A professional licensed health insurance advisor discussing plan documentation with a client across a wooden desk in a modern daylight office
A professional licensed health insurance advisor discussing plan documentation with a client across a wooden desk in a modern daylight office

Coverage Overview

Understanding Group Health & Medicare Options

Navigate employer group plan structures, metallic coverage tiers, ancillary benefit packages, and Medicare options with clear, expert guidance from local brokers.

Employer Coverage

Group Health Plans & Metallic Tiers

Select the ideal health coverage structure based on business size, risk preference, and employee needs.

Funding Structure
Funding Structure

Fully Funded Plans

Partially Self-Funded Plans

The employer pays a fixed monthly premium to the insurance carrier. The carrier assumes all financial risk (minus the deductible and out of pocket max) for medical claims, providing complete budget predictability.

Employers pay actual health claims as they occur while purchasing stop-loss coverage to cap major risks, unlocking potential savings for healthy group populations.

Small Group (1-50)

Mid Group (51-100)

Large Group (101+)

Community-rated benefit plans designed for small businesses with streamlined compliance and standardized metallic tiers.

Flexible plan designs bridging small group simplicity with customizable benefits and partial self-funding opportunities.

Custom-engineered benefit strategies featuring tailored networks, wellness programs, and detailed claims data analytics.

Bronze Tier

Silver Tier

Gold Tier

Platinum Tier

Covers roughly 60% of care costs. Features lower monthly premiums paired with higher deductibles for major protection. Usually bundled with a Health Savings Account.

Covers roughly 70% of care costs. Delivers balanced cost-sharing between monthly payments and out-of-pocket expenses.

Covers roughly 80% of care costs. Higher monthly premiums offset low deductibles and predictable copays for care.

Covers roughly 90% of care costs. Highest monthly premium with minimal out-of-pocket costs for frequent care needs.

Supplemental Lines

Ancillary Business & Voluntary Benefits

Round out healthcare plans with essential voluntary protections that safeguard employee health and financial wellbeing.

Dental Coverage

Vision Coverage

Pharmacy Benefits

Life: Term vs. Whole

Covers routine diagnostic exams, preventive cleanings, basic fillings, and major restorative services including crowns and oral surgery.

Provides full annual eye examinations plus annual allowances for prescription eyeglass frames, corrective lenses, and contact lenses.

Structured formulary management covering generic, preferred brand, and specialty maintenance medications with clear copay tiers.

Term Life offers high-value protection over fixed terms. Whole Life provides lifetime protection with (or without if chosen) guaranteed cash value buildup.

Senior Coverage

Medicare Parts & Supplemental Options

Clear definitions of Original Medicare parts and private supplemental coverage designed to protect individual retirees.

Hospital Care
Medical Services
Medigap Policies

Medicare Part A

Medicare Part B

Supplemental Plans

Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and home healthcare services for qualifying beneficiaries.

Covers outpatient medical care, physician visits, preventive exams, durable medical equipment, lab work, and routine healthcare services.

Private Medigap policies designed to pay out-of-pocket costs left by Part A and B, including deductibles, copayments, and coinsurance.

Get a Customized Plan Breakdown

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