Clear, accurate answers to the most common, and most confusing, questions about health insurance and employee benefits. Choose a category below to find what you need.
Browse FAQs by Category
Plans & Coverage
How health plans work: plan types (HMO/PPO/EPO/POS), metal tiers, provider networks, prescriptions, claims and appeals, preventive care, and cost-sharing.
Costs & Affordability
Understanding what health coverage really costs: premiums, deductibles and cost-sharing, the ACA affordability rules, and how employer contributions are structured.
Enrollment & Eligibility
Who can enroll and when: open enrollment, special enrollment periods after a life event, new-hire waiting periods, and eligibility rules for employer health coverage.
Strategies
Employer strategies for plan design and funding: self-funding, stop-loss, captives, reference-based pricing, level-funding, and cost control.
Tax-Advantaged Accounts
Save on healthcare and dependent-care costs with tax-advantaged accounts: HSAs, FSAs, HRAs, and Premium Only Plans (POPs).
Compliance Requirements
The federal and state rules employers must follow when offering benefits: ERISA, COBRA, SBCs, Form 5500, ACA reporting, HIPAA, and more.
Supplemental & Ancillary Benefits
Benefits that complement major medical coverage: dental, vision, group life and AD&D, disability, accident, critical illness, hospital indemnity, and Employee Assistance Programs.
Individual Coverage
Individual Coverage HRAs (ICHRA), QSEHRAs, and other ways employers can help employees buy their own individual health insurance instead of offering a traditional group plan.
Medicare Coverage
How Medicare works alongside employer coverage: enrollment timing at 65, who pays first, Part D creditable coverage, and HSA rules for employees who keep working.