INTERNATIONAL LEADERSHIP OF TEXAS

Healthcare

 

Q:  Can employees’ dependents be on their insurance? If so, for how long? 

A:  Children can remain insured as dependents up to their 26th birthday. A child may remain insured at age 26 or older if you can certify that the child is disabled or has another qualifying health condition. In addition, if the child turns 26 in the beginning or middle of a month, she/he can remain insured until the end of the month. For example, if Jane turns 26 on March 4, she can remain insured through the end of March 31st. 

 

Q:  How can I make a change after I have selected my benefit options? 

A:  Once employees have selected their coverage options, they cannot legally change their coverage unless they have a ‘qualifying event.’ This would be a change in their life situation, such as getting married, divorced, having a baby, or losing health coverage. If one of these events applies to you, please contact the benefits coordinator for assistance.

 

Q:  How do employees know what kind of health benefits they need?

A:  As an employer, we are not obligated to provide advice to employees on which benefits they may need. However, we encourage you to ask yourselves these questions:

• Do you prefer to stay in a network to get coverage?

• Are you willing to switch to a plan that may exclude your current doctor or medical providers close to you?

• Are you OK if procedures and specialists require a referral from your primary care doctor?

• Considering the type of treatment, you or your family received in the past, what medical needs do you anticipate this year?

• What kind of budget do you need to keep to cover premiums and out-of-pocket costs?  

 

Q:  If employees are not married, will the plan still cover their partners?

A:  Not necessarily. If your company’s plan does not have domestic partnership coverage, employee’s significant others may need to secure healthcare coverage through their employers or through the exchange. 

 

Q:  Can employees choose either dental insurance or vision insurance, or do they have to enroll into both plans?

A:  Employees can select one, both, or neither, as they are separate options. 

 

Q:  I want to sign-up for an amount of life insurance that is requires an Evidence of Insurability form.  Why do I have to provide this and what is this form?

A:  Evidence of Insurability (EOI) is required documentation about the employee’s health or his/her dependent’s health. It ensures employees are eligible for coverage and it determines their cost of participation.

Flexible Spending Accounts (FSA)

 

Q:  What are FSAs and how does it work? 

A:  Health flexible spending account is a plan that lets people use pre-tax dollars to pay for eligible health care expenses for themselves, their spouse, and eligible dependents. Money is set aside from an employee’s paycheck before taxes are taken out. Employees can then use these pre-tax FSA dollars to pay for eligible health care expenses during the plan year. 

 

Q:  What is a Dependent Care FSA? 

A:  A Dependent Care FSA is a plan in which employees can use pre-tax dollars to pay for qualified out-of-pocket dependent care expenses. 

 

Q:  Can both an employee and his/her spouse sign-up for the Dependent Care FSA? 

A:  Potentially. For a Dependent Care account, the total per household must not exceed $5,000 ($2,500 each if married and filing separately) per IRS guidelines.

 

 

Consolidated Omnibus Budget Reconciliation Act (COBRA)

 

Q:  What is COBRA and how does it work?

A:  The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that requires employers with 20+ employees who offer health care benefits to offer the option of continuing this coverage to individuals who would otherwise lose their benefits due to termination of employment, reduction in work hours, or certain other events. 

 

Q:  How much would employees have to pay COBRA for themselves and their family?

A:  The employee generally pays for the full cost of the insurance premiums. Employers can charge 102% of the premiums and keep 2% for administrative costs. 

 

Q:  How long is someone allowed to be on COBRA? 

A:  If the qualifying event is a termination of employment or a reduction in hours of employment, the COBRA continuation period is 18 months.