Employee Benefits

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Employee Benefits Defined

Benefits and perks in the form of non wage compensation in addition to your employees’ salaries are essential for retaining top talent. Some may know this as fringe benefits. Employees rely on their employers to provide benefits that will provide value in their everyday lifestyle. Some of these benefits may include Health, Life, Dental, Vision, or anything you need to provide for your employees and their family. These benefits could be fully or partially covered by the employer.

Job applicants require medical insurance, but may also want a retirement plan and disability insurance. Though retirement plans and paid vacations are not required, many companies are offering them to stay competitive. If you are unable to provide these benefits, you may be sending top candidates out the door before they even begin working. Providing the best benefits will ensure low turnover and your employees will be happier with their career choice.

If you look at the companies rated the best places to work, you’ll see that they offer a wide variety of benefits including daycare, health club memberships, and even tuition reimbursement. If you don’t believe us, we practice what we preach. We were awarded Philly.Com Best Workplaces in 2017. http://www.philly.com/philly/business/workplaces/Top-Workplaces-2017--Small-Companies.html

Whether your business is ready to provide extra fringe benefits, here is our process for helping you find the perfect plan for your business:

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Consultative evaluation of Group Medical, Prescription Drug, Dental, Vision, Life & Disability coverages

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Funding Analysis: fully-insured, self-funded, level-funded alternatives

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Employer/Employee Contribution Analysis

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Written Service Timeline

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Negotiating competitive pricing with all carriers

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Employee Communication & Education

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Claims Advocate

Hardenbergh’s Approach To Employee Benefits

The conversation about benefits between you as the employer and your employees may be a touchy subject. Our job is to walk that fine line to make sure that the benefits package is affordable for the employer, and at the same time, beneficial for the employee. We want to offer a competitive package in order to retain and attract the right workforce for your business.

We at Hardenbergh offer strategic solutions after listening to your Insurance needs. Navigating the dense landscape the IRS has paved for business owners can be difficult for employers, so we utilize our extensive resources to create a plan specific to your business. We will help you navigate Federal and State Regulations while also resolving any of your budgeting concerns. As a result, your business and your employees will receive a customized benefits package that aligns with your overall goal.

The legislative arena and the many insurance regulations tied to these laws is changing on a daily basis. We monitor and communicate the impact of these regulations to you. The ERISA requirements on health and welfare plans are complicated and we work to be sure you are compliance with their provisions. We partner with your Human Resource department to efficiently handle HR issues and to allow them to concentrate on your business.

We work with multiple carriers to ensure you the most cost-effective medical, dental, retirement, and life insurance plans. Once a benefits package is designed, the next step is to communicate the benefits package and offer employee support. Hardenbergh assesses the employer’s compliance and make sure what is offered is the best plan according to Federal and State Regulations. If you are a new client, we assess compliance during our strategic consulting before becoming the broker of record.

Creative Benefit Package Solutions

Whether you are a small business or a large organization, our goal is to customize a benefits package tailored to your business. Not every business is the same. What is important to one may not necessarily be important to another.

We go over pain points of some of the benefits you currently provide and see what is working and what doesn’t. The only way to retain the best talent is to help your employees. We have been able to find savings through packaging and working with overlooked aspects like evenly distributing income.

Because Hardenbergh wants to benefit the employees according to their lifestyle. Blue collar workers are not looking for 100k in life insurance. If an employee is single and own a home, perhaps scale back on medical. Companies will come to Hardenbergh and tell us why their current benefits are not working. A common problem is that their current benefits never pay for what it’s suppose to pay for. We listen to the needs and peel back the layers of what you really want in order to give you the best plan.

We understand that employers want to provide something that they can be proud of. As you receive information and read contracts about benefit options, we will be able to help you dig into the details. That way, we can determine what the problems are and create a solution that everyone agrees with at half the cost.

HR And Compliance

At Hardenbergh, we offer solutions through listening to your Insurance needs. Whether budgetary concerns, creative benefit planning sessions or help navigating the dense landscape the IRS has paved for business owners, we can utilize our extensive resources on your behalf. After we help determine what you are looking to accomplish, we can create a solution that will help you navigate Federal and State Regulations while reaching the overall goal, giving your business and your employees a customized benefits package.

Here is what you can expect from us:

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HR Professional Support Line

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HR Audit Checklist

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Carrier Audit & Reconciliation

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Monthly Benefit Newsletter

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5500 Reports

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Erisa Wrap Documents

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COBRA & State Continuation

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Surveys

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ACA Reporting

The most important part of the benefits package is fitting the overall business insurance needs. We will identify potential vendors by basing it on the day to day lifestyles of your business and employees. Because we maintain close relationships with our clients and HR professionals, we can also consult on technology. If your office is spending too much time on a particular task, we can help with that. Although we are not in HR by any means, we are able to bring value to your business by sharing our knowledge and making the connections at our disposal.

The Basics Of Employee Benefits

All plans provide coverage for visits to primary care physicians and specialists, hospitalization and emergency care. Alternative medical care, wellness, prescription, vision and dental care coverage will vary by the plan and employer. Employers are required to provide healthcare to employees who work at least 30 hours per week.

When searching for the right plan for your employees, the terms may be overwhelming. To make it easier, we compiled a list of commonly used terms used for health coverage.

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Allowed Amount - The maximum amount your plan will pay for healthcare services. You may also hear related terms such as “eligible expense,” “payment allowance" or "negotiated rate." If your provider charges more than the allowed amount, you may have to pay the difference.

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Appeal - A request for your health insurer to review your grievance again.

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Balance Billing - When a healthcare provider bills for the difference between what the provider is charging and the allowed amount. For example, if the provider is charging $100 and the allowed amount is $70, then you are responsible for the remaining $30.

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Co-insurance - Your share of the costs of a covered health care service after you’ve paid the deductible. You pay co-insurance plus any deductibles you owe. Let’s say the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your

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Co-payment - A fixed amount you pay in addition to the amount paid by the insurer.

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Deductible - The specified amount of money you pay for health care services before your health insurance or plan begins to pay. Let’s say your deductible is $1000, your plan won’t pay anything until you’ve met your $1000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services.

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Grievance - A official statement of complaint that you communicate to your health insurer or plan.

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Habilitation Services - Health care services that help a person keep, learn or improve skills and functioning for daily living. This may include physical and occupational therapy, speech-language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings.

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In-network Co-insurance - If your expenses surpass the out of pocket limit, your health insurance or plan will pay the remaining amount. In-network co-insurance usually costs you less than out-of-network co-insurance.

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In-network Co-payment - A fixed amount you pay for covered health care services, usually when you receive the services, to providers who contract with your health insurance or plan. In-network co-payments usually are less than out-of-network co-payments.

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Network - The facilities, providers and suppliers your health insurer or plan has contracted with at a discount to provide health care services.

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Non-Preferred Provider - A provider who does not have a contract with your health insurer or plan to provide services to you. You will pay more to see a non-preferred provider. Check your policy to see if you can go to all providers who have contracted with your health insurance or plan, or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers.

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Out-of-network Co-insurance - The amount you pay of the allowed amount for covered health care services to providers who do not contract with your health insurance or plan. You will pay more for out-of-network co-insurance than in-network co-insurance.

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Out-of-network Co-payment - A fixed amount you pay for covered health care services from providers who do not contract with your health insurance or plan. You will usually pay more for out-of-network co-payments than in-network co-payments.

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Out-of-Pocket Limit - The most you pay during a plan period before your health insurance or plan begins to pay in full the allowed amount. This limit does not include your premium, balance-billed charges or health care that is not covered by your health insurance or plan. Some health insurance or plans don’t count all of your co-payments, deductibles, co-insurance payments, out-of-network payments or other expenses toward this limit.

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Preferred Provider - Your health insurance or plan has contracts with preferred providers who are able to provide services to you at a discount. It is a managed care organization that consists of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates.

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Premium - The amount that must be paid by your employer or sponsor for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly.

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Provider - A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), health care professional or health care facility licensed, certified or accredited as required by state law who helps in identifying or preventing or treating illness or disability.

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Specialist - A health care professional whose practice is limited to one particular area and is certified by a specialty board as being qualified to limit their practice. Specialists are primarily responsible for providing emergency medical treatment, limited primary care and health protection and evacuation from a point of injury or illness.

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UCR (Usual, Customary and Reasonable) - Rates established based on the geographic region and the medical service provided to you. The UCR amount sometimes is used to determine the allowed amount.

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How To Find The Best Benefit Formula For Your Business
Listening to the employer’s needs is important to us. When it comes to budgetary concerns or compliance issues, we want to make sure that you leave with all issues and concerns resolved. By having our close relationships with vendors, we will help you accomplish your goals for your business.

How To Find The Best Benefit Formula For Your Business

Listening to the employer’s needs is important to us. When it comes to budgetary concerns or compliance issues, we want to make sure that you leave with all issues and concerns resolved. By having our close relationships with vendors, we will help you accomplish your goals for your business.

We research the industry standards, legislative updates, audit procedures, carrier complaints, and government compliance. Compliance is an integral part of the process. Between the basics of the ACA, group size, and all of the carrier regulations with the Department of Labor, there are no shortage of requirements. For example, different sized groups have different requirements.

Employee Benefits FAQ

It is very easy to make mistakes even from just a processing standpoint. Errors can cost American taxpayers billions of dollars per year. Hardenbergh will help you navigate the complexities of the ever-changing healthcare system. Some things to consider is the health care reform checklist, diagnosis, whether you own a business, and more. Here are some commonly asked questions that may help you in the process:

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Getting Married - can I add my new spouse on the coverage or do I have to wait for open enrollment?

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Am I required to contribute to my employees health care premiums?

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How do I know if I am Federal Cobra vs State Continuation?

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What is the difference between an HRA, F.S.A. and H.S.A.?

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What are the minimum amounts of hours my employees have to work to be eligible for health benefits?

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As an employer, am I required by law to offer benefits to my employee’s spouses and/or dependents?

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Am I allowed to ask my employees questions about their health conditions?

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I am getting married soon. Can I add my new spouse and/or stepchild(ren) to my coverage or do I have to wait until there is an open enrollment period?

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I am expecting a baby soon. What are the requirements for adding my baby to my coverage?

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How long may my dependent children remain covered under my benefit plans?

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Can my dependent parents be covered by my benefit plans?

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I am resigning or my appointment expires at the end of the month. How long will my coverage be in effect?

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Since Delta does not issue identification cards, what information should be given to the provider to confirm benefit eligibility?

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When am I eligible to enroll for benefits?

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How can I determine if my doctor is in-network?

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What is the process to file a claim appeal for a denied claim?

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Can I participate in both and H.S.A. and an FSA?

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Can I change my Flexible Spending Account (FSA) election

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Can I use my Medical FSA to reimburse my spouse’s deductible and/or co-payment expenses, even if he/she is enrolled in a different health plan?

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How often does my prescription drug plan formulary change?

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Can I continue my health benefits if I resign?

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If I am disabled on a long-term basis, will I continue to receive income?

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What is the difference between pre-tax and post-tax long-term disability (LTD) plans?

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Are there preexisting condition limitations if I change health plans?