Group Benefits

With a self-funded health plan, the employer pays the employees’ medical claims as they occur instead of paying fixed premiums to an insurance carrier. The employer assumes the financial risk, with stop-loss protection for large or unexpected claims. This structure can offer greater flexibility and potential cost savings for some employers.

A level-funded health plan combines features of both fully insured and self-funded coverage. Employers pay a fixed monthly amount that covers claims funding, administrative costs, and stop-loss protection. If claims are lower than expected, the employer may receive a refund at the end of the plan year. 

A Health Savings Account (HSA) is a tax-advantage account that can be offered as part of an employer-sponsored high-deductible health plan. It allows employees to set aside pre-tax money for qualified medical expenses. Funds roll over year to year and can be invested to grow tax-free. 

A Health Reimbursement Arrangement (HRA) is an employer-funded benefit that reimburses employees for qualified medical expenses. The employer sets the contribution amount, and employees submit eligible expenses for reimbursement. Unused funds remain with the employer.

A Flexible Spending Account (FSA) allows employees to set aside pre-tax dollars for qualified medical expenses. It can help reduce out-of-pocket healthcare costs, but funds generally must be used within the plan year or they may be forfeited. 

Minimum Essential Coverage (MEC) plans provide basic health benefits that satisfy Affordable Care Act (ACA) minimum coverage requirements. These plans typically cover preventative services such as annual wellness visits and screenings but are not intended to replace comprehensive major medical insurance.

Vision insurance helps reduce the cost of routine eye care, including annual eye exams, prescription glasses, and contact lenses. Premiums may be paid by the employer, the employee, or shared between both. 

Group term life insurance provides a death benefit to an employee’s beneficiary if the employee passes away while covered under the plan. Premiums are typically employer-paid.

Voluntary life insurance gives employees the option to purchase additional life insurance coverage for themselves and, in many cases, their dependents. Coverage is optional and paid for by the employee, providing extra protection beyond basic group life insurance.

Short-term disability insurance provides income replacement when an employee is unable to work because of a covered illness, injury, or medical condition. Benefits typically replace a portion of the employee’s income for a limited period while they recover. Coverage may be employer-paid, employee-paid, or shared. 

Long-term disability insurance provides income replacement when an employee is unable to work for an extended period because of a covered illness or injury. Benefits typically begin after short-term disability ends. Coverage may be employer-paid, employee-paid, or shared. 

Hospital indemnity insurance pays a cash benefit when an employee experiences a covered hospital stay or other qualifying inpatient services. Benefits are paid directly to the employee and can be used for medical bills or everyday expenses. Coverage is typically employee-paid.

Critical illness insurance provides a lump-sum cash benefit if an employee is diagnosed with a covered serious illness, such as cancer, heart attack, or stroke. The payment can be used for medical expenses or any other financial needs during recovery. Coverage is typically employee-paid.

Accident insurance provides a cash benefit when an employee suffers a covered accidental injury. Benefits are paid directly to the employee and can help cover medical expenses, deductibles, or everyday bills during recovery. Coverage is typically employee-paid.

Gap coverage helps pay certain out-of-pocket healthcare expenses, such as deductibles, copays, and coinsurance, that may not be fully covered by a primary health insurance plan. Coverage is typically employee-paid.