Healthcare Reform

Group Life Insurance

Along with Health Insurance, Life Insurance is a key part of the benefit package for employees. Studies have shown that employees that feel financially secure are more productive, and experience higher job satisfaction. Life insurance a great tool for attracting top talent.

Life insurance provides for an employee’s final expenses, taxes, mortgage and even their children’s education as well as offering additional added benefits.  Stovik Insurance can help employers protect their employees and their employees’ families with a variety of different life insurance products.

Permanent Life Insurance
Life insurance that builds cash value and the savings can be tax deferred and/or borrowed against, if needed. These policies are known as Permanent Life Insurance.

Term Policy
Life insurance that does not build cash value, however, it will pay a set amount to the named beneficiary upon the death of insured within the stated term. Some policies may also make payments upon terminal or critical illness.

Protect Your Key Employees and Your Business

A Key Person Life Insurance policy is one that is taken out on the life or health of an employee whose knowledge and overall contribution is considered exclusively valuable and vital to their company. This type of protection helps to offset any expenses and/or losses which the employer is likely to experience due to the loss/death of a key person.

Just as the death of a key employee can impact the bottom line of a business, so can a disability.

Key Person Disability Insurance can provide a lump sum payment, or a monthly check, after the waiting period or disability period has been met. Many businesses only purchase Key Person Life Insurance, but the odds of a disability occurring, depending on the age of the key employee, are less likely than death.

Buy-Sell Agreements: Protecting a business after death of a key employee can also be accomplished with Buy-Sell Agreements (also known as Continuation Agreements) which are tied to and funded by life insurance policies. The agreement sets out the details of the transfer of business interest by the executive (or his/her estate) upon a certain triggering event–usually, disability, retirement or death. The surviving or continuing business owner or partner can rest assured knowing they will be able to purchase the key associate’s share without interference from the survivors of the associate and his/her estate.

Additional Enhanced Ancillary Benefits: Typical group long-term disability insurance and supplement life insurance benefit packages usually only cover a fraction of an executive’s high income. Providing a customized supplemental life insurance and/or carve out disability to key employees is an important part of the Executive Benefit Package which will help your organization to attract and retain key personnel.

Buy-Up or Purchase Additional Coverage

In addition to offering Life, Disability and Dental as part of the basic benefit offering, some employees may wish to “buy-up” their employer provided coverage, and/or they may also want to purchase an additional separate Life, Disability or Dental policy, either for themselves, or their dependents.

Retirement Plans

Many employers today offer 401(k) plans as a way to enhance the benefit package and gain a competitive edge in the market.  With the cost of living rising, and with the emergence of COVID, many employees have depleted their savings and need a way to rebuild a nest egg for the future.  Contributions, that can be matched by the employer, are made through easy payroll deductions and with pre-taxed dollars, and employers can even save for their own retirement.

We provide full-service plan design and administration for both qualified and non-qualified retirement programs, including all types of defined contribution and defined benefit plans. As with all of our services and products, our main objective is to design and administer the retirement plan that best meets the needs of our clients. But we don’t stop there. We will continue to monitor your plan ensuring it meets with all compliance regulations, making recommendations for changes as needed and we’ll also provide plan education for your employees when needed.

Our retirement plan experience includes:

• -401(k) or 403 (b) design and administration
• -Pension/profit sharing design and administration

Wellness Benefits

Most insurers include wellness benefits in their comprehensive coverage, designed to improve lives and keep members healthy. Your group health plan will generally include services like preventative medical screenings, free or discounted gym memberships, diet advice, disease management, telehealth, and much more.

For those employers serious about taking wellness to a higher level, we work with vendors that will help you get employees in control of their own well-being. These programs provide your employees with tools and services designed to encourage employees to use preventive care to create healthy living habits and to identify and address early potential medical issues.

Gap Plans

Gap insurance provides benefits that supplement a low premium, high deductible major medical health plan. It works by paying a significant amount of the deductible.  More specifically, the additional benefits help to cover out-of-pocket expenses related to coinsurance, co-pays and deductibles for inpatient and outpatient services. For example, if you have a $5,000 deductible on your major medical plan, gap coverage could pay up to $4,000 of that deductible.  You may find you save more money with a low premium high deductible health plan, along with the additional premium for gap insurance, when compared to one low deductible, high premium plan.

Long Term Care

Long-Term Care plans are a popular voluntary benefit offered by employers today. The prospect of long-term care is one of the most important issues your employees may have to face. The cost of long-term care is expensive and generally not covered by other employee benefits. If someone requires long-term care, it is not just an emotional strain but a financial one as well, impacting retirement savings and overall financial position.

Long-Term Care Insurance generally covers care not covered by health insurance coverage and includes:  home care, assisted living, adult daycare, respite care, hospice care, nursing home and Alzheimer’s facilities. It covers the cost of a visiting or live-in caregiver, therapist or private duty nurse up to seven days a week, 24 hours a day (up to the policy benefit maximum).

Wise employers know that access to additional resources can increase employee productivity when confronted with managing long-term care situations. Long-Term Care plans demonstrate to your current and prospective employees that your company cares about them — increasing the ability to attract and retain the very best talent.

Protect your employees by offering an enhanced benefit package through providing a employer paid or voluntary Group Long-Term Care plan that offers important coverage not found in health, disability, Medicare or Medicaid insurance.

Accident Plans

Accidents can happen anytime and bring unexpected costs not fully covered by medical insurance.  Accident Insurance is very affordable and complements your major medical policy, in the case of an accidental injury.

Accident insurance helps to protect you, your family, or your employees, from suffering through financial hardship due to a great deal of medical and out-of-pocket expenses that follow accidental injuries. Emergency treatment, hospital stays, medical exams, transportation and lodging needs are just a few of the expenses that accident insurance can help cover. Some policies can even pay benefits in as little as one day, based on time of claim submission.

Cost Saving Strategies

The following innovative benefit arrangements allow for employers and employees to pay for premiums, healthcare services, and other qualifying expenses, with pre-taxed dollars, saving both the employer and the employee money.

Health Savings Account (HSA)
Many group health plans benefit by having a Health Savings Account (HSA) feature that combines a high deductible/lower premium health insurance plan (PPO) with a savings account. Both employer and employee can contribute, tax-free to the savings account, which can help fund the deductible and other qualified medical expenses. Then, the insurance will begin paying claims, once the deductible is satisfied.

Health Reimbursement Account (HRA)
A Health Reimbursement Account (HRA) combines high deductible/low premium health insurance with a tax favored savings account. Employers contribute to the savings account, which can be used for to fund co-pays and other qualified expenses prior to the deductible being met.

Flexible Spending Account (FSA)
A Flexible Spending Account (FSA) is a cafeteria plan under Section 125 of the tax code and allows for benefits to be paid with pre-tax dollars which results in tax savings to both the employee and the employer.

The average working employee in America spends thousands of dollars annually on certain types of medical benefits, daycare expenses and transportation services. By participating in an FSA, an employee’s taxable income is reduced, which increases the percentage of pay they take home and allows them to pay for these benefits and services with the pre-taxed dollars, in essence giving them a discount on these services.

Here’s how they work
This tax-favored savings account is funded solely by the employee through regular pre-tax payroll deductions. Employees elect how much they want withdrawn from each pay period, which can be changed annually or upon a qualifying event such as marriage or divorce. Throughout the plan year, funds can be withdrawn from the account (tax-free) to pay for eligible medical, dental, vision, prescription and dependent daycare expenses. Some FSAs include work-related parking and transit costs. The administrator of the FSA account can issue a debit card that is tied to the FSA making it easy to use the account when needed.

Group Dental & Vision

Employees consider Dental (and Vision) Insurance part of the core essential benefit package.  Studies have shown that regular dental and vision exams help employees to stay healthier and more productive in the work place. Additionally, you can detect serious underlying conditions such as heart disease, diabetes, high blood pressure and other conditions through regular dental and vision exams. In fact, the National Association of Dental Plans and the Centers for Disease Control have performed studies that show that employees with dental and vision insurance have better attitudes and are less likely to suffer from depression, a common condition in today’s fast-paced world.

We offer Preferred Provider Organization (PPO) designs, Pre-paid and Health Maintenance Organization (HMO) designs as well, with a wide range of deductibles, coinsurance, and maximums options.  These plans offer offer a variety of diagnostic, preventative care and corrective services.  We work with multiple national carriers with the largest dental and vision provider networks in the country for your employees’ benefit.

• -Dental coverage includes (but not limited to) cleanings, exams, x-rays, fillings, root canals, orthodontia for children, and emergency care while traveling.
• -Vision coverage includes (but not limited to) exams, eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK.

Group Disability Plans

When an employee is unable to work due to illness or an accident, the financial impact can be devastating for them.  When this happens, Disability Insurance replaces a portion of your employee’s income, while they are unable to work.  While worst case scenario might seem remote, employees are often surprised to learn statistics show chances of becoming disabled are greater than dying between the ages of 25 & 45.  In fact, more than one in four 20-year-olds will experience a disability for longer than 90 days before the age of 67.

With these statistics, it is no wonder that national surveys continue to show that Disability Insurance remains of high importance for most employees as an affordable strategy to widen their financial safety net. Those who wish to purchase a wrap-around policy to augment their employer provided coverage may do so.  Bottom line, savvy employers attract and retain top talent by offering Short Term and Long Term Disability as part of the employer paid benefit package or as a voluntary (worksite) benefit.

Short Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), STD generally allows for income payments to the employee to begin after about a two-week waiting period and will continue to pay the employee until he/she recovers or maxes out the benefits–usually anywhere between one month to two years, depending on the policy.

Long Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), LTD generally allows for income payments to the employee to begin after about a 90-day waiting period. However, it could be much longer depending on the policy. The policy will pay the employee far longer than STD–for a few years, up to age 65, or even for life.

Types of Group Health Plans

Health Maintenance Organization (HMO)
A Health Maintenance Organization (HMO) is a group health plan that requires group members to obtain their health care services from doctors and hospitals affiliated with the HMO. Members will designate a primary care physician who treats and directs health care decisions for the member. Additionally, the primary care physician will coordinate any referrals to specialties within the HMO network. HMOs offer access to a comprehensive package of covered health care services in return for a prepaid monthly amount (or “premium”). Most HMOs charge a small co-payment depending upon the type of service provided.

Preferred Provider Organization (PPO)
Another option for group health plans are a Preferred Provider Organization (PPO). With this plan, members save the most money on healthcare if they use providers within the PPO. Members will risk being covered for services if providers outside of the network are used. Deductibles must be met on this plan before some services will be covered. PPOs require a co-pay for physician visits.

Point-of-Service (POS)
A Point-of-Service plan (POS) is a group health plans that is a managed care plan with a twist, in that it combines some elements of both an HMO and a PPO plan. Like an HMO, participants designate a primary caregiver within the network. However, with a POS plan, participants may also use providers outside of network for health care services, but will pay a majority of the cost, unless the primary care provider has referred the out-of-network provider. In such a case, the POS plan will pay for the services.

A new kind of self funding for small employers

Partially-Funded Plans (aka Level-Funded) are a variation of a Self-Funding and allows small employers to take advantage of all the cost saving and benefit design features of a fully self-insured plan, however, they share the risk with one of our top national carriers. The premiums for shared funding plans are generally much lower than fully insured plans. An employer may save even more by implementing wellness programs into the benefit strategy.

What is the difference between a Fully-Funded Health Plan and a Self-Funded Health Plan?

A fully-funded health plan is one where the insurance carrier assumes all the risk in exchange for a monthly premium.  They will pay all claims on the plan, and service the plan’s administration.  A self-funded plan requires the employer to assume all the risk, paying all claims on the plan, and will often partner with a PPO to provide healthcare services for the plan.  They will also hire a third-party vendor TPA to service the plan’s administration.  In other words, the employer becomes the insurer.

The main advantage of a fully-funded plan is the employer knows exactly what the plan is going to cost them.  With a self-funded plan, employers benefit from a significant savings in the overall cost of their benefit programs.  Additionally, employers have more control over the benefits that the plan offers.

The downside of a fully-funded health plan is when benefits go unused, the employer does not get any money back.  The downside of a self-funded health plan is the employer runs the risk of a large catastrophic claim and must purchase stop-loss insurance to protect themselves in such an event. Even with the additional expense of stop-loss insurance, employers save a significant amount of money on premiums and other advantages.

Permanent Life Insurance

This type of life insurance policy has multiple purposes, however, can be a good fit for anyone who has loved ones who depend on them.  Young people who want to invest in their future, or someone nearing retirement may also consider permanent life insurance.   Permanent life insurance provides a death benefit to help your family maintain their lifestyle after your death and pays your final expenses and debts.  However, it also helps you build wealth and save for the future by building a cash value.  Several other advantages of permanent life include borrowing against the policy or building a tax deferred investment income.

Types of Permanent Life Insurance
Whole Life, Variable Life and Universal Life are all types of cash value life insurance. Cash value insurance is also known as permanent life insurance because it provides coverage for the policyholder’s entire life.

Term Life Insurance

Term Life is a simple, budget friendly life insurance solution for young people, families on a budget, and for people who may want to convert their term policy to a more permanent solution later down the road. You may also want to supplement a permanent life insurance policy. Generally, it provides the largest immediate amount of protection for the lowest cost and pays a death benefit upon your death.

How it works
Term Life covers you for a set period of time, provided you pay the monthly premium, or in some instances, a lump sum in advance. The policy will pay to the named beneficiary the face amount of the policy (set benefit and/or lump sum) upon death of the insured within the stated term. Depending on the policy, it may also make payments upon terminal or critical illness.

Critical Illness Plans

Surviving cancer and other critical illness is becoming increasingly common with the advances in modern medical technology.  Critical Illness Insurance can help you, your family or your employees reduce the personal financial impact of the cost of fighting these illnesses or keeping up with everyday bills through that process.  If you have a health insurance plan and/or disability insurance, Critical Illness Insurance will provide benefits in addition to your other coverage.

Some key features:

• -Lump-sum cash benefit paid directly to you.
• -You decide how best to spend your payment.
• -No network restrictions.
• -Benefit level choices to fit your needs and budget.
• -Simple plan options for your needs and budget.

The benefits and riders offered are supplemental and are not intended to cover all medical expenses.  Certain terms, exclusions and limitations may apply.

Travel Medical Insurance

Medical travel insurance is typically very affordable and provides valuable medical coverage when traveling in the US or abroad, much like a regular health insurance policy. Most often these types of policies will cover care and services that are not typically covered by your regular health policy or Medicare.

Short Term Health Plans

Short Term Medical Plans can be purchased any time of the year and help to bridge gaps in coverage.  Length of coverage may vary by state and be up to 1 year with an option to renew for longer terms.  Short-term health coverage is less expensive than traditional health insurance because it does not provide full coverage, nor does it cover pre-existing conditions. Additionally, short-term health insurance plans do not contain the essential benefits required by the Affordable Care Act (ACA).

Hospital Plans

Unlike a traditional major medical plan that reimburses you or pays directly to a provider for approved hospital stays and medical care, a Hospital Indemnity Plan is a limited benefit plans that pays a lump-sum payment directly to the insured.

When paid directly to the insured, cash payments help you, your family or your employees with out-of-pocket expenses and covers you when you are off work due to a hospital stay. There are no plan maximums, however the coverage is usually a set amount per day, per week, per month, or per visit depending on the benefit level selected.

Long Term Care Plans

A Long Term Care Plan augments your regular health insurance and pays for services associated with performing tasks required for daily living such as dressing, bathing, eating, getting in/out of bed, toileting, walking or other basic activities. These services fall under skilled care or personal care and are the types of services that Medicare or Disability generally does not cover.

As stated, long-term care is usually not medical care and most often does not require a doctor or a nurse. In addition, the need for LTC is not always age related. In fact, statistics tell us that more than half of all individuals age 65 & over will need LTC at some point. Even so, it is important to note that roughly 40% of those receiving LTC today are between the ages of 18 and 64.

Why LTC Insurance?

Regular health insurance, Medicare or Medicaid typically will not pay for Long-Term Care services. The cost of LTC can quickly add up and burden those closest to you, both financially and emotionally. Purchasing a LTC plan can help you avoid those difficult situations, as well as give you the power you need to maintain control of your care, choosing the facilities that best suit your needs. Thus, instead of allowing welfare or the government to make your LTC decisions for you, you are in charge. Additionally, you should be aware that Disability Income Insurance is not designed to cover LTC expenses, but simply replaces part or all of your income during your working years should you become disabled. You need specific coverage to pay for long-term care needs.

Here are examples of what LTC policies may cover:

Institutional Care: Nursing home, assisted living services, residential care facility, hospice care, adult foster home, respite care and more.
Home Care: Home health care, adult day care, personal care, homemaker services, hospice care, respite care and more.

Disability Plans

Disability Insurance protects your ability to earn a living during your working years. In other words, it protects one of your most valuable assets. And, this is pretty important considering that statistics show our chances are greater of becoming disabled than dying between the ages of 25 & 45. During the time you are unable to work due to a qualifying disability (illness or injury), the replacement of your regular income through a monthly benefit provided by disability insurance helps to maintain your pre-disability lifestyle.

Employers often provide standard short-term disability (STD) and long-term disability (LTD) insurance to meet federal guidelines. Individual disability income insurance can be customized to meet your needs and considers your occupation, age, income and other factors in determining your cost and monthly benefit payment amount.

Types of Disability Coverage

A standard Short Term Disability (STD) policy allows for income payments to begin after a two-week waiting period. Payments will continue to the insured until he/she recovers or maxes out the benefits. Thus, total benefits for a STD could last for anywhere from one month to two years, depending on the policy.

A Long Term Disability (LTD) policy allows for income payments to begin after a ninety-day waiting period, although it could be much longer depending on the policy. Once payments begin, they will continue far longer than STD. Thus, the total benefits for a LTD could last for a few years, up to age 65, or even for life.

Dental and Vision Plans

Individual and family dental & vision plans or policies are relatively inexpensive and can be purchased any time of the year.  Studies have shown that having access to dental and vision care promotes overall well-being.  Regular dental and vision exams optimize eye and oral health, and can also detect serious underlying medical conditions. Some studies have even shown that people who have dental and vision insurance suffer less from depression, than those who do not have coverage.

Save 10% to 60% on dental care services with no caps and no waiting periods. Plus take advantage of additional savings available on Telemedicine, Vision, Rx and more!  Plans can range from a PPO or HMO to Pre-Paid, Fee-for-Service, and Discount on a variety of diagnostic and preventative care services including:

What if you miss the annual open enrollment deadline or your circumstances have changed?

You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:

• -change in legal marital status
• -a change in the number of dependents
• -a change in place of residence and the current carrier is not available
• -significant cost or coverage change
• -a change in coverage of a spouse or dependant
• -a COBRA qualifying event
• -legal judgements, decrees and orders
• -entitlement to Medicare or Medicaid

Medicare Special Enrollment

Once enrolled in Medicare, if you wish to change or purchase Medicare plans you must act during the open enrollment period.

When open enrollment is closed, there are special circumstances in which one may qualify to enroll outside of the enrollment period. Listed below are the qualifying events:

-You are turning 65
-You move to a new area that is not in your current plan’s service area
-Recently moved back to the US
-You lose your current coverage (either Group or Medicaid)
-You now need a SNP (Special Needs Plan) or you no longer need a SNP