Employee Benefits

COBRA Continuation Deadlines During the Pandemic 150 150 Encore Benefits

COBRA Continuation Deadlines During the Pandemic

During the economic instability surrounding the COVID-19 pandemic, terminated or furloughed employees should understand some new federal regulations governing COBRA continuation. What Hasn’t Changed If you were enrolled in group medical, dental or vision benefits sponsored by a COBRA-subject employer (addressed later) and lost eligibility for that coverage (through termination, loss of hours, etc.), you…

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HIPAA For Employers 150 150 Encore Benefits

HIPAA For Employers

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) obligates employers, health care providers, insurance agents, insurance carriers and others to respect the confidentiality of the Private Health Information (PHI) of employees and their dependents. This is a quick overview of what employers should and should not do with PHI. You, the employer, must…

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What is an “Out-of-Pocket Max?” 150 150 Encore Benefits

What is an “Out-of-Pocket Max?”

It’s known by a few terms – “out-of-pocket max, “maximum out-of-pocket,” “maximum liability,” and a few others – and that’s only part of the confusion: What is it, and what does it mean for your insurance coverage? As explained in “What is a Deductible?,” your health insurance deductible is the amount which you are expected…

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What is a Deductible? 150 150 Encore Benefits

What is a Deductible?

In insurance, a deductible is the amount that you (the insured) are responsible for FIRST before the insurance company starts paying toward your covered care.  Deductibles for all ACA individual insurance and most (but not all) employer group insurance are tracked by calendar year, regardless of when your coverage started. For example, if your insurance…

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Temporary Employee Benefit Coverage 150 150 Encore Benefits

Temporary Employee Benefit Coverage

If you ever employ temporary or “seasonal” employees, or you wonder whether your employees are temporary, here are the basics you should know. Temporary Employee Benefit Coverage Under The Affordable Care Act According to the definitions contained in the Affordable Care Act (ACA): A “temporary” employee is one who is hired with the mutual expectation that…

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What is a Wrap Document? 150 150 Encore Benefits

What is a Wrap Document?

What Is A Wrap Document? A wrap document is where all of the information about an employer’s insurance benefits is kept. It incorporates, or “wraps” around additional documents that provide further details. If your employee benefits open enrollment took place recently, (more benefit plans renew on January 1 than at any other time), you either:…

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Fully Insured, Self-Insured, Level-Funded: What Does It All Mean to the Small Employer? 150 150 Encore Benefits

Fully Insured, Self-Insured, Level-Funded: What Does It All Mean to the Small Employer?

Small employers are examining more closely what it means to be “fully” insured. Today, employers with as few as five full-time employees can find other funding arrangements which allow them more control—and more accountability—over their insurance premiums. Fully Insured “Fully insured” is what most people mean by insurance. The employer pays a premium to the…

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Open Enrollment Deadlines Are NOT Just Guidelines 150 150 Encore Benefits

Open Enrollment Deadlines Are NOT Just Guidelines

Open Enrollment Due to increased federal oversight, health insurance carriers currently have a lot less “wiggle room” than in the past to enroll employees beyond their official new hire enrollment periods. Local and national carriers frequently find themselves audited by one of several federal and state agencies to ensure that the carriers are consistently applying…

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Can An Employer Pay For Individual Health Insurance Policies? 150 150 Encore Benefits

Can An Employer Pay For Individual Health Insurance Policies?

Group Sponsored vs Individual Plans Can an employer pay for individual health insurance policies? Since the affordable care act was passed, a lot of the distinctions in policies have changed. Both individual and small-group health insurance is now issued on a “guaranteed issue” basis. Insurance companies cannot decline to issue a policy based on past or…

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