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Health Insurance FAQs
Health Insurance FAQs

questions and answers about health insurance and employee benefits

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Health Insurance FAQs

questions and answers about health insurance and employee benefits

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.

What is hospital indemnity insurance?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

Hospital indemnity insurance is a supplemental policy that pays a fixed cash benefit when you’re admitted to or spend time in a hospital, paid directly to you, regardless of what your major-medical plan covers. It’s meant to help with deductibles, coinsurance, and everyday bills, not to replace health insurance.

What is an Employee Assistance Program (EAP)?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

An EAP is an employer-sponsored benefit that gives employees and their household free, confidential access to short-term help: counseling for mental health, stress, relationships, grief, and substance use, plus referrals for legal, financial, and work-life issues. It’s typically offered at no cost to the employee.

How does dental insurance work?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

Most dental plans follow a 100/80/50 structure: preventive care (cleanings, exams) covered at 100%, basic work (fillings) around 80%, and major work (crowns, bridges) around 50%, subject to an annual maximum benefit (often $1,000–$2,000) and sometimes waiting periods. DHMO plans are cheaper but network-restricted; PPO plans cost more but offer more flexibility.

What does vision insurance cover?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

Vision insurance is typically a low-cost plan that covers a routine eye exam and gives an allowance toward glasses or contact lenses, usually once every 12 months, plus in-network discounts. It is not medical eye care; injuries and eye disease are handled by your health plan.

What’s the difference between group term life and AD&D insurance?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

Group term life insurance pays a benefit to your beneficiary if you die while covered (often 1–2× salary as employer-paid “basic,” plus optional employee-paid amounts). AD&D pays a separate benefit only for death or specified injuries caused by an accident; it’s much narrower and is not a substitute for life insurance.

What’s the difference between short-term and long-term disability insurance?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

Short-term disability (STD) replaces part of your income for a few weeks to a few months after an injury or illness, usually after a short waiting period. Long-term disability (LTD) starts after STD ends and can continue for years, sometimes to retirement age. Both typically replace about 50–70% of income.

What are accident and critical illness insurance?

HealthInsuranceFAQs, June 16, 2026June 16, 2026

Accident insurance pays a fixed cash benefit for injuries from a covered accident (such as an ER visit or a fracture), and critical illness insurance pays a lump sum when you’re diagnosed with a covered condition like cancer, heart attack, or stroke. Both pay you directly to help with costs your medical plan doesn’t, and are popular alongside high-deductible plans.

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Tax-Advantaged Accounts

  • POPs (Premium Only Plans)
  • FSAs (Flexible Spending Accounts)
  • DCAs (Dependent Care Accounts)
  • HSAs (Health Savings Accounts)
  • HRAs (Health Reimbursement Arrangements)
  • MERPs (Medical Expense Reimbursement Plans)
  • MPRAs (Medicare Premium Reimbursement Arrangements)
  • ICHRAs (Individual Coverage HRAs)
  • QSEHRAs (Qualified Small Employer HRAs)

Compliance Requirements

  • Marketplace Notice
  • HIPAA Notice
  • COBRA
  • State Continuation
  • SBCs
  • ERISA
  • Medicare Part D Notice
  • Medicare Secondary Payer
  • RxDC Reporting
  • Employer Reporting
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