At the Employee Benefits Advisors Group, we understand that navigating the maze of health insurance options and requirements is stressful and time-consuming. We help employers, employees, individuals and families figure out which medical and dental benefits and plans best fit their needs and their budgets.
Employer Sponsored Health Insurance
Employer sponsored health insurance, or a group plan, is selected and purchased by an employer and offered to eligible employees and their dependents to assist with health care costs. Employers usually pay a portion of the premium and employees are responsible for the balance.
Under the Patient Protection and Affordable Care Act (Obamacare), most employers with 50 or more employees must offer health care plans and individuals are required to have coverage. Employers are required to provide health care to employees who work at least 30 hours a week, and some part-time workers are covered by employer plans.
Most group plans provide coverage for visits to primary care physicians and specialists, hospitalization, and emergency care. Alternative medical care, prescriptions, vision, and pediatric dental care coverage, as well as deductibles and co-pays for specific services, will vary by the plan and employer.
Individual Health Insurance
Individual or personal health insurance plans can be purchased for individuals and/or their families. You can choose the insurance company, the plan and the options that meet your needs, as well as renew or switch plans during annual Open Enrollment periods.
Health care exchanges have been set up for workers who are not covered by their employers or who choose to find coverage outside of employer plans. You may be eligible for a subsidy from the federal government to purchase an Affordable Care Act (State Exchange) compliant individual plan. However, if your employer is offering a health plan, you will not be eligible for subsidy.
Deciding whether to enroll in a health insurance plan through your employer or whether to purchase an individual medical plan can be difficult. The Employee Benefits Advisors Group will help you cut through the confusion by explaining the differences in benefit options, flexibility and costs.
Most dental care insurance plans focus on prevention and diagnostics. Coverage typically includes basic procedures such as annual exams, routine cleanings and X-rays. Similar to health insurance, dental care plans can vary from provider to provider, with some covering major services such as oral surgeries.
A dental insurance plan can be purchased individually or through an employer’s insurance coverage plan. Some companies pay for all or a portion of their employees' dental coverage as part of their employee benefits package.
Whether you are an employer or an individual, the Employee Benefits Advisors Group will work with you to find a reputable insurer and choose affordable dental benefits that provide the optimal level of coverage.