FAQs
Answers to common benefits questions. Articles
How does a deductible work?
A deductible is a fixed amount of money you must pay before your insurance kicks in. And an out-of-pocket (OOP) limit represents your "worst case" financial exposure in a given plan year.
What are my plan options?
A high-level explanation of plan types (PPO, HMO, POS, and EPO)
What's the difference between a High vs Low Deductible Plan?
Which health plan is best, and how much will it cost?
What is a Qualifying Life Event?
A change in your situation can make you eligible for a 30-day special enrollment period.
What's the difference between an HSA, FSA, & HRA?
Learn the difference between tax-advantaged accounts.
What are Qualified Medical Expenses?
View of list of qualified medical expenses.
How do I compare plans?
When you have multiple health plans to choose from, most decisions are driven by three questions.
Who can I add to my health plan?
Generally, coverage is offered to an employee's legal spouse and dependent children. The ACA extends coverage until a child turns 26.
Do I have to enroll in healthcare benefits?
As part of the Affordable Care Act, all Americans are required to have medical insurance. This is commonly called the "individual mandate".
What is Form 1095-C?
Learn about Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
What is FMLA leave?
The Family and Medical Leave Act (FMLA) is a Federal law, enacted to help employees balance work and family life.
What is an SBC?
A Summary of Benefits & Coverage (SBC) summarizes the key features of a health plan or coverage (such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions).
What is an EAP?
An Employee Assistance Program (EAP) is a voluntary, work-based program that offers free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.
What's Out-of-Network Liability and Balance Billing?
When you go out of network, you pay a larger part of the cost share for those services than you would for the same services provided by an in-network provider.
What is a Drug Formulary?
Each insurance carrier has a list of prescription medications that they cover called a drug formulary or Prescription Drug List (PDL).
How does U.S. healthcare work?
The United States primarily relies on employers to provide health insurance coverage to their employees and dependents. There is no universal healthcare (government programs are confined to older persons, people with disabilities, low-income mothers...
