Plan analysis design.
Plan Design
Intelligent plan analysis design, implementation, and a timely renewal strategy are all part of our core capabilities. Additionally, we are commited to becoming strategic partners with our clients. In partnering with you, we take the time to get to know you. We believe this important step creates continuity and accountability. And, it helps us to fully understand your needs.
As your HR partner, we will perform a rigorous behind the scenes process. This process is designed to help us customize solutions that save you the most time and money. And, we can achieve these results while significantly enhancing your benefit offering.
- We perform a sophisticated analytical review of your current benefit offering. Thus, this includes reviewing voluntary benefits, life and disability programs, executive benefits and more. Accordingly, we identify risk and looks for ways to enhance the benefit offering while minimizing cost.
- We’ll perform a complete market analysis and conduct carrier negotiations on your behalf. And, we work with more than 30 of the industry’s finest carriers to bring you a wide range of plans featuring options and pricing packages.
- We also perform physician and network analysis. And, we will leverage our strong relationship with our vendors to get the best price on services.
We perform intelligent plan analysis design. However, that is only half of our job.
We continue the process with dedicated and thorough customer service. Thus, our dedicated team will help you streamline the administration of your health and welfare benefits.
Click below to learn more about the various group benefits we offer and how they typically work. We are happy to consult with you and plan analysis design to develop your perfect benefit package.
Request a Group Quote
Traditional Group Health
If you would like a quote, please close this window. Then refer to the Group Quote Form located at the bottom of this page.
We perform plan analysis design and traditional health plans through most major carriers. And, depending on your needs, we have plans that offer the Minimum Essential Coverage (MEC) as required by the Affordable Care Act (ACA). Additionally, we offer full customized packages that offer a rich variety of benefits. Whatever your needs may be, we will work with you to find the right fit for your unique needs.
A Health Maintenance Organization (HMO)
An HMO requires group members to obtain their health care services from doctors and hospitals affiliated with the HMO. Thus, members are required to designate a primary care physician within the HMO. Then, the primary care physician treats and directs health care decisions. In addition, the primary care physician coordinates 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”). Accordingly, most HMOs charge a small co-payment depending upon the type of service provided.
Preferred Provider Organization (PPO)
You you belong to a PPO, you will save the most money on healthcare if they use providers within their network. Thus, if providers outside of the network are used, it is possible that those services may not be covered at all. Deductibles must be met on this plan before some services will be covered. PPOs require a co-pay for physician visits.
Health Savings Account (HSA)
An HSA 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. Then, the account is used to help fund the deductible and other qualified medical expenses. Once the deductible is met, the insurance starts paying.
Health Reimbursement Account (HRA)
An HRA combines high deductible,low premium health insurance plan with a tax favored savings account. Employers contribute to the savings account. Then, the account can be used to fund co-pays and other qualified expenses, prior to the deductible being met.
Single, Dual or Triple Option Plans offer eligible employees a choice between several different types of plans as described above.
Through our plan analysis design, we can help you determine which traditional health plan is right for your company.
Self-funded Health Plans
If you would like a quote, please close this window and refer to the Group Quote Form located at the bottom of this page.
Plan analysis design will help you determine if self-funding is an option for your company.
When employers self-fund their own health plan, they will benefit from a significant savings in the overall cost of their benefit programs. Examples of savings may be in premiums, increased cash flow, tax advantages in addition to having more control over the benefits that the plan offers. In the past, self-funding was not available to small employers. However, today self-insured plans are considered to be good options for both small and large employers.
JS Benefits Group specializes in helping employers set up and maintain self-funded health plans. Accordingly, we would be happy to give you a no cost analysis to determine if a self-funded health plan option is right for your company.
How self funding works.
A self-funded health plan requires the employer to become the insurer. Most often, employers will partner with a PPO to provide services for the plan. Then, a third party administrator (a TPA) is engaged to handle claims and processing. Self-insured employers run the risk of large catastrophic claims. As a result, they will purchase stop-loss insurance to protect them in such an event. Even with the additional expense of stop-loss insurance, employers can enjoy saving thousands in premiums and other advantages. Our plan analysis design will determine self-funding is right for your company.
Federal (SHOP)
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We can help you obtain the small business tax credit available to eligible employers through the Federal Marketplace. This program is known as SHOP (Small Business Health Options Program). Eligible employers may have thier premiums reduced by as much as 50%. To be eligible, you must cover at least 50 percent of the cost of employee-only (not family or dependent) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation beginning in 2014) per year.
We suggest you use our Business Tax Calculator to find out if you qualify. Thus, those who qualify will be able to purchase traditional group health plans as described above through SHOP. Also, through our plan analysis design, we can help you determine if obtaining your benefits through SHOP is right for your company.
FSAS (Section 125 Plans)
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A Flexible Spending Account (FSA) is a cafeteria plan under Section 125 of the tax code. Thus it 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. In turn, this increases the percentage of pay they take home and allows them to pay for these benefits and services with the pre-taxed dollars. Accordingly, this is similar to receiving a discount on covered services.
How does an FSA work?
This tax-favored savings account set up and funded solely by the employee through regular pre-tax payroll deductions. Employees elect how much they want withdrawn from each pay period. Elections can be changed annually or upon a qualifying event such as marriage or divorce. Then, 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, thus making it easy to use the account when needed.
Premium Only Plans (POPs)
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Our plan analysis design will help you determine if implementating premium only plans (POPs) is right for your company and it’s employees.
A Premium-Only Plan allows employees to purchase their own individual insurance with pre-tax dollars. Thus, employees can potentially save thousands annually in taxes and premiums combined.
How does a POP work?
Employees elect a set amount of pre-tax dollars to be deducted from each payroll. The employee purchases an individual health insurance policy from a carrier of their choice. Accordingly, the employee is responsible responsible for paying the monthly premiums directly to the carrier. The employee is then reimbursed by the employer for the monthly premium with the pre-taxed dollars.
Our plan analysis design can help determine if POP plans are right for you and your employees.
Shared Funding Plans
If you would like a quote, or free plan analysis design please close this window. Then refer to the Group Quote Form located at the bottom of this page.
Our plan analysis design will help you determine if shared funding is a good option for your company.
Shared Funding Plans allow small employers to take advantages of all the cost saving and benefit design features of a self-insured plan. These plans are typically designed for larger groups. However, any small or large group could benefit greatly by the cost saving opportunities of a shared funding plan.
Here’s how it works.
An employer will select any of the fully insured plans that the carrier offers. And, rates will be determined by the group’s claim history. Then, stop-loss insurance is added to protect against catastrophic claims. Just like with an insured plan, the carrier will handle the administration of the plan. This includes processing claims, in addition to offering members online access to their benefits.
What are the advantages of Shared Funding?
The premiums for shared funding plans are generally much lower than fully insured plans. That is because the employer shares some of the risk. Additionally, an employer may save even more by implementing wellness programs into the benefit programs. Our plan analysis will design will help you determine shared-funding is right for your company.
Mini-Med Plan with Self Reimbursement
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Mini-Med plans with self-insured reimbursement is a group health plan option that offers very low premiums for employees. They are much like a self-insured (employer funded) plan. However, unlike a self-insured plan, claims are paid on an expense reimbursement basis.
Who is a Mini-Med plan good for?
Mini-Med plans are typically offered to employees who do not qualify for, or cannot afford regular, major-medical coverage. While benefits are similar to regular health insurance and are available anytime during the plan year, they are typically capped very low. They may have deductibles and copayments but cover many of the basic services a majority of people need such as physician visits, emergency room visits and prescriptions.
Through our plan analysis design, we can help you determine if mini-meds are right for your company.
Gap Insurance
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Our plan analysis design will help determine if purchasing a gap policy will save your company money.
Many employers find that gap coverage, combined with a low cost, high deductible major medical plan, is together much less expensive than one stand alone, lower deductible, major medical policy. Thus, gap insurance provides benefits that supplement a major medical and comprehensive benefit package.
How does Gap coverage work?
Gap coverage will pay a significant amount of the deductible on a major medical plan. 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.
Through our plan analysis design, we can help you determine if obtaining a GAP policy would save you money on your benefit programs.
Our plan analysis design will help determine if purchasing a gap policy will save your company money.
Many employers find that gap coverage, combined with a low cost, high deductible major medical plan, is together much less expensive than one stand alone, lower deductible, major medical policy. Thus, gap insurance provides benefits that supplement a major medical and comprehensive benefit package.
How does Gap coverage work?
Gap coverage will pay a significant amount of the deductible on a major medical plan. 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.
Through our plan analysis design, we can help you determine if obtaining a GAP policy would save you money on your benefit programs.
Group Dental and Vision Plans
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We offer individual, group or voluntary Dental and Vision Plans through many of our major insurance carriers. And, whether as voluntary or paid benefit, employees appreciate both dental & vision coverage as part of their Employee Benefits Package. Accordingly, you will find detailed information on the benefits of Dental and Vision plans.
Dental Plans
Studies have shown that regular dental exams help employees to stay healthier and more productive in the work place. Additionally, you can detect serious underlying conditions such as heart disease and diabetes, through regular dental exams. In fact, the National Association of Dental Plans and the Centers for Disease Control have performed studies that show that employees with dental insurance have better attitudes and are less likely to suffer from depression, a common condition in today’s fast-paced world.
Dental insurance offers a variety of diagnostic, preventative care and corrective services. This includes cleanings, exams, x-rays, fillings, root canals, orthodontia for children, and emergency care while traveling.
Vision Plans
Similar to dental policies, vision plans are inexpensive and save employees money on routine eye care. Examples of care include exams, eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK. Also, monitoring your eye health with regular exams helps to prevent serious eye diseases like glaucoma and cataracts. In addition, regular eye exams help to detect early stages of diabetes, high blood pressure, and high cholesterol.
Group Disability
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National surveys have shown that Short Term Disability and Long Term Disability remain of high importance for most employees. Thus, savvy employers attract and retain top talent by offering both STD and LTD insurance as part of the employer paid benefit package. However, even as a voluntary (worksite) benefit, employees appreciate the opportunity to expand their benefits. Here’s how disability plans typically work.
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 a two-week waiting period. The insurer will continue to pay the employee until he/she recovers or maxes out the benefits. Benefits can last up to two years, depending on the policy.
Long Term Disability
If 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. It could longer. Payments will continue to the employee far longer than STD. Benefits can last for a few years, up to age 65, or even for life.
Group Long Term Care
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Group Long-Term Care plans are becoming an increasingly common benefit offered by employers on a voluntary basis. That’s because the prospect of long-term care is one of the most important issues your employees may ever have to face. And, long-term care can be very expensive. However, it is not covered, in most cases, by other employee benefits, disability or even Medicare. Thus, if someone requires long-term care, it is not just an emotional strain but a financial one as well, as it greatly impacts a person’s overall financial position.
Savvy employers know that access to additional resources can increase employee productivity when confronted with managing long-term care situations. And, Long-Term Care plans demonstrate to your current and prospective employees that your company cares about them. Thus savvy employers also know offering LTC plans, even as a voluntary benefit, increases their ability to attract and retain the very best talent.
Many LTC plans pay for care provided through nursing homes and assisted living centers, although, they also cover home health care and adult day care. And, employers can provide a base benefit while giving the employees the opportunity to “buy up” and obtain the level of coverage that they need for their families.
Group Life Insurance
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Why offer life insurance to your employees? Because your employees will be more productive feeling secure that their loved ones will be taken care of, in the event of illness or an untimely death. Thus, you should consider life insurance a key part of the benefit package for your employees. And, also a valuable tool in attracting top talent.
Whether employer paid or voluntary, a good life insurance policy provides for an employee’s final expenses, taxes, and mortgage. Additionally, it may even pay for their children’s education.
Accordingly, JS Benefits Group can help employers protect their employees and their employees’ families with a variety of different life insurance products.
Permanent Life Insurance
This type of life insurance builds cash value which can be tax deferred and can be borrowed against, if needed. However, most employers only offer basic term life insurance (see below), but also offer permenant life insurance on a voluntary basis. Even so, employees appreciate the opportunity to widen their safety net.
Term Policy
This type of life insurance 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. Additionally, some policies may also make payments upon terminal or critical illness.
Voluntary or Worksite Benefits
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Worksite benefits (aka voluntary or ancillary benefits) are additional insurance products, plans or programs which an employee can purchase through their employer to expand their benefits or fill in gaps in their benefits. However, even though employees pay their own premiums for worksite benefits, they enjoy a discounted group rate and pay for them through pretaxed payroll deductions, making them very affordable. Accordingly, more and more employers are using worksite benefits as a tool to promote wellness and boost employee retention.
These are examples of ancillary or voluntary benefits we offer.
-Life Insurance
-Disability Insurance
-Dental and Vision Plans
-Long Term Care
-Cancer
-Heart/Stroke
-Critical Illness