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What are “carve-outs” in health insurance?

Carve-out plans take specific diseases or categories of services and place them under control of a third party managed care organization. Usually, the carve-out involves higher priced services that will require additional payments from employees and beneficiaries. Some carve-outs involve specialized fields like mental health and drug abuse. The second type of carve-out creates employee […]

What are cafeteria plans for health insurance?

Cafeteria plan — it’s a strange name that has nothing to do with food. It’s an employee benefits’ program designed to take advantage Section 125 of the Internal Revenue Code. While it may be the first time you’ve heard of this type of tax savings, the plans are not new. The very first cafeteria plans were […]

What is “stop-loss” in health insurance?

Stop-loss coverage is a much needed financial protection for any company that decides to self-insure employees for medical benefits. It is different from a health insurance policy in that the insurer does not pay for any medical services, but simply reimburses the company for any amounts over the liability amount. Enter your zip code above […]

What is a self-funded health insurance plan?

A group health plan can be either self-funded or fully funded. A self-funded plan requires the employer to assume all the financial risks in regards to providing health insurance to its employees. The biggest difference between a self-funded and fully-funded health insurance policy is the way claims are paid. In a self-funded health insurance plan, employers […]

What is an HRA account and how does it work?

An HRA is an employer-funded account that sends funds to employees to reimburse them for health and medical expenses. The HRA can go with employer-sponsored health insurance, and it is particularly well adapted to work with High Deductible Health Plans. The new Small Business HRA can stand by itself as an employer-funded health benefit from […]

What is group health insurance coverage?

If you are a small business owner that believes group health insurance coverage is designed to only compliment larger companies and corporations, you are not alone. When you explore what actual group health insurance coverage is, it becomes clear that it is meant for any-size business and number of employees. All it takes to find […]

What is your group number for health insurance?

An employer may insure a group of people working in the company under one health insurance plan. Each of the employees gets a medical insurance card from the insurance company, which has a group number. Therefore, a group number is the number assigned to an employer that purchases health insurance plans from one provider. The […]

Is your spouse considered a dependent on health insurance?

When you fill out an application for health insurance, you have to list the primary insured’s name and all dependents. But, who’s a dependent? That question has led many to fill out applications incorrectly or leave someone off the application that is eligible for coverage. Most errors in an application have to do with your […]

Is healthcare a business expense?

Health insurance is a deductible expense for organizations and sole proprietors. It is a business expense for most firms and business entities that either pay or contribute to employee health plans. The Affordable Care Act reformed the insurance industry. People would no longer get denials for pre-existing conditions. The insurance rates were much more consistent […]

What if I already have health insurance?

What if I already have employer-based health insurance? If you already have employer-based health insurance, you do not need to enroll in a plan through the healthcare marketplace and you will not be responsible for paying the individual mandate penalty fine. In 2016, this fee was $695 per adult and $347.50 per child with a […]

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