Health Benefit Products for Groups

All of the individual types of plans can be purchased on a group basis. Only full time employees may participate in these plans, as determined by the insurance company. (Usually 25 hours per week is considered full time.) It is generally required that the employers pay a percentage of at least the employee portion of the premium. This ensures adequate participation for the insurance companies so as to avoid adverse selection. (Meaning- they don't want your sick employees only)

Health benefit products for groups present several advantages: 

• A variety of plan designs to meet the employees' needs.
• A choice of multiple plan designs and networks (where available) for employees.
• Quality services such as 24-hour customer service and access to information from registered nurses through a subsidiary nurse helpline.
• Optional benefits including group dental, group vision, and weekly income insurance.

When selecting a plan for your employees, you can choose from two different funding arrangements. Depending on your state and group size, the option(s) available include:

• Traditional fully insured health insurance plans. You want a choice of flexible plans for your employees, but you're looking for traditional plans where your business just pays a premium to an insurance company.
• Self-funded health benefits. You want greater control and more detailed information about your plan and how it works, and you're willing to manage more of the plan finances. You also have a relatively healthy group with at least 25 employees.

Different customers have different needs, and we provide customers who have group plans with the following value-added services and benefits.

Maternal wellness program: This program allows pregnant mothers whose AMS-marketed plan includes maternity coverage to access information from registered nurses during their pregnancy.

Multiple plans/multiple networks or It's Your Choice : Employers can combine multiple plan designs and/or multiple networks (where available) into the group benefits package to better meet the needs of their employees. We realize that different people need different plan designs, even if they're part of the same group.

Section 125 Cafeteria Plan : This program may allow employees to reduce tax payments by setting payroll dollars aside in a flexible spending account (FSA) for certain unreimbursed expenses before taxes are applied to their pay.

Group Dental Insurance : Coverage is generally provided for preventive services, (cleanings, x-rays, and exams), minor restorative services (fillings), and major restorative services (crowns, bridges, root canals). Sometimes and optionally, orthodontia is covered.

Dental products offer several advantages including :

• Options for offering dental on a stand-alone, voluntary, or employer-sponsored basis.
• A variety of plan design options to meet employees' needs.
• Dual-choice option where a group may select any two dental plan designs.
• Quality services such as 24-hour customer service and access to information from registered nurses through our subsidiary, Nurse Healthline, Inc.
• Optional vision benefits or tax-saving programs like Section 125 Cafeteria or Premium Only Plans.

    Two options for puchasing group dental with medical insurance include:

• Employer-sponsored where the employer and employees may share the costs of dental insurance.
• Voluntary where employees add dental insurance to their benefits package at their own cost.

Note: Coverage statements are general descriptions only. The full and exact contract is contained only in the policy. Product availability only in the state of Texas.  Please email an agent if you have any questions.