLife 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.
Here’s How Disability Plans Typically Work.
Short Term DisabilityDuring 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 DisabilityDuring 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.
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.
Dental PlansRegular 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 PlansSimilar 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.
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 release, accompanying 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:
- The HRA must not be an integral part of the plan;
- The HRA must provide benefits that are limited in amount;
- The HRA cannot provide reimbursement for premiums for certain health insurance coverage;
- 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.
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