Home & Auto
Build a Group Employee Benefit program whereby the employer pays 100% (except for long-term disability (LTD), where the employee pays 100% of the premium) of the plan.
The option for employers to pay 100% of premiums. This is helpful when renewal increases arise because it is often difficult for business owners to take premium increases to employees. When employers pay 100% of the premium, the employer is the one responsible for the increase and not the employees.
It's all about being informed for owner and employees, often they have no idea that the price changes year to year based on usage.
For some clients, to make group affordable, the plan may involve using large coinsurance’s e.g., 50% coinsurance on EHC or Dental (usually 80% with a $50 Single / $100 Family deductible)
The owner who is communicating that the plan is mandatory and part of their "total compensation package".
To maximize tax efficiency and to help with cost sharing ,the employees should pay for the life, AD+D, Dep Life, and LTD. This will ensure that life, AD+D, Dep life are not taxable benefits. With LTD, the employee would receive non-taxable benefit at the time of a claim.
With the introduction of many specialty medications, and the rising overall cost of drugs in the marketplace, groups can always consider a drug cap (perhaps $2,000).
A drug cap allows for the majority of basic medications to be covered, however, it will cap out any high cost claims, or employees taking several medications that add up to more than the drug max.
The drug cap reduces the insurance company's risk significantly and there will be large reductions to the EHC premiums which will increase the affordability of a basic plan.
Having 80% co-insurance, a dispensing fee deductible on drugs (this is often overlooked), mandatory generic drugs, and combined paramedical maximums can all be nice cost containment features.
Once the plan is up and running it can always be enhanced over time as the company grows.