Employee Benefits-
What are my options?

If you need cost-effective health insurance that you can offer to your employees or organization members and their families, group health insurance is right for you. Talk to us about Affordable Care Act (ACA) plans, level funded health plans, self-funded insurance, and more.

Fully Insured

Small group ACA (affordable care act)

Only 2 or more eligible employees working 30 or more hours per week (cannot be married spouses)

Requires 50% participation of all eligible employees to enroll

Employer must contribute 50% of employee only premium (must meet affordability test of 9.5%)

No underwriting

Guaranteed issue

No Pre-existing conditions

100% paid preventive care on all plans

Level Funded

Fully underwritten with employee applications

In most cases, rates lower than traditional ACA plans with select carriers

Potential claims refund after contract period

ONLY need 5 Full Time employees

More carrier options

Premier One

Benefits the Employer

Opportunity to offer a fully insured insurance plan to employees

Employer sets contribution amounts

Once convenient monthly invoice

Employee payroll deduction same as group plans

Modest administration fees

No Cobra

No Participation requirements

Employees select their own fully insured ACA healthcare plan based on their individual healthcare needs

Many employees are eligible for subsidy premium taxcredits and cost sharing benefits

Family members can not be denied for pre-existing conditions

Plan premiums are funded by the employer with pre-tax contributions and/or the employee through convenient payroll deduction

Plans

(HRA) Health Reimbursement Arrangement

MEC Plan (Minimal Essential Coverage)

Maximizes employee healthcare benefits

Works for employers not offering group health plans

Enhanced benefit for employers offering group plans

Provides tax savings for employers

Business determines eligibility and rules

Employees incur expenses and submit claims

Business reimburses employee tax-free for approved expenses

MEC plans generally cover preventive and wellness-related tests and treatments. While they meet certain requirements outlined under the Affordable Care Act (ACA) and ERISA, they are not what most think of as traditional health insurance

© 2019 - 2022 PMG Agency