GOLDMARK FREQUENTLY ASKED QUESTIONS
Questions About Group Health Insurance
1What types of group health insurance plans are available for small businesses?
Small businesses generally have access to HMOs, PPOs, EPOs, and HDHPs (High-Deductible Health Plans). Goldmark Benefits works with all major carriers in PA, NJ, and DE and will walk you through the pros and cons of each plan type to find the right fit for your team and your budget.
2How many employees do I need to offer group health insurance?
Most group health plans require a minimum of 2 eligible employees, though it can vary by carrier. Goldmark Benefits works with small- and mid-sized companies and can help you determine eligibility and the best options for your headcount.
3How long does it take to get a group health insurance quote?
After an initial conversation to understand your needs, Goldmark Benefits can typically provide pricing and recommendations within 48 hours.
4Can Goldmark Benefits handle adding or removing employees from our health plan?
Yes. Goldmark Benefits manages all employee additions and deletions on your behalf, so your HR team doesn't have to go back and forth with the carrier for routine changes.
5What is a Section 125 POP plan, and does my business need one?
A Section 125 Premium Only Plan lets employees pay their share of health insurance premiums with pre-tax dollars, which lowers taxable earnings for both the employee and the employer. It's a simple, low-cost way to make your benefits package more tax-efficient, and Goldmark Benefits can set it up as part of your overall benefits strategy.
Questions About Dental Insurance
1What does group dental insurance typically cover?
Most group dental plans cover preventive care, such as twice-yearly exams and cleanings, as well as basic restorative work, including fillings, X-rays, crowns, and root canals. Many plans add toward more complex procedures, though coverage levels vary by plan tier.
2Is dental insurance separate from health insurance?
Yes, dental is typically offered as a separate group benefit from medical coverage. Goldmark Benefits can bundle it with your other plans or set it up as a standalone option, depending on what works best for your business.
3Do employees have to use a specific dentist?
It depends on the plan. PPO dental plans give employees the flexibility to see any dentist, with lower costs for in-network providers. HMO dental plans require using network dentists. Goldmark Benefits can help you compare options based on what matters most for your team.
Questions About Vision Insurance
1What does group vision insurance cover?
Group vision plans typically cover annual eye exams and provide an allowance toward prescription glasses or contact lenses. Some plans also include discounts on procedures like LASIK. It's one of the most appreciated and affordable benefits you can add to your package.
2Is vision insurance worth offering as a small business?
Absolutely. Vision coverage is relatively inexpensive, and employees genuinely value it. It's an easy, cost-effective way to strengthen your benefits offering and improve retention without a big impact on your benefits spend.
Questions About Group Life and Disability Insurance
1What is the difference between short-term and long-term disability insurance?
Short-term disability typically replaces a portion of an employee's income for a few weeks to up to six months if they can't work due to illness or injury. Long-term disability picks up from there and can provide income replacement for years, or even until retirement age. Many employers offer both as part of a well-rounded benefits package.
2Does my small business need to offer life insurance to employees?
It's not legally required, but group life insurance is a low-cost benefit that employees genuinely appreciate. It's typically offered as a flat benefit, like one or two times annual salary, and can be a real differentiator when you're recruiting. Goldmark Benefits can help you find competitively priced options regardless of your company's size.
3What happens to an employee's life or disability coverage when they leave?
Many group life and disability policies include a portability or conversion option that allows departing employees to continue coverage individually, usually without having to re-qualify medically. Certain terms depend on the carrier and plan design.
Questions About GAP Insurance
1How does GAP insurance work alongside a high-deductible health plan?
GAP insurance covers portions of the cost-sharing employees owe under a high-deductible plan, such as inpatient or outpatient deductibles that their primary health plan doesn't cover. It lets employers offer a lower-premium HDHP while still protecting employees from large, unexpected out-of-pocket bills.
2Is GAP insurance the same as supplemental insurance?
GAP insurance is a type of supplemental coverage that fills the gap between what a primary health plan covers and what the employee owes. It's different from other supplemental products, such as accident or critical illness insurance, which pay fixed cash benefits regardless of actual medical costs.
Questions About FSA, HSA, HRA, and Spending Accounts
1What is the difference between an FSA, HSA, and HRA?
All three are tax-benefited accounts for healthcare expenses, but they work differently. An FSA is employer-sponsored, funded by the employee pre-tax, and generally needs to be used within the plan year. An HSA is paired with a high-deductible health plan, can be funded by both the employer and employee, and rolls over year to year with no expiration. An HRA is funded entirely by the employer and reimburses employees for qualified medical expenses. Goldmark Benefits can help you figure out which option, or combination of options, makes the most sense for your workforce.
2Can employees use FSA funds for their dependents' medical expenses?
Yes. FSA funds can be used for eligible medical expenses for the employee, their spouse, and qualifying dependents. A separate Dependent Care FSA, also available through Goldmark Benefits, can cover eligible childcare and eldercare expenses.
3What is an ICHRA, and how is it different from a traditional group health plan?
An Individual Coverage HRA allows employers to reimburse employees tax-free for individual health insurance premiums and qualifying medical expenses, rather than giving a traditional group plan. It gives employees more flexibility to choose a plan that works for them, while giving employers more predictable, defined-contribution costs.
Questions About COBRA and Compliance
1What is COBRA, and am I required to offer it as a small business?
COBRA allows employees and their dependents to continue group health coverage after a qualifying event, such as job loss or a reduction in hours, typically for 18 to 36 months. Federal COBRA generally applies to employers with 20 or more employees, but some states have mini-COBRA laws that cover smaller employers as well. Goldmark Benefits handles COBRA administration and can help you stay compliant no matter your company size.
2How does Goldmark Benefits help with ACA compliance?
Goldmark Benefits provides timely healthcare reform updates and gives clients access to HR360, a step-by-step compliance guide covering ACA requirements, COBRA, FMLA, and other federal and state regulations. Think of them as an ongoing resource so you're never caught unprepared by a regulatory change.