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A Brief Background

Since the adoption of the workers' compensation, short term disability (dbl), unemployment, and Social Security laws, most states now impose at least the statutory or compulsory lines of coverage. These plans are often considered 'welfare plans' as they protect the welfare of the employee in the event of a loss. But for companies looking to attract and maintain quality employees, other benefit packages should be offered as part of total compensation package. We recommend plans that offer the greatest impact and affect the largest number of the employees in the group. Since every company and the need of it's employees are different, the plans offered should by tailored around the group.

Health insurance is probably the most sought after employee benefit and is most often the focal point of any package. This is because medical care costs are spiraling out of control and the expense of health care can financially ruin the savings of an individual if at least catastrophic health insurance is not secured. But the demand for more comprehensive health benefits are greater because of utilization. As people mature, the need for medical care increases. Prescription drugs and doctor visits become almost routine. A good health plan will allow the member to utilize the services of a health care provider without incurring a high cost of the visit. A small co-payment is designed to encourage visits to an internist to treat a patient early on before a condition can worsen. In theory this process can be preventative in nature as good health habits practiced early on can prevent disease and sickness later in life thus lowering the cost to the carriers and to the employers.

Ancillary coverages, such as dental, life, long term disability and care, vision, etc. are all designed to protect an employee from a loss. The financial impact of a claim can be as great or even greater than with medical, especially with regard to a death or disability. Group life and disability plans are designed to protect the employee and their families in the event of a tragedy. We recommend offering these lines of coverage at least on a voluntary basis which empowers the employee to decide whether the protection is needed. Payment of premium can often be made by payroll deduction.

Dental insurance seems to be more popular than other ancillary products because of the frequency of utilization, but the financial impact of dental claims is generally not as great. Coverage for dental insurance can be comprehensive or designed to cover preventative and basic services. As with health insurance, the cost can vary substantially between plans based on the level of coverage, the network, and out of pocket expenses to the user.

Plans designed to enrich an employees welfare are pensions and savings accounts. These products are used to fund an employees retirement or enhance their savings. There are many types of retirement and savings accounts such as 401k's, ESOP's, stock options, tax deferred annuities, Keogh's, SEP's, defined benefit plans, Simple IRA's, etc. Many of these plans are considered 'qualified' by the IRS as the contributions are on a pre-tax basis and the earnings within the plan can grow tax deferred. Thus it is generally recommended to seek the advise of an accountant to discuss which type of program would offer the best situation to the company and the group members before implementing any one of these programs. These plans can be entirely funded by the employer or more often offer an employer an opportunity to match the contributions of the employee. The concept of matching affords the employer a vesting period. This creates a lock-in time frame whereby an employee wouldn't be entitled to the entire contributions of their employer until they satisfy a certain pre-established waiting period. This is often regarded as the golden handcuffs to the employer as they are able to hold the employee captive until the vesting period has expired.

At Group Coverage, Inc., members of our office and our affiliates are trained on tailoring these plans around the needs of the group. Our staff, along with our affiliates, typically examine a multitude of variables, aspects that enable us to conduct a comprehensive analysis of the employees’ needs.  We then make recommendations for the plans that offer a great value to the group as a whole. Our goal is to provide the company with a benefit planning package that is both affordable to the organization and offers the greatest impact to it's members.

William F. Schaake, CIC, CRM © 2007


Is Your Company Compliant with the Non-Discrimination Laws?

Reporting and Disclosure Guide for Employee Benefit Plans

Employee Benefits Compliance Section


Large Group Section

Large Group Health Insurance

Large Group Submission Guide

Shared Employer Responsibility & ACA Reporting

Large Group Health Insurance Plans Under Donald’s Trump’s Regime

NY Featured Health Carrier

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Group Benefit Plans should be designed to protect or enrich an organization’s most   important  asset class–-it's employees. In this competitive business environment, it is essential for an organization to carry at  least some type of employee benefit package to attract key personnel and talent.  In creating a program, it’s crucial to  choose an agency team that is capable of designing plans, service the account, and address question and concerns of the employees and management.

Group Coverage, Inc. Utilizes the many talents of various men & women and is considered by many in the insurance industry as the ‘Broker’s Broker’ assisting insurance professionals with the marketing and servicing of their own clients. Why do other insurance agents and brokers work with the staff of Group Coverage, Inc.?

Employee Benefit Plans

Health Care Reform Basics

Health Care Reform Section

Understand Your Fiduciary Responsibilities Managing A Group Health Plan Read About it >>

Shared Employer Responsibility & ACA Reporting

Search a Doctor & Provider

Affordable Care Act Videos

Featured Health and Medical Insurance Articles

Health insurance and how did it evolved

“As it is commonly known that the health insurance pays for the medical expenses. Now the question is what kind of medical expenses does a health insurance cover...”


The author, William Richards explains what is and what is not covered in his article published by www.takeartilces.com.

Health Care Reform: What Employers and Employees Need to Know

“The health care reform law -- officially called the Patient Protection and Affordable Care Act of 2010 -- was signed by the President in March 2010. As widely reported, the law makes substantial changes to the health insurance system in this country. Because many people currently receive their health insurance through their jobs, the law will have a significant impact on employers and employees alike. However, most changes don't take effect right away; this article explains some of the basic changes employees and employees can expect in the coming years...”  

The author, Lisa Guerin, J.D. explains what is important about Healthcare Reform published by in a recent article published by www.nolo.com.

Understanding Your Health Insurance Coverage

“You can avoid many health plan disputes by learning exactly how your insurance coverage works...”

The author, Kathleen Michon, Attorney explains the essentials of what is covered by health insurance and the various types of medical plans published by www.nolo.com.

What are my health insurance choices?

The Insurance Information Institute explains the differences between indemnity plans, managed care programs and health savings accounts.    

Source:  Insurance Information Institute

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