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Medical Plans
Do your employees want an HMO or PPO? Do you want the plans to be self-directed, partially funded by employees, fully or not at all? Do you want to offer dental and vision? Let CBC help you choose the right plan for your corporate needs.
- HMO Plans (Health Maintenance Organization) -- When we talk about HMOs, we are talking about medical plans that provide healthcare coverage that is coordinated through a primary care physician. HMOs are popular with some employers and employees. In this type of plan, primary care physicians are pre-selected and can be an independent practitioner or belong to a medical group or physician association, and coordinate any medical care for the HMO member and is responsible for referring the member to a healthcare specialist if needed. This type of health plan provides the lowest out-of-pocket expenses for its members compared to other types of medical plans. An HMO plan can be employer-sponsored (a group plan) or set up on an individual or family basis.
- PPO Plans (Preferred Provider Organization) -- This is a medical plan designed to give members incentives to use health care providers designated as "preferred providers," that provide services at discounted rates, but that also gives members substantial coverage for medical services received from any health care provider. A PPO plan primarily differs from an HMO plan in that a PPO does not require its members to select a Primary Care Physician and it allows its members to see any healthcare provider without a referral from a PCP. A PPO plan can be employer sponsored or set up on an individual or family basis.
- POS Plans (Point of Service) -- A POS is a medical plan that provides different levels of cost for medical services. These levels are usually a combination of HMO-type benefits coupled with those offered by a good PPO. At the point when a POS member needs medical care, the member chooses which level of service they wish to access. It could be the HMO level with low out-of-pocket expenses with medical care and referrals coordinated through a primary care physician. Or it could be the PPO level with the freedom to self-refer to any healthcare provider at an increased cost of the total medical bill. A POS Plan can be employer-sponsored or set up on an individual or family basis.
- Self-Funded / Partially Self-Funded Medical Plan (EPO, ISO, etc.) -- Utilizing company-subsidized funding for payment of medical claims up to specific amount per employee and also up to an total aggregate amount per company, this type of plan has cost "caps" built in. Amounts that exceed these "caps" can be insured by special reinsurance carriers. When this type of plan is designed correctly, the employer's potential liability is "capped" at some predetermined amount per year while providing potentially larger savings for the employer in years where claims are low. In addition to cost savings, these plans can provide more flexibility in design and are best suited for employers with more than 100 employees.
Let us help you choose the right dental plan for your employer and employee needs.
- Pre-Paid (DHMO-Dental Health Maintenance Organization) -- This type of plan lets members select a Primary Care Dentist (PCD) who manages the overall dental care of the member including the coordination of referrals to specialists as needed. This type of dental plan has no waiting periods before services can be accessed and there are no deductibles or annual maximums. The member simply pays a predetermined discounted co-payment for the dental procedure needed. This dental plan provides a high level of coverage with low out-of-pocket member costs. The Pre-paid plan can be employer sponsored (a group plan) or set up on an individual or family basis.
- Self-Funded / Partially Self-Funded Dental -- This type of comprehensive dental program utilizes company-subsidized funding for payment of dental claims. There is generally no need for reinsurance carriers unlike self-funded medical plans where you worry about "catastrophic claims." When the plan is designed correctly, the employer's potential liability is limited, and in years where claims are very low could provide large savings for that employer. Offering a lot of flexibility in design, this type of plan is best suited for an employer with more than 100 employees.
| 401K / Pension Plans |
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Qualified and non-qualified retirement plans present significant opportunities to corporate clients who want tax benefits, increased employee motivation and cost containment of employee benefit programs. Client-specific plans with a variety of options are provided through customized proposals. Our process has six important steps to ensure appropriate plan design.
- Discovery
- Evaluation
- Development
- Selection
- Conversion
- Ongoing Monitoring
It's a sure bet that some of your employees will retire from your company. What type of programs do you have to assist them in that transition? You have questions? We have the answers to give your employees and brighter financial future.
- Qualified Retirement Plans -- This plan meets certain specified tax rules contained in Section 401(a) of the Internal Revenue Code called "Plan Qualification Rules." If the rules are satisfied, the plan's assets are exempt from current taxation. These plans may be funded by employer contributions, employee salary deferrals or a combination of both.
- 401(k) Plans -- This is an extremely popular plan, because it offers a tax-deferred defined contribution plan that gives eligible employees the opportunity to defer a portion of their current compensation into the plan. Amounts that are contributed to the plan are excluded from the participant's gross income in the year they are deferred. This allows employees to save for their own retirement on a tax-favored basis. Many employers utilize 401(k) plans as an employee benefit/profit incentive program. Employers may also contribute to these plans either as a match or in the form of a profit-sharing contribution. Employer contributions to the plan may be determined on a year-by-year basis, depending on the profitability of the company.
NOTE: CBC Benefits is a member fof National Retirement Partners (NRP)
http://www.401kadvisorsusa.com/
- Profit Sharing Plans -- One of the most flexible and simplest of the defined contribution plans, profit sharing permits discretionary annual contributions that are generally allocated on the basis of compensation. The employer determines the amount to be contributed each year, depending on the company's profitability and cash flow. The corporate deduction for profit sharing contributions to the plan cannot exceed 25% of total compensation paid to employees participating in the plan excluding employee deferrals.
- Non-qualified Retirement Plans -- Originally developed for Fortune 500 companies as a retirement program for their top executives, "Non-Qualified" plans do not have the filing or non-discrimination testing requirements of a traditional "qualified" retirement plan. Because these plans are "Non-Qualified," the plan sponsor can pick and choose which employees are to be covered under the plan. Over the years plan designs originally developed for large corporations have been adapted for use with small to middle market employers.
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We work with a wide range of carriers, but with these plans, the employer sponsors them. The employee chooses from a panel or network of individually practicing optometrists and/or ophthalmologists and obtains a comprehensive eye exam at a predetermined office visit co-payment. The member can also obtain lenses and frames for either a predetermined materials co-payment or much discounted wholesale cost. There is generally also a benefit of a specified dollar allowance for the purchase of contact lenses. These stand-alone plans are beneficial if you have a large number of employees (and their families who might need vision services). All eligible employees must be covered by the plan.
| Voluntary Benefits Plans |
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You can also offer a range of voluntary benefits that are employee-paid, but should you? We help you make the right decisions.
- Employee-Paid Dental and/or Vision Plans -- Choose from pre-paid (HMO) or PPO dental plans that are paid for with elective contributions (employee payroll deducted contributions.) Though no employer funding is required for these plans, an employer can set up a Section 125 Plan so employees can pay the premiums with pre-tax dollars (See Section 125 Plans). These plans give the employee a choice to either participate in the voluntary dental plan and pay the premiums or elect to waive out.
- Employee-Paid Short-Term / Long-Term Disability Plans -- There are either short-term disability plans (STD) or long-term disability plans (LTD) paid for with elective contributions (employee payroll deducted contributions.) In some cases, guaranteed amounts of disability benefits can be negotiated for the employees. Though no employer funding is required for these plans, an employer can set up a Section 125 Plan so that the employees can pay the premiums for this plan with pre-tax dollars (See Section 125 Plans.) An employee needs to be aware that an STD and/or LTD plan premium that is paid with pre-tax dollars will cause the benefits, if paid out in the case of a disability, to be taxed. These plans give the employee a choice to either participate in the voluntary STD and/or LTD plan and pay the premiums or elect to waive out.
- Employee-Paid Life Insurance Plans -- These are term life insurance plans that are paid for with elective contributions (employee payroll deducted contributions). There is no employer funding required, and they give the employee a choice of generally 5-, 10-, and 20-year terms of level premium. Some plans are portable, allows the employee to keep the policy and pay the premiums directly, give the employee a choice to participate in the voluntary term life plan and pay the premiums or elect to waive out.
- Universal Life Insurance Plans -- These plans are paid for with elective contributions (employee payroll deducted contributions). No employer funding is required, but an employee can pay for the premiums through payroll deduction. Certain guaranteed limits can be negotiated similar those in voluntary term life plans. Most plans are portable and allow the employee to keep the policy and pay the premiums directly. These plans give the employee a choice to either participate in the voluntary term life plan and pay the premiums or elect to waive out.
- Employee-Paid Cancer Protection Plans -- Designed to protect employees and their families from additional expenses associated with the diagnosis and treatment of cancer, these plans cover the treatment of cancer. Supplemental cancer plans provide additional funds for expenses incurred during the process of dealing with this disease, such as the spouse taking time off work, transportation and lodging at specialized cancer centers away from home, new experimental non-FDA-approved treatments. These plans are paid for with elective contributions (employee payroll deducted contributions). No employer funding is required for these plans, but an employer can set up a Section 125 Plan so the employees can pay the premiums for this plan with pre-tax dollars (See Section 125 Plans). Section 125 plans give the employee a choice to either participate in the voluntary cancer protection plan and pay the premiums or elect to waive out.
- Employee-Paid Accident Supplement Plans -- These plans protect employees and their families from the additional expenses associated with an accidental injury. Medical plans, though covering most of the expenses of the injury, still have office visit co-payments, prescription drug co-payments and, possibly, even hospital deductibles. These plans provide funds to cover additional expenses and other expenses associated with an accidental injury, such as time off work, which brings with it loss of income.
Call Corporate Benefit Coordinators today at 1-888-900-7440 for a free quote, or browse our website for more information about Our Strategic Partners or Our Team. If you have any other questions or comments, please contact us.
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