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As a business owner, do I have to pay anything towards employee’s benefits package?Medical insurance carriers typically require a 50% contribution towards the employee-only rate. This contribution can also reduce your overall tax liability.
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Do you help communicate and explain my employee’s benefits to them?Yes! We connect with of your employees within your preferences to ensure they each have clarity on their benefits, whether that means emailing, calling, texting, sending carrier pigeons, or creating smoke signals.
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What size companies do you work with?PBC partners with companies ranging from 5 to 1000 employees, serving each of them as if they were our only client.
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What do your services cost?Nothing! At least, not for you. We are paid by the carriers, and we don’t have contracts. So, if you give us a shot and decide you want to use another benefits company, you’re free to move on.
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How long has PBC been in business?PBC was founded by experienced health insurance professionals in May of 2007 to pursue their goal of offering the highest level of service to clients of all sizes and backgrounds.
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What is a Qualifying Event?A Qualifying event is a life change that gives you the ability to enroll in your employer’s health insurance plan outside of the annual Open Enrollment period or New Hire Enrollment. Here are some examples of qualifying events (but not a full full list). 1. Losing qualified health coverage 2. Getting Married or Divorced 3. Having a baby or adopting 4. Death in the family
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How does offering benefits to my employees affect my taxes?Employee benefits offer pre-tax savings for healthcare plans for your employees and contributions toward benefits can reduce your company’s overall tax liability.
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What annual compliance topics do I need to be aware of?There are several factors that determine what compliance regulations apply to you, PCORI Fees, 5500 filing, 1095s, Medicare Part D notices, Transparency notices, are just a few that you may be subject to.
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Who can you work with geographically?While we have a Southeastern United States focus, we do business across 30 states from Florida to California. We don't mind racking up those frequent flyer miles.
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What are copays, deductibles, coinsurance, and out of pocket maximums?Copay: Co-pays are your fixed fee for certain covered medical services. The Copay is a set amount you pay each and every time you use a particular service like visit the doctor, an X-ray, or a medication. The amount of the copay is preset by your insurance provider and will be the same fixed amount no matter how often you use the plan. The most common copays apply to primary care, specialist, and urgent care visits as well as prescriptions but not every plan has copays. Deductible: The deductible is the amount you pay for covered health care services before your insurance plan starts to pay. Typically, if a service doesn’t fall under a copay, it falls under your deductible instead. It’s important to note that your premium (that monthly membership fee) and your copays do not count toward your deductible. Also, the deductible renews each year (usually calendar year) and you have to start over towards meeting your deductible. Coinsurance: Co-Insurance is a cost the insurance carrier shares with you for covered medical services. Coinsurance is usually described as a percentage of the expenses shared between you and the insurance company. It applies after you have met your deductible and before your out-of-pocket maximum has been met. Once you reach your deductible, coinsurance applies, and you and your Health Insurance plan share your medical costs. For example, coinsurance of 80/20 means that your insurance will pay 80% of the cost and you will pay 20%. Out of Pocket Maximum: As the name implies, the out of pocket maximum is the most you have to pay for covered services in a year (usually calendar year). After you spend this amount on deductibles, copayments and coinsurance, your health plan pays 100% of the costs of covered benefits.
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