Essential Details
With EssentialCare, it's about flexibility. It allows you to assemble the right combination of benefits for employers and decide whether or not to participate with contributions. Choices are:
- Medical/Rx coverage
- Dental coverage
- Vision care
- Life insurance/short-term disability (available through 4 Ever Life Insurance Company)
Whatever your situation, we will work with you to select a plan that's right for your business.
Group Requirements
EssentialCare is the most comprehensive and creative solution available today for employers with 500 or more eligible part-time or hourly employees. It is ideal for service companies such as restaurants, retailers, hotel/motel/casinos, unarmed security, grocery and convenience stores, and staffing. Companies who cannot be covered include trucking, mining, fishing, Professional Employee Organizations (PEOs), and association business (except associations of employer groups where each employer with more than 500 eligible employees chooses to make the coverage available).
If the employer has fewer than 500 employees but is willing to contribute to the plan's cost, the minimum size requirement may be lowered. Contact us for more information.
Eligibility
Any non-benefited hourly employee may enroll in the EssentialCare plan. An employer meeting the group requirements determines the minimum number of hours per week and any employment waiting period for eligibility.
Employees who choose coverage for themselves can elect to add their spouse or dependents up to age 26.
Payroll Deduction
EssentialCare offers a payroll deduction model that accommodates employees who may not take home a paycheck every week. If an employee misses a paycheck or if a paycheck does not cover the premium, the missed premium payment may be made directly to PAI. An employee may make up missed premiums for up to six consecutive weeks - ensuring continuous coverage. After that time, EssentialCare coverage will be terminated and the employee must wait until the next open enrollment period to re-enroll.
Billing Options
Providing EssentialCare benefits to employees is designed to be a smooth process for employers. Employers select how premium payments are made. Options include:
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Payroll Deduction - Employee's coverage typically begins the Monday following the paycheck with the premium deduction. Premium is collected consistently with the company's pay cycles.
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Monthly Bill - This itemized group bill covers employees for the entire month after employees are eligbile and enrolled.
Enrollment
Enrollment in EssentialCare occurs when a new group is effective and annually thereafter during an open enrollment period. New hires may enroll in the EssentialCare plan within 30 days of becoming eligbile.
EssentialCare allows for enrollment changes related to changes in family status, including marriage, divorce, legal separation, death of a spouse, and birth or adoption of a dependent.
EssentialCare offers several enrollment options, and we can talk with you about what suits your work environment: paper application, interactive voice response (IVR) enrollment, or using our convenient Web-based online enrollment system.