Overview: Health care insurance provides protection against the risk of medical expenses and generally provides coverage for doctor visits, hospital stays, medicines and other medical expenses defined in the contract. Issuers of group health insurance can assess the risk associated with an employer's group and develop a financial arrangement typically in the form of a monthly insurance premium.
A health insurance policy or contract is a written document that defines the type and amount of health care services covered, and, if both parties agree, are renewable on a periodic basis, usually annually. In employer group health plans, employees usually share the cost of their health plan with their employer by paying their share of premium contributions and by paying deductibles, co-payments and co-insurance.
Tracy Morley, SPHR, Legal Editor
Employee benefits, such as health insurance, sick pay, disability pay, workers' compensation insurance and retirement savings plans, may be subject to withholding for federal income taxes (FIT), Social Security and Medicare (FICA) taxes or federal unemployment (FUTA) taxes. This section assists HR professionals in understanding how each particular type of benefit plan must be structured and how to properly tax and report contributions, reimbursements and distributions in order to ensure compliance with the Internal Revenue Code.
On February 20, 2013, the Department of Health and Human Services (HHS) released a final rule under the Affordable Care Act (ACA) that will allow insurers and states to forge ahead with both federal and state health exchanges. The rule specifically outlines insurance issuer standards related to the coverage of essential health benefits (EHBs) and the determination of actuarial value.
XpertHR's Retail Resource Center for HR: Employee Benefits helps retail employers handle their most vexing employment issues by bringing relevant resources together in one place for easy access.
The requirements of the Affordable Care Act (ACA) go into effect over several years. The following is a summary of major provisions of health reform that are already in effect as well as those that will become effective over the next several years.
HR guidance on the importance of understanding health care insurance.
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