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.

A Health Savings Account (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.

A Health Reimbursement Account (HRA) combines high deductible/low premium health insurance with a tax favored savings account. Employers contribute to the savings account, which can be used for to fund co-pays and other qualified expenses prior to the deductible being met.

Single, Dual or Triple Option Plans offer eligible employees a choice between several different types of plans as described above.

A self-funded health plan requires the employer to become the insurer. Most often, employers will partner with a PPO to provide services for the plan. A third party (a TPA) is engaged to handle claims and processing. Because self-insured employers run the risk of large catastrophic claims, they will purchase stop-loss insurance to protect them in such an event. Even with the additional expense of stop-loss insurance, employers can enjoy saving thousands in premiums and other advantages.

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. Here’s how they work.

This tax-favored savings account is funded solely by the employee through regular pre-tax payroll deductions. Employees elect how much they want withdrawn from each pay period, which can be changed annually or upon a qualifying event such as marriage or divorce. Throughout the plan year, funds can be withdrawn from the account (tax-free) to pay for eligible medical, dental, vision, prescription and dependent daycare expenses. Some FSAs include work-related parking and transit costs. The administrator of the FSA account can issue a debit card that is tied to the FSA making it easy to use the account when needed.

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 such as heart disease and diabetes. 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 including 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, 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.

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 employer paid or voluntary, 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. Steven Driss Insurance Aency, Inc. 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 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 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.

Worksite Benefits are sometimes referred to as ancillary or voluntary benefits. They are additional insurance products, plans or programs which an employee can purchase through their employer, through payroll deductions, at a discounted group rate to supplement their employer-paid benefits.

Examples of ancillary or voluntary benefits offered are listed below.

-Life Insurance
-Disability Insurance
-Dental and Vision Plans
-Long Term Care
-Cancer
-Heart/Stroke
-Critical Illness
-Accodent

Wellness in the workplace is proven effective to help employees live a healthy life style, leading to significant improvements in workplace wellness, including spiked morale, productivity and reduced absenteeism, to name a few.

Health and wellness not only saves employers money, but also insurers.  Accordingly, all of our carriers have invested heavily to trend consumers towards a healthier life style and offer robust tools for their clients.  These tools may cover areas such as:

• Diet & Nutrition
• Physical Fitness and Exercise
• Health Screenings
• Telehealth
• Smoking and other Addiction Cessation Programs
• and More….

We also work with wellness providers and networks that offer completely customizable options that deliver everything you need to develop and implement a results-driven wellness program.

Typical Group Life and Disability insurance offered to employees usually only cover a fraction of a key executive’s high income.  Providing an enhanced, customized benefit package to wrap around the group plan for key executives not only protects the executive and his/her family, but also the business in the event of a sudden critical illness or death.  Executive benefits can include supplemental life insurance and/or carve out disability, and plans may be structured to avoid taxation of benefits at the time of claim.   Following are some more specific examples of Key-Person Executive Benefits:

Key Person Life Insurance is designed to protect your business should one of the main partners pass away unexpectedly. This policy will name your business as the beneficiary and premiums are billed under the business name. Benefits and premiums are tied the value you have established through financial records. Benefit payments are made to the business to help minimize financial loss should your business lose the insured (key personnel) due to death.

A Business Overhead Disability policy prevents businesses from going under from regular overhead expenses while the business owner is unable to work and run the business due to disability. These types of policies will typically pay for things like employee salaries, rent and utilities, among other expenses.

Buy-Sell Agreements are intended to protect a business after the death of a key employee. Buy-Sell Agreements (also known as Continuation Agreements) are tied to and funded by life insurance policies. The agreement sets out the details of the transfer of business interest by the key-person (or his/her estate) upon a certain triggering event–usually death, disability and retirement. The surviving or continuing business owner or partner can rest assured knowing that they will be able to purchase the key-person share without interference from other survivors of the key person and his/her estate.

An Executive Medical Reimbursement Plan is a supplemental, group executive medical expense reimbursement insurance policy. It allows employers to reimburse their key employees for medical expenses not otherwise covered by regular group health insurance.  In addition to covering deductibles, this type of policy covers a range of services including prescription and over- the-counter drugs, dental and vision expenses, hospital expenses and more.