Group Health & Employee Benefits

We can help you obtain the small business tax credit available to eligible employers through the Federal Marketplace, Small Business Health Options Program (SHOP). Eligible employers may have their premiums reduced by as much as 50%. To be eligible, you must cover at least 50 percent of the cost of employee-only (not family or dependent) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation beginning in 2014) per year.

We suggest you use our Business Tax Calculator to find out if you qualify. Those who qualify will be able to purchase traditional group health plans (PPOs) through SHOP.

To find out more information, contact us at info@pathwaymarketplace.com or call 214-707-6056.

Dental Plans offer a variety of diagnostic, preventative care, & corrective services including cleanings, exams, x-rays, fillings, root canals, orthodontia for children, & emergency care.

Whether on an employer paid basis, or offered as a voluntary benefit (where employee pays all of the premium), employees appreciate dental coverage as part of their Employee Benefits Package.

To learn more about our group dental products, please contact us at info@pathwaymarketplace.com or call 214-707-6056.

A Flexible Spending Account (FSA) is a cafeteria plan under Section 125 of the tax code and allows for benefits to be paid with pre-tax dollars which results in tax savings to both the employee and the employer.

The average working employee in America spends thousands of dollars annually on certain types of medical benefits, daycare expenses and transportation services. By participating in an FSA, an employee’s taxable income is reduced, which increases the percentage of pay they take home and allows them to pay for these benefits and services with the pre-taxed dollars, in essence giving them a discount on these services.

Here’s how it works:

This tax-favored savings account is funded solely by the employee through regular pre-tax payroll deductions. Employees elect how much they want withdrawn from each pay period, which can be changed annually or upon a qualifying event such as marriage or divorce. Throughout the plan year, funds can be withdrawn from the account (tax-free) to pay for eligible medical, dental, vision, prescription and dependent daycare expenses. Some FSAs include work-related parking and transit costs. The administrator of the FSA account can issue a debit card that is tied to the FSA making it easy to use the account when needed.

To find out more information, contact us at info@pathwaymarketplace.com or call 214-707-6056.

A Premium-Only Plan lets employees purchase their own individual insurance with pre-tax dollars, potentially saving employees thousands annually in taxes and premiums combined.

Employees elect a set amount of pre-tax dollars to be deducted from each payroll. The employee purchases an individual health insurance policy in which he/she chooses completely on their own and is responsible for paying the monthly premiums directly to the carrier.

The employee is then reimbursed by the employer for the monthly premium with the pre-taxed dollars.

To find out more information, contact us at info@pathwaymarketplace.com or call 214-707-6056.

Partially Funded Health Plans (Shared Funding)

Shared Funding Plans allow small employers to take advantages of all the cost savings and benefit design features of a self-insured plan that typically is designed for larger groups. Any small or large group could benefit greatly by the cost saving opportunities of a shared funding plan.

Here’s how it works.
First, an employer will select any of the fully insured plans that the carrier offers and rates will be determined by the group’s claim history. Stop-loss insurance is added to protect against catastrophic claims.

Just like with an insured plan, the carrier will handle the administration of the plan, processing claims and offering members on-line access to benefit explanations and other reporting tools.

Premiums for shared funding plans are generally much lower than fully insured plans because the employer shares some of the risk.

Employers who opt for shared funding plans may save even more costs by implementing wellness programs into the workplace.

Self-Funded Health Plans

When employers self-fund their own health plan, they will benefit from a significant savings in premiums, increased cash flow, tax advantages in addition to having more control over the benefits that the plan offers.

Although not always a popular choice for small employers, today, self-insured plans are considered to be good options for both small and large employers. Pathway Health Insurance Experts, Inc. can help you set up and maintain self-funded health plans and will be happy to give you a no cost analysis to determine if a self-funded health plan option is right for your company.

Here’s how it works:

A self-funded health plan requires the employer to become the insurer. Most often, employers will partner with a PPO to provide services for the plan. A third party (a TPA) is engaged to handle claims and processing. Because self-insured employers run the risk of large catastrophic claims, they will purchase stop-loss insurance to protect them in such an event. Even with the additional expense of stop-loss insurance, employers can enjoy saving thousands in premiums and other advantages.

To find out more information, contact us at info@pathwaymarketplace.com or call 214-707-6056.

We offer a rich variety of Voluntary Benefits to help your employees manage rising healthcare cost and risk. Employees can purchase voluntary benefits at reduced group rates through pre-taxed payroll deductions.  We can help your employees get the additional voluntary employee benefits coverage they want or need—at no cost or hassle to your company.  Following are examples of our Voluntary Products offered to your employees:

Life – Term and Permanent (Cash Value) Life Insurance

Accident Insurance – Offers different benefit level choices to fit your employee’s needs and budget, and provides cash benefits in addition to regular health insurance and/or disability insurance, in the case of an accidental injury.

Disability – Provides your employees with an option to purchase additional disability coverage to supplement their employer provided coverage.

Long-Term Care – Whether an employer sponsored benefit or on a voluntary basis, Long-Term Care insurance goes a long way to help protect your employees’ financial future and well-being.

Dental & Vision – Dental and vision benefits are one of the most requested health benefits from employees, behind major medical and life insurance.  Yet with rising premiums, many employers are challenged to keep them in the traditional benefit offering.  Studies show that offering voluntary Dental and Vision is a perfect way to help employers off-set these costs pressures, while promoting good health for their employees and ensuring employee satisfaction.

Critical Illness – Surviving a critical illness is very common with the advances in modern medical technology.  Critical Illness Insurance pays a cash benefit directly to your employees, which can be used to help reduce the personal financial impact of fighting a critical illness and keeping up with everyday bills through that process.

Hospital Indemnity – This plan will pay a lump-sum payment directly to the insured which can help your employees with out-of-pocket expenses and everyday bills when they are off work due to a hospital stay.  The coverage is usually a set amount per day, per week, per month, or per visit depending on the benefit level selected.

Gap – Gap insurance provides benefits that supplement a major medical and comprehensive benefit package. It works by paying a significant amount of the deductible on a major medical plan. More specifically, the additional benefits help to cover out-of-pocket expenses related to coinsurance, co-pays and deductibles for inpatient and outpatient services. For example, if your employees have a $5,000 deductible on their major medical coverage, gap coverage could pay up to $4,000 of that deductible.

Final Expense –  This type of life insurance has a much lower face value than traditional term insurance because it is intended to only cover costs related to a person’s final expenses. Therefore, these policies can often be purchased by your employees at a low or reasonable premium.

To find out more information, contact us at info@pathwaymarketplace.com or call 214-707-6056.