Health Care Benefits: Federal

Original Author: Jayne Zanglein, Western Carolina University

Updating Author: XpertHR Editorial Team

Summary

• 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.
• Association health plans (AHPs) are designed to allow small employers to band together to purchase the types of coverage that are more readily available to large employers. See Association Health Plans.
• Employers may design benefit packages to meet the needs of a multigenerational workforce. See Meeting the Needs of a Diverse Workforce.