Eligibility and Enrollment
Who is considered an Eligible Employee under the Insperity Group Health Plan?
Full-time or part-time benefits eligible employees if their client's benefits package offers benefits.
What is the coverage period for the Insperity Group Health Plan?
Calendar Year.
If an employee elects to drop coverage during open enrollment, would COBRA be offered to them?
No.
Program created to reimburse employees under ALL benefit packages who legally adopt a child, including such costs as adoption agency fees, legal fees, pregnancy and hospital expenses of the natural mother, and immigration/naturalization expenses.
Adoption Assistance Program
What is an Applicable Large Employer? What
How can an employee terminate their group health plan?
During Initial Enrollment (IE), Open Enrollment (OE), or (MYC).
What does COC stand for?
Certificate of Coverage.
How many days does a Qualified Beneficiary (QB) have to complete their enrollment in COBRA?
60
Program designed to encourage eligible employees to acquire additional education/certifications on a voluntary and independent basis to maintain or improve skills that will be beneficial to the employee and employer.
Education Assistance Program
How is a client’s ALE status determined?
A client’s ALE status is based on the number of full-time (and full-time equivalent) employees the client had in the prior calendar year (the employee count also includes employees in any other companies in the client’s controlled or affiliated service group). ALE status applies for the entire calendar year, regardless of any fluctuations in employee count during the year.
How long must an employee be with the company to qualify for FMLA?
12 months.
What is the maximum amount of conversion insurance available if the insured has been covered for at least 5 years and the policy is terminated?
$10,000.
How many days is the grace period if the initial payment isn't submitted on the same day as the enrollment?
45 days
Program that allows eligible employees to make pre-tax contributions to a program for approved expenses associated with regular commutes to work.
Commuter Benefits Program
How are clients notified about their ALE status?
ALE Status Determination Letters and ALE Email/Eloqua Communications
What is required for an insured person to apply for a conversion policy of life insurance if coverage ends?
Application must be submitted within 62 days after the policy has ended.
What is the fixed amount the participant pays for a covered service from an in-network provider called?
Copay.
What systems are used to verify COBRA QBs?
Wex and Travis COBRA
Program provides virtual assistance to Insperity employees with caregiving responsibilities for children, elderly parents, and family members or friends who are disabled or ill.
Caregiver Support Program (Cariloop)
How do I check client’s current ALE status?
Using AIMS or Salesforce
What information should be collected for Escalations if a claims issue remains unresolved after the employee contacted the carrier and Health Care Support?
Confirmation the employee has spoken with both the carrier and Health Care Support without resolution, patient name, and date of service.
What does the "annual out of pocket maximum" mean?
The most a participant will pay before their insurance carrier pays 100% for the remainder of the coverage period.
What is the COBRA rate for the HPHC HMO Bundled PBQ and child?
$1,966.87
Program that includes confidential money coaching, educational resources, and a secure digital platform offering self-help tools to help you reach short-term and long-term goals.
Financial Wellbeing
What is an ACABEE?
Full-time AND Part-time employees who are considered eligible for benefits.
If a client is an Applicable Large Employer (ALE), Full-Time Employees will be eligible for benefits no matter how many hours worked; however, Part-Time Employees would be considered an ACABEE if they accrue an average of 30 hours or more per week during their initial or standard measurement periods.