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FAQ

Question: Is it possible to offer one group plan even though I have employees in several states?
Answer: Yes. Several companies offer plans with nationwide networks.
Question: When does the "deductible" period start?
Answer:The deductible runs on a calendar year and starts over every January. However, some plans may offer a deductible carryover credit, which will allow the deductible to carryover to the next year, if you met the deductible in the last 3 months of the year.
Question: Are there exceptions to this calendar year period for deductibles?
Answer:Yes, be careful of plans that have a deductible "per surgery" or "per illness". These kind of deductions make it hard to protect your total annual risk exposure.
Question: How are preventive visits covered?
Answer: Preventive care is now covered at 100%. Plans after 10/1/2010 are not even subject to a copay.
Question: What is generally NOT covered?
Answer: Each plan design should specifically list exclusions. HSA plans are unique because they allow you to use your "savings account" portion of the plan to pay for certain approved services that may not be covered by an insurance policy. (For example alternative healthcare such as acupuncture and chiropractic care)
Question: What is a PPO?
Answer:   A PPO stands for "preferred provider organization". This means that there is a preferred network of doctors that will offer contracted or discounted rates to the insurance company. You do have the option to go out of the network for care with a PPO.
Question: How do I know if my doctor is in my PPO network?
Answer: Most companies offer an updated directory on their web site. However, it's always best to check with your doctor to make sure they plan on staying on that network.

Question: I am thinking of offering dental benefits to my employees. Since I haven't offered it in the past, will there be a waiting period?
Answer: Some companies offer immediate coverage for basic and major services, even if you have not had previous dental coverage.
Question: I am starting a new company and would like to offer group health insurance to my employees. Is this possible?
Answer:  "Yes", many insurance companies will offer coverage to a new company.
Question: How many employees must I have to be able to offer a group plan?
Answer: You only need 2 full-time employees to write a group plan.

HSA Plans for Groups

Question: Do you have to be self-employed to have a HSA account?
Answer:  No, anyone can have an HSA, but you do have to have a HSA compatible health insurance plan first.
Question: Can an employer offer an HSA plan to their employees as a "group" plan?
Answer: Yes.
Question: What are the contribution limits for HSA plans?
Answer:
Question: Are there rules on when you can contribute to an HSA savings account?
Answer: You can contribute from January through April 15th of the following year, as long as you haven't exceeded limits per IRS guidelines.
Can I cover my 1099 employees on my group health plan?
Answer:"Yes", as long as they are full-time employees and you don't discriminate among them.

Question: Does every group have to offer COBRA?
Answer: No. In Texas, smaller groups are subject to State Continuation for up to 9 months.
Question: How long can a child stay on their parent's plan?
Answer: Per the new Health Care reform to age 26, whether the child is married or not.

ACA/Health Exchange Questions

Question: I know that in 2014 everyone must have insurance but what if I can't afford it?
Answer: Based on your income, you may be eligible for a government subsidy.