Health Care Benefits
(Jump to state content for this section)
Original Author: Jayne Zanglein, Western Carolina University
Updating Author: Tracy Morley, XpertHR Legal Editor
- Employer-sponsored health care benefits are an important part of the overall compensation package. See Choice and Flexibility in Health Care Coverage.
- Employee benefit plans may purchase health insurance products that are subject to state insurance regulations and federal and state health mandates. See Fully-Insured Plans.
- Self-insured plans are generally not subject to state insurance laws or mandates, but are subject to some of the Patient Protection and Affordable Care Act (PPACA) mandates. See Self-Insured Plans.
- Health plans may be traditional indemnity plans or managed care plans. See Fee-for-Service/Traditional Indemnity Plans; Managed Care Plans.
- Fee-for-service (FFS) plans offer employees more freedom to choose health care providers. See Fee-for-Service/Traditional Indemnity Plans; Standard Health Care Packages.
- Managed care plans include preferred provider organizations (PPOs), health maintenance organizations (HMOs) and point-of-service (POS) plans. See Managed Care Plans.
- Consumer driven health plans (CDHPs) allow employees to combine a high deductible plan with flexible benefits tailored to their individual needs. See Consumer Driven Health Plans.
- The Patient Protection and Affordable Care Act was enacted in an effort to expand health care coverage; control health care costs; and improve how health care services are delivered. See The Patient Protection and Affordable Care Act.
- Employers may offer comprehensive medical coverage as well as prescription drug, dental and vision coverage. See Standard Health Care Packages.
- Cafeteria plans give employees the flexibility to tailor benefit packages according to individual needs and reduce their federal income tax. See Section 125 Flexible Benefit Plans.
- Cafeteria plans must meet the requirements of the Internal Revenue Code (IRC). See Section 125 Flexible Benefit Plans.
- Flexible spending accounts (FSAs) allow employees to pay for eligible medical and dependent care expenses with pre-tax dollars. See Flexible Spending Accounts.
- Employers may design benefit packages to meet the needs of a multigenerational workforce. See Meeting the Needs of a Diverse Workforce.
The following states have additional requirements for this topic under applicable state law.
- District of Columbia
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia