EBCP Module 1 US Employment Benefits and Insurance

Benefit plans that provide coverage for doctor's office visits, x-ray, laboratory tests, emergency room services, inpatient hospitalization, physical therapy, inpatient and outpatient surgery, and related medical services that are not cosmetic in nature.

Medical benefit plans

Vision Benefit Plan

Dental Benefit Plan

Behavioral Health Benefit Plan

Benefit plans that provide coverage for dentist office visits, dental cleaning and x-rays, fillings, and other services related to dental care, dental diseases, and teeth-related accidents.

Medical benefit plans

Vision Benefit Plan

Dental Benefit Plan

Behavioral Health Benefit Plan

Benefit plans that provide coverage for eye exams, eyeglass frames and lenses, and, in some cases, contact lenses and Lasix surgery.

Medical benefit plans

Vision Benefit Plan

Dental Benefit Plan

Behavioral Health Benefit Plan

Primarily provides for a monetary (life insurance) benefit amount to the designated beneficiary of an employee, should the employee die while employed by the employer.

401K Benefit Plan

Accidental Death & Dismemberment Benefit Plan

Supplemental Life Benefit Plan

Group Term Life Insurance Benefit Plan

Provides monetary benefit To the designated beneficiary of an employee, should the employee die due to an accident while employed by the employer and/or to the employee in case of loss of fingers, hands, feet, legs, eyesight or hearing.

401K Benefit Plan

Accidental Death & Dismemberment Benefit Plan

Supplemental Life Benefit Plan

Group Term Life Insurance Benefit Plan

Benefit plan primarily is an optional additional life insurance benefit that the employee can purchase from the employer to supplement the Group Term Life insurance benefit automatically provided to the employee

401K Benefit Plan

Accidental Death & Dismemberment Benefit Plan

Supplemental Life Benefit Plan

Group Term Life Insurance Benefit Plan

Benefit plans replace a portion of lost salary (usually 40% - 60%) due to a non-work-related illness or injury. There is a short waiting period (usually 14 days) before the benefit kicks in.

Short Term Disability Benefit Plan

Long Term Disability Benefit Plan

Employee Assistance Program

Dependent Care Benefit Plan

Benefit plans kick in when an employee's disability continues after the short-term disability benefits end. It replaces a portion of lost salary (usually 50% - 60%) due to a non-work-related illness or injury.

Short Term Disability Benefit Plan

Long Term Disability Benefit Plan

Employee Assistance Program

Dependent Care Benefit Plan

Primarily provides counseling service for employees dealing with personal challenges or needs. This service can provide referrals to discounted legal services, mortgage lenders, debt consolidation services as well as psychiatrists, and family or couple therapists.

Short Term Disability Benefit Plan

Long Term Disability Benefit Plan

Employee Assistance Program

Dependent Care Benefit Plan

Primarily provides outpatient and inpatient services for employees dealing with behavioral or mental illnesses and disorders. This benefit also provides inpatient and outpatient rehabilitation for drug and alcohol dependencies.

Short Term Disability Benefit Plan

Long Term Disability Benefit Plan

Supplemental Life Benefit Plan

Behavioral Health Benefit Plan

Primarily provide a way for employees to set aside funds from their paycheck on a pre-tax basis to fund several different types of accounts.

Flexible Spending Accounts (FSA)

Healthcare Flexible Spending Accounts (HCFSA)

Dependent Care Flexible Spending Accounts (DCFSA)

Supplemental Life Benefit Plan

Benefit plans that allow employees to set aside funds from their paycheck before taxes are taken out up to a maximum amount specified by the employer (this cannot exceed the maximum allowed by the IRS). Funds in this account can be used to reimburse the employee for qualified medical expenses specified by the IRS that are not covered by the employee's medical insurance plan.

Flexible Spending Accounts (FSA)

Healthcare Flexible Spending Accounts (HCFSA)

Dependent Care Flexible Spending Accounts (DCFSA)

Supplemental Life Benefit Plan

Benefit plans that allow employees to set aside funds from their paycheck before taxes are taken out up to a maximum amount specified by the employer (this cannot exceed the maximum allowed by the IRS). Funds in this account can be used to reimburse the employee for qualified expenses spent on childcare to allow the employee to work.

Flexible Spending Accounts (FSA)

Healthcare Flexible Spending Accounts (HCFSA)

Dependent Care Flexible Spending Accounts (DCFSA)

Supplemental Life Benefit Plan

Benefit plans that allow employees to set aside funds from their paycheck before taxes are taken out up to a maximum monthly amount specified by the employer (this cannot exceed the monthly maximum allowed by the IRS). An employee can elect both plans or just Transit or just Parking.

Flexible Spending Account

401K Retirement Benefit

Voluntary Benefits

Qualified Transit and Parking ("Commuter") benefit plan

A retirement benefit plan that allows employees to set aside funds from their paycheck on a pre-tax basis (before taxes are taken out) up to a maximum monthly amount specified by the employer to save for retirement

401K Retirement Benefit

Voluntary Benefits

Medical Benefit Plan

Healthcare Flexible Spending Accounts (HCFSA)

Also known as Worksite Benefits, are insurance products offered by the employer that employees can elect to supplement their benefit coverage to meet certain needs.

401K Retirement Benefit

Medical Benefit Plan

Voluntary Benefits

Healthcare Flexible Spending Accounts (HCFSA)

This key player is involved in the offering, contracting and access of employee benefits provide coverage to employees and dependents.

Enrollment Systems

Employer

Payroll Companies

Third Party Administrators

This key player is involved in the offering, contracting and access of employee benefits. They are either individuals or firms who look for insurance companies, then negotiate and coordinate with on behalf of the Employer.

Brokers

Employers

Payroll Companies

Enrollment Systems

They are part of the benefit package given to by their employer, they can access care by using their HMO cards when they want to see doctors for medical consultation or go to hospitals for laboratory tests and treatments.

Employers

Brokers

Employees and Dependents

Carriers

Also known as the "insurers." They are the insurance companies an Employer's Broker negotiates and coordinates with for the best medical plans and rates that would fit the Employer's population profile.

Payroll Companies

Brokers

Enrollment Systems

Carriers

This key player is involved in the offering, contracting and access of employee benefits. They deliver services and support to the insured on behalf of the insurance companies ("carriers."). They provide support by taking care of the administration of employee benefit plans such as enrollments and billing reconciliations.

Payroll Companies

Enrollment Systems

Third Party Administrators

Employees and Dependents

They provide flexible internet-based services to companies regardless of size and across all industries.

They usually offer the following services to Employers:

Third-party 401k and benefits plan integration
Attendance and schedule monitoring of employees
Direct deposit account set-up for employers
Computation of payroll taxes and accurate deductions
Provide electronic payroll records to employers and employees

Payroll Companies

Third Party Administrators

Enrollment Systems

Carriers

A platform that makes possible the automated administration and management of annual benefits open enrollment. It centralizes employers' benefit elections in one system. It allows self-service so employees have more flexibility during open enrollment.

Third Party Administrators

Enrollment Systems

Payroll Companies

Carriers

EBCP Module 1 US Employment Benefits and Insurance

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