What is a metal tier?
All health insurance plans in the market are broken into four metal tiers: Bronze, Silver, Gold, and Platinum. These metal levels differ in how the costs of your healthcare are split between you and your insurance company. Generally speaking, plans with higher premiums have lower annual deductibles. Plans with lower monthly premiums tend to come […]
How does my monthly premium get paid?
Once you sign up for health insurance through BEN360, you don’t have to worry about paying the insurance company directly. Benafica automatically remits your monthly premium on your behalf. If your plan costs more than your employer’s ICHRA contribution, we work with your employer to deduct the difference from your paycheck, typically on a pre-tax […]
How can I make sure my prescriptions are covered?
Insurance plans typically classify drugs into tiers: Tier 1 to Tier 4. You can find more information on how much you will pay for each drugs in each tier in your plan’s Summary of Benefits. Tier 1 drugs are generally generic versions of brand name drugs and require the lowest copayment while Tier 4 drugs […]
How can I make sure my doctors are in-network?
During enrollment, you can use the BEN360 provider search to look up your preferred medical providers and exclude plans which they do not accept. We also always recommend that you verify which individual insurance plans your preferred medical provider accepts by calling their office or looking on their website. Your provider may sometimes list only group plans […]
What’s the difference between on-exchange and off-exchange plans?
When browsing health insurance plans in the app, check the labels next to each plan’s name to understand its type. Definitions: On-Exchange: BEN360 purchases this plan for you from the Health Insurance Marketplace (“Exchange”). Off-Exchange: BEN360 purchases this plan for you directly from insurance companies. On & Off-Exchange: This plan is available both on-exchange and off-exchange. You […]
What happens if I leave the company?
If you decide to leave your job or you are terminated/laid off, your allowance stops when your employment ends. However, the individual health insurance plan is yours to keep, and you can continue paying for it on your own.
Understanding health plan terms (premium, deductible, OOP max, etc.)
Choosing a health insurance plan is easier when you understand the key terms used to describe how your coverage works. Below is a simple guide to the most common health care terms you’ll see while shopping in BEN360. Your premium is the amount you pay each month to keep your health insurance active. Think of […]
I am already enrolled in my spouse or parents’ insurance plan. Can I use my company’s ICHRA contribution to pay for my share?
Your company’s ICHRA contribution CANNOT be used to pay for a group or individual plan coverage from your spouse or parents’ insurance plan, even if you are included on their plan. You have to be the primary enrollee in order to claim the ICHRA contribution towards the plan.
Can I use an ICHRA to reimburse my Health Sharing Ministry membership?
Per the Internal Revenue Code §213(d)(1)(d), you cannot use ICHRA money to reimburse your membership for a health ministry.
Can I receive ICHRA money for COBRA coverage?
COBRA premiums are considered a qualified medical expense. If your employer offers an HRA account (“Health Wallet”), you can use this account to cover a portion or all of your COBRA premiums. However, you must also purchase an individual health plan. This means you will have two health insurance plans. Keeping your COBRA plan typically does […]