Benefits

Give Your Employees The Best

The benefits package offered to your employees can serve multiple purposes. In addition to keeping you compliant with employer regulations, it can it can be used as a tool to attract and retain quality employees. The benefit plan we create for you will be customized to the needs of you and your employees.

HERE TO HELP

  (267) 384-5300

(717) 500-3437

 Find A Representative

Give Your Employees The Best

The benefits package offered to your employees can serve multiple purposes. In addition to keeping you compliant with employer regulations, it can it can be used as a tool to attract and retain quality employees. The benefit plan we create for you will be customized to the needs of you and your employees.

HERE TO HELP

  (267) 384-5300

(717) 500-3437

 Find A Representative

Health Insurance
Health Insurance

There are many plans available to you and we can find what is best for your current group of employees. As an independent agency, we offer health insurance through multiple companies and we are familiar with the variety of plans offered by each. You’ll be guided through the selection process to help alleviate the weight of choosing the correct coverage for your group.


Employer Compliance & COBRA

Employer Compliance & COBRA

Regulations for employers are rapidly changing. Are you losing sleep for fear that you aren’t complaint with the current rules and regulations? Whether it’s the Affordable Care Act (ACA), Family Medical Leave Act (FMLA) or Consolidated Omnibus Budget Reconciliation Act (COBRA), we will provide the tools to stay in compliance and gain a restful nights’ sleep.

Compliance and Health Care Reform Education Center


Affordable Care Act (ACA) Compliance
Affordable Care Act

From HealthCare.gov:

The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).

The law has 3 primary goals:

  • Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
  • Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
  • Support innovative medical care delivery methods designed to lower the costs of health care generally.


Health Advocacy Services
Health Advocacy Services

We are your first contact when you have claims and coverage questions instead of the insurance company. Your designated service advisor provides assistance when needed and walks you through the claim process.


Voluntary Benefits
Voluntary Benefits

You can give your employees the option to select policies a la carte. These benefits are chosen and paid for by the employee via payroll deferral and, in some cases, pretax. Policies available include dental, life, short term disability, long term disability, vision, and cancer/critical illness.


Health & Wellness Programs
Health & Wellness Programs

The overall cost of your health insurance is based on your employees’ past health expenses. A wellness program can be put into place to incentivize employee wellness. The benefit of this can go well beyond the price point for your health insurance plan.


Workers Compensation
Workers CompensationThere are steps you can take to keep your employees safe at work but if they are injured, suffer from an illness, or even death as a result of their job, workers compensation provides coverage for expenses, lost wages, and rehabilitation services. This is different than a traditional insurance policy and we can help you manage the cost of work-related injuries.

Learn more >>

Corporate Retirement Plans
Corporate Retirement PlansLeverage the experience of our retirement plan advisors to put the right plan in place for your business.

Learn more >>

Health Insurance

There are many plans available to you and we can find what is best for your current group of employees. As an independent agency, we offer health insurance through multiple companies and we are familiar with the variety of plans offered by each. You’ll be guided through the selection process to help alleviate the weight of choosing the correct coverage for your group.


Employer Compliance & COBRA

Regulations for employers are rapidly changing. Are you losing sleep for fear that you aren’t complaint with the current rules and regulations? Whether it’s the Affordable Care Act (ACA), Family Medical Leave Act (FMLA) or Consolidated Omnibus Budget Reconciliation Act (COBRA), we will provide the tools to stay in compliance and gain a restful nights’ sleep.

Compliance and Health Care Reform Library


Affordable Care Act (ACA) Compliance

From HealthCare.gov:

The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).

The law has 3 primary goals:

  • Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level.
  • Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
  • Support innovative medical care delivery methods designed to lower the costs of health care generally.


Health Advocacy Services

We are your first contact when you have claims and coverage questions instead of the insurance company. Your designated service advisor provides assistance when needed and walks you through the claim process.


Voluntary Benefits

You can give your employees the option to select policies a la carte. These benefits are chosen and paid for by the employee via payroll deferral and, in some cases, pretax. Policies available include dental, life, short term disability, long term disability, vision, and cancer/critical illness.


Health & Wellness Programs

The overall cost of your health insurance is based on your employees’ past health expenses. A wellness program can be put into place to incentivize employee wellness. The benefit of this can go well beyond the price point for your health insurance plan.


Workers Compensation
There are steps you can take to keep your employees safe at work but if they are injured, suffer from an illness, or even death as a result of their job, workers compensation provides coverage for expenses, lost wages, and rehabilitation services. This is different than a traditional insurance policy and we can help you manage the cost of work-related injuries.

Learn more >>

Corporate Retirement Plans
Leverage the experience of our retirement plan advisors to put the right plan in place for your business.

Learn more >>

Contact an Advisor

J.R.

Insurance
Advisor

Kyle

Insurance
Advisor

Julie

Service
Advisor

Benefits FAQs

Do you offer compliance advice for HR Managers and business owners?

Yes. Resources are provided here. To subscribe to our Employee Benefits Newsletter, contact Julie Yoder.

Does our group health policy cover employees while traveling in the United States?

Generally speaking, your policy will cover an Emergency Room visit if travelling domestically. However, if you are in need of non-emergent care, please call the Customer Service number on the back of your ID Card in order to be directed to an in-network facility.  Always refer to your Summary of Benefits and Coverage for detailed information about your plan benefits.

Does our group health policy cover employees while traveling internationally?

The coverage is very limited for interntational travel. An emergency doctor visit may be covered however most expenses are not. We offer Individual International Plans that provide better coverage while out of the country.

Is there any dental coverage for my children on a group health plan?

For Independence Blue Cross (IBC), yes.  IBC contracts with United Concordia to provide Keystone HMO and DPOS plan members with pediatric dental.

Members have to be assigned by United Concordia to an in-network provider before scheduling an appointment for their children.  For example, A Plus Family Dental Care in Harleysville is an in-network provider, but you have to call United Concordia first in order for them to assign you to this dental office.  They will then inform A Plus Family Dental Care that you have been assigned to their office and you can then schedule the appointment for your children.  In order to receive your assignment, please call United Concordia at 1-800-332-0366 and they will take care of you.  Make sure to have your ID card on hand when you call.

How do I find out if my doctor is in-network?
What is a Wrap Summary Plan Description (Wrap SPD)?

The Summary Plan Description, or SPD, is the main vehicle for communicating group health insurance plan rights and obligations to participants and beneficiaries. As the name suggests, it is a summary of the material provisions of the plan document, and it should be understandable to the average participant of the employer.

Am I required to obtain a Wrap Summary Plan Description (Wrap SPD) and distribute it to my employees?

Yes, if you offer group health insurance to your employees, you’re required by ERISA law, enforced by the Department of Labor and the Affordable Care Act, to distribute a Wrap SPD within 120 days of the Plan’s effective date to all employees. Failure to provide the Wrap SPD within 30 days of request triggers a $110 a day fine per participant. Not having a Wrap SPD can also trigger an audit by the Department of Labor.  The insurance company’s Master Contract, Certificate of Coverage, or Summary of Benefits is not a Wrap SPD.  This requirement applies to all employer-sponsored group health insurance offerings, including a one-person plan. The ERISA and ACA required Group Health Insurance Wrap SPD document is available from Core Documents for a one-time fee of $99 and can be purchased here.

What is a Section 125 plan?

The Section 125 Plan, also known as a POP (Premium Only Plan) or Cafeteria Plan, is an integral part of any small business owner’s employee benefits package because it provides benefits not only to the employee but also the employer. For a one-time setup fee of $99, this plan allows your employees to purchase health insurance and other accompanying benefits, tax-free. It also eliminates the employer-matching Social Security and Medicare taxes, as well as some Federal and State unemployment taxes.  For more information or to purchase your own Section 125 plan for a one-time fee of $99 from Core Documents, click here.

What compliance documents am I required to distribute to my employees?

Contact your FIFS Service Advisor and we will send you a Benefits Notices Guide that will walk you through all of the documents that you are required to distribute, who to distribute them to, and when.

What is CMS Reporting and am I required to report?

The Centers for Medicare & Medicaid Services (CMS) requires that you report your creditable group medical plan(s) within 60 days of your renewal to inform them of your Medicare-eligible employees and dependents.  Generally speaking, Medicare is available for people ages 65 or older, but please note that it is also available for younger people with disabilities and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). 

Our recommendation is to report your creditable coverage every year, as you could be unaware of an employee or dependent that is Medicare eligible or you may hire one throughout the year.

Click on this link to complete the report: CMS Reporting.

Do I need to distribute the compliance documents to all employees or just the employees covered by our group health plan?

We recommend that you distribute all documents to all employees to make sure that you are compliant.  Contact your FIFS Service Advisor to obtain a Benefits Notices Guide that will walk you through all of the documents that you are required to distribute, who to distribute them to, and when.

May I distribute compliance documents to my employees electronically?

Yes, but only if they have daily access to a work computer.  If not, then you are required to obtain consent.  Please refer to the ERISA Electronic Delivery Safe Harbor chart in our Library.

How can we help?

We’re a small business and have been with Franconia for years now. Joanne, Kyle, Janelle, Julie, JR, Ben and Kristel are all very knowledgable, responsive and provide exceptional customer service. I wouldn’t hesitate to recommend them to anyone shopping for their business or personal insurance needs.


Karen F.

Doylestown

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