Day to day insurance questions and service needs can pile up. Searching for the answers we need on the internet can often lead to misinformation or confusion.
What do you as an employer do when an employee tells you about a serious health issue and needs help resolving a claim? You know too much now and are likely out of compliance with Health Insurance Portability and Accountability Act (HIPAA). This is a real challenge that most businesses face.
Our Philosophy - "The needs of our customers come first."
At Radwick & Lightle, we have created a culture that is customer-focused. You can expect to receive these service which are a direct reflection of our values:
Dedicated customer service for your business and employees
Employee confidentiality for Health Insurance Portability and Accountability Act (HIPAA) compliance
Answers to individual employee and dependents inquiries regarding benefits, claims, and eligibility
No confusing automated systems to work through
Immediate response to request and continuous updates until resolved
Continuous group administration assistance
New employee enrollments, changes, and terminations
Assistance with Consolidated Omnibus Budget Reconciliation Act (COBRA) compliance, eligibility, and communication
Consultative professional Human Resources (HR) resources and service
Our Core Values
Do what we do passionately
Tell the truth and do good
Empathize with our customers and their request for assistance
Patience for working through each individual's situation
Persistence to reach resolution
Desire to grow and improve by listening to our customers and asking for feedback
Human Resources (HR) Services
We are in an era, with the challenges of navigating Health Insurance Portability and Accountability Act (HIPAA), Employee Retirement Income Security Act (ERISA), Consolidated Omnibus Budget Reconciliation Act (COBRA), and Affordable Care Act (ACA) aka healthcare reform, where employers need their brokers to do more than just renew insurance plans.
At Radwick & Lightle we have partnered with an award winning company that offers more than just a "help line." Our clients receive:
A team of Senior Level Human Resources (HR) experts standing by to listen to your questions and provide answers
A library of training solutions to meet your organization's needs
Job Description & Employee Handbook Builder
Performance Review Tools
Downloadable forms and tools
Compliance & certificate training
When your organization works with Radwick & Lightle, you get much more than a broker. You receive invaluable resources and a trusted advisor and advocate to help you run your business.
We have partnered with an industry leader for an easy to use web and app based Human Resources (HR) and benefits administration platform. As your needs and compliance requirements evolve, change, and scale, our platform and service will scale with you, allowing you to stay in control.
Fully Insured is another way of saying that there is no risk or liability as the policyholder. The insurance company assumes all the risk aside from paid premiums. This is the most common and hands off approach to group insurance.
Typically as the policyholder for a group/organization with less than 100 benefit eligible employees, you won't get any specific data regarding trends of utilization or claims information. Your rates are community based. For groups/organizations with more than 100 benefit eligible employees, you will receive loss and trend information. This is because your rates are now based on the merit of the group and are underwritten by the carrier.
Here are a list of common characteristics of fully-insured health plans:
Rates are fixed up to one year
Monthly premiums only change with the number of enrolled members
Health plans for small groups are community rated and typically age-banded
No risk is passed to the group/organization
Below is an illustration of how fully-insured premiums typically itemize or breakdown:
Partially Self-Funded is the unique answer for employers trying to save money on the cost of health insurance. These programs are usually created by a third party administrator (TPA) who has pre-established vendors who will manage all aspects of the health plan including account management, the prescription drug plan, and stop-loss carrier(s). Employers are given a lot of flexibility in how their plans are designed including selecting which provider network to use (i.e. Aetna, Cigna/Great West, etc.).
Another difference in partially self-funded insurance is in the name. The employer will have a fixed set of premiums for the entire policy year. They will pay a fixed amount for administration fees, individual stop-loss, aggregate stop-loss, and funding for the claims account to give a total fixed cost per employee and their dependents.
Some of the characteristics of partially self-funded are:
Up to 12/21 Contract basis
Internal pooling point maximizes potential for employer refund
Most industries are eligible
Group sizes are typically between 10-200 employees
Unused claims funds are paid back to the group based on the original contract with the third party administrator (TPA) [50% is typical]
Stop Loss insurance offers full protection for larger claims. Employers will never have to pay more than the maximum monthly cost.
The predictability of a fixed monthly cost. There are no extra charges if there are high claims.
Employee Retirement Income Security Act (ERISA) plan that is exempt from some of the new federal Affordable Care Act (ACA) regulations and taxes that equal more in premiums
A vital aspect of any company's employee benefit programs is the other possible lines of insurance beyond health. One of the main reasons employers are finding it harder and harder to attract and retain the best talent is the benefits they offer and the benefits they don’t offer.
Dental, vision, life, disability, and other lines of insurance and benefits are more than just expenses to an organization. According to the Bureau of Labor Statistics in Forbes Magazine, employees feel happier and more appreciated when more benefits are offered by their employer.
At Radwick & Lightle, we leverage our relationships in the marketplace to ensure our clients receive the best rates and coverage. We also try to bundle as many lines of coverage as possible to get multiple-line discounts.
Types of Insurance:
Dental PPO (Preferred Provider Organization) / DMO (Dental Maintenance Organization)
Life & AD&D (Accidental Death & Dismemberment) Insurance
We don’t just install benefits. We assess:
Classification of services ensuring you get what you pay for
Largest network of providers
Cost saving options such as Dental Maintenance Organization (DMO)
Adult & child orthodontia coverage
Waiting periods for late-entrants or enrollments
Definition of disability
Length of benefit
Employee Assistance Program (EAP)
Benefit maximums include top earner salaries
Making voluntary increases available
Portability for employees
Adequate coverage amount
Helping your employees plan for their future is more than just choosing to offer a retirement plan. Radwick & Lightle is prepared to help you consider factors such as:
Types of accounts
Company matching strategies
Post, pre-tax, or both
Overall benefits package