Executive & Employee Benefits

Your business may be running smoothly. You could be making money hand over fist. But don’t be lulled into thinking that a catastrophe could never hit your business. Disasters can strike in many ways; even a minor one could wipe out a lifetime of hard work.

Fortunately, the appropriate business owner’s insurance policy, sometimes called a BOP, can help protect your company in the event of property damage, business interruption, or legal troubles.

A BOP can insure a company’s buildings and equipment in much the same way as homeowners insurance covers a residence and its contents. A standard BOP policy helps protect against a specific list of perils, such as fire, wind, hail, water damage, and vandalism.

It’s advisable to insure for “replacement value” rather than “actual value.” That way, you might not have to come up with extra money to get back to business. The premiums will be higher, but the extra expense may well pay for itself if it means getting back to work in a matter of days rather than weeks or months. You may be able to offset the extra expense by working with the insurer to identify and reduce certain types of risks to help lower premiums.

This coverage is essential if someone were to become injured on your premises, by your employees, or by one of your products. It can be used to pay medical costs for the injured parties or to defend against liability claims, even if a claim is unfounded. Liability coverage also helps protect against claims of slander or libel.

If your business operations cease because of a disaster, this coverage can help replace the lost income and expenses related to operating from a temporary location.

A natural disaster is only one of the many threats facing small businesses. In such a situation, a business owner policy can help put you back in business.

If you own your own business, chances are you’ve at least thought about the conditions under which you will leave the business and who is going to take over after you’re gone. Business continuation is difficult enough under normal circumstances, but if it takes place following the unexpected death of a key person or owner, the complications can increase exponentially.

Company-owned life insurance is one way to help protect a business from financial problems caused by the unexpected death of a key employee, partner, or co-owner. If the covered individual dies, the proceeds from this type of insurance can help in several ways.

A buy-sell agreement typically specifies in advance what will happen if an owner or a key person leaves the company, either through a personal decision or because of death or disability. The death benefit from a company-owned life insurance policy can be used to purchase the decedent’s interest in the company from his or her heirs.

If a decision is made to continue the business, there may be a period when operations cease while the survivors develop a plan to move forward. The death benefit can be used to help replace lost revenue or to pay costs associated with keeping the doors open, including rent, utilities, lease payments, and payroll. It may also help the surviving owners avoid borrowing money or selling assets.

If a business owner has family members who depend on the income from a business, which simply could not continue if he or she were suddenly gone, the proceeds from company-owned life insurance could help replace the lost income and help protect the family’s quality of life while they adjust and move on.

The appropriate coverage amount will depend on several factors. It could be a multiple of the business owner’s annual salary or the company’s operating budget. Don’t forget to factor in such details as the cost of hiring and training a successor, where applicable, and any debts that the family may have to repay.

A thorough examination of a business and the related personnel should be conducted before the exact amount of coverage is determined.

Remember that the cost and availability of life insurance depend on factors such as age, health, and the type and amount of insurance purchased. Before implementing a strategy involving life insurance, it would be prudent to make sure that the individual is insurable. As with most financial decisions, there are expenses associated with the purchase of life insurance. Policies commonly have contract limitations, fees, and charges, which can include mortality and expense charges. In addition, if a policy is surrendered prematurely, there may be surrender charges and income tax implications.

The loss of an owner can be devastating to a small business. A company-owned life insurance policy may help reduce the financial consequences if such a loss were to occur.

Life insurance can be an important part of a business owner’s financial strategy. It can also be a great benefit to offer to key employees. However, sometimes the cost can be prohibitive. With split-dollar life insurance, the cost of life insurance can be managed by splitting it up.

To be clear, split-dollar life insurance is not an insurance product but rather an arrangement to purchase and fund life insurance between two parties, generally an employee and an employer.

Basically, an agreement is made under which a life insurance policy is purchased on an individual. The employer will pay all or a portion of the premiums on the policy, depending on the arrangement. When the individual dies, the employer receives a portion of the death benefit equal to the amount paid in premiums. The remaining benefit goes to the individual’s beneficiaries.

For example, if a $200,000 policy were purchased for an individual who died after the employer had paid $28,000 in premiums, then the employer would get back the money it had paid in premiums and $172,000 would go to the insured individual’s beneficiaries.

This agreement is attractive to both parties because the employer recoups its money and the employee receives a life insurance policy at a better rate because the company is picking up all or a portion of the cost. The death benefit is free of income tax for both parties as well.

A split-dollar life insurance arrangement can be used for a variety of reasons.

• It can be used to fund a buy-sell agreement.
• It can help recruit and retain quality executives.
• Business owners who might not otherwise be able to afford life insurance might benefit from a split-dollar arrangement.

Split-dollar life insurance policies can be set up in different ways. Usually, the individual owns the policy and designates beneficiaries, then by absolute assignment transfers to the employer an amount equal to the premiums paid by the employer. In this case, the individual retains all ownership rights, but when the individual dies, the employer is reimbursed before the individual’s named beneficiaries are paid. If the individual leaves the company, any cash value in the policy would be used to repay the company.

In other arrangements, the policy can be purchased by the employee and assigned to the employer as collateral in exchange for the employer paying the premiums. Because the company holds the policy as collateral, it can be confident that it will recoup the money spent on the insurance premiums.

In some cases, the employer can take out a life insurance policy on the employee. The employer names itself as a beneficiary of an amount equal to the cash value and designates that any funds in excess of that amount will be paid to the individual’s beneficiaries.

The cost and availability of life insurance depend on factors such as age, health, and the type and amount of insurance purchased. Before implementing a strategy involving life insurance, it would be prudent to make sure that you are insurable.

As with most financial decisions, there are expenses associated with the purchase of life insurance. Policies commonly have contract limitations, fees, and charges, which can include mortality and expense charges. In addition, if a policy is surrendered early, there may be surrender charges and income tax obligations.

One of your greatest assets is the ability to earn an income. If you were to lose that ability due to a disabling accident or illness, how would you pay your bills, send your kids to college, and save for retirement?

A disability can create substantial economic hardship for individuals and their families. As a business owner, both your personal finances and your business could be at risk.

One way to help protect against the financial loss associated with a disability is to purchase disability income insurance. If you pay the premiums, an individual policy can provide you with a tax-free income stream while you are unable to work.

When evaluating disability income insurance policies, it’s helpful to consider the following.

• Definition of disability. You can typically choose between “own occupation” coverage and “any occupation” coverage. With “any occupation” coverage, you can claim disability only if you are unable to perform any type of job. This type of coverage is generally less expensive than “own occupation” coverage.
• Amount of monthly coverage. You can purchase disability insurance that will replace a certain percentage of your income —normally up to 50% or 60% of your pre-disability income. You should purchase coverage that will enable you to meet your monthly financial obligations.
• Waiting period. The waiting period represents the amount of time that must pass between the date you become disabled and the date that disability income payments begin. The longer the waiting period, the less expensive coverage will be.
• Benefit period. The benefit period can range from several months to life. The longer the benefit period, the higher the cost of insurance.

A disability income insurance policy could make the difference between financial security and financial hardship. Don’t wait to consider this protection until it’s too late.

Rising health-care costs have driven the demand for, and the price of, medical insurance sky-high. The availability of group coverage through employment has helped many Americans face such costs. However, people who are not currently covered by their employers have few affordable sources for group coverage currently. As a result of the Patient Protection and Affordable Care Act, state and/or regional insurance marketplaces offer coverage to individuals and some small businesses.

Individuals seeking medical coverage on their own can explore purchasing an individual health insurance policy. In addition those age 65 and older may qualify for Medicare coverage.

There are three general classifications of medical insurance plans: fee-for-service (indemnity), managed care (e.g., HMOs and PPOs), and high-deductible health plan (HDHP).

With a basic fee-for-service (indemnity) insurance plan, health-care providers (such as physicians, nurse practitioners, surgery centers, and hospitals) are paid a fee for each service provided to insured patients.

Indemnity plans normally cover hospitalization, outpatient care, and physician services in or out of the hospital. You select the health-care provider for consultation or treatment. You are then billed for the service and reimbursed by the insurance company, or you can “assign” direct payment to the provider from the insurance company. Indemnity plans typically require the payment of premiums, deductibles, and coinsurance. Limits on certain coverage or exclusions may apply. Lifetime limits on benefits are prohibited as are limits on annual benefits.

Managed-care plans became popular in the 1990s as a way to help rein in rising medical costs. In managed-care plans, insurance companies contract with a network of health-care providers to provide cost-effective health care. Managed-care plans include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point-of-service (POS) plans.

Health maintenance organization. A HMO operates as a prepaid health-care plan. You normally pay a monthly premium in addition to a small copayment for a visit to a physician, who may be on staff or contracted by the HMO. Copayments for visits to specialists may be higher. The insurance company typically covers the amount over the patient's copayment.

Each covered member chooses or is assigned a primary-care physician from doctors in the plan. This person acts as a gatekeeper for his or her patients and, if deemed necessary, can refer patients to specialists who are on the HMO’s list of providers. Because HMOs contract with health-care providers, costs are typically lower than in indemnity plans.

Preferred provider organization. A PPO is a managed-care organization of physicians, hospitals, clinics, and other health-care providers who contract with an insurance company to provide health care at reduced rates to individuals insured in the plan. The insurance company uses actuarial tables to determine “reasonable and customary” fees for each type of service, and health-care providers accept the PPO’s fee schedule and guidelines.

The insured can see any health-care provider within a preferred network of providers and pays a copayment for each visit. Insured individuals have to meet an annual deductible before the insurance company will start covering health-care services.

Typically, the insurance company will pay a high percentage (often 80%) of the costs to the plan’s health-care providers after the deductible has been met, and patients pay the balance.

Although insured individuals can choose providers outside the plan without permission, patient out-of-pocket costs will be higher; for example, the initial deductible for each visit is higher and the percentage of covered costs by the insurance company will be lower. Because PPOs provide more patient flexibility than HMOs, they may cost a little more.

Point-of-service plan. A POS health-care plan mixes aspects of a PPO and HMO to allow greater patient autonomy. POS plans also use a network of preferred providers. Patients turn to their preferred providers first and then receive referrals to other providers if deemed necessary. POS plans recommend that patients choose a personal physician from inside the network. The personal physician can refer patients to other physicians and specialists who are inside or outside the network. Insurance companies have a national network of approved providers, so insured individuals can receive services throughout the United States. Copays tend to be lower for a POS plan than for a PPO plan.

An HDHP provides comprehensive coverage for high-cost medical bills and is usually combined with a health-reimbursement arrangement that enables participants to build savings to pay for future medical expenses. HDHPs generally cover preventive care in full with a small (or no) deductible or copayment. However, these plans have higher annual deductibles and out-of-pocket limits than other insurance plans.

Participants enrolled in an HDHP can open a health savings account (HSA) to save money that can be used for current and future medical expenses. There are annual limits on how much can be invested in an HSA. The funds can be invested as the investor chooses, and any interest and earnings accumulate tax deferred. HSA funds can be withdrawn free of income tax and penalties provided the money is spent on qualified health-care expenses for the participant and his or her spouse and dependent children.

Remember that the cost and availability of an individual health insurance policy can depend on factors such as age, health, and the type of insurance purchased. In addition, a physical examination may be required.

Medicare is the U.S. government’s health-care insurance program for the elderly. It is available to eligible people age 65 and older as well as certain disabled persons. Part A provides basic coverage for hospital care as well as limited skilled nursing care, home health care, and hospice care. Part B helps cover physician services, inpatient and outpatient medical services, and diagnostic tests. Part D prescription drug coverage is also available.

Medicare Advantage is a type of privately run insurance that includes Medicare-approved HMOs, PPOs, fee-for-service plans, and special needs plans. Some plans offer prescription drug coverage. To join a Medicare Advantage plan, you must have Medicare Part A and Part B and you have to pay the monthly Medicare Part B premium to Medicare, as well as the Medicare Advantage premium.

Medicare Supplement Insurance, or Medigap, supplements the benefits covered under Medicare.  It also fills in some of the gaps left by Medicare, such as deductible and coinsurance or copayments. Medigap policies are sold by private insurance companies and must be clearly identified as "Medicare Supplemental Insurance." Currently, 10 standardized plans are available (Plans A-D, F and G, and K-N) except in Massachusetts, Minnesota, and Wisconsin, which have their own standardized plans. Each lettered plan corresponds with a certain level of coverage that is identical from insurer to insurer, prices may differ and not all plans are available in every state.

Basically, under the Patient Protection and Affordable Care Act (ACA) for years 2018 and earlier, most individuals who are not covered by employer-sponsored health insurance, Medicare, Medicaid, or another government program are required to have “minimum essential coverage” or pay an annual penalty. Starting in 2019, if you don't have coverage during 2019, the annual penalty no longer applies. You will not need an exemption in order to avoid the penalty. If you’re 30 or older and want to enroll in a “catastrophic” plan for 2019, you must claim a hardship exemption to qualify. A catastrophic health plan offers lower-priced coverage that mainly protects you from high medical costs if you get seriously hurt or injured.

Individuals and families who are not covered by employer-sponsored health plans and who can't afford private health insurance may shop for coverage through health insurance marketplaces created under ACA. A health insurance marketplace is essentially a one-stop health insurance outlet. Marketplaces are not issuers of health insurance. Rather, they contract with insurance companies that make their insurance coverage available for examination and purchase through the marketplace. In essence, marketplaces are designed to bring buyers and sellers of health insurance together, with the goal of increasing access to affordable coverage.

Since 2010, as a result of the health-reform act, adult children up to age 26 have been eligible for dependent coverage under their parents’ health insurance plans provided they are not eligible for their own employer-based coverage. Insurance companies are no longer able to refuse coverage for children (under age 19) with pre-existing conditions nor can adults with pre-existing conditions be rejected or charged higher premiums.