Carve Out Coverage

February 26, 2024

Carve-Out Coverage

A Closer Look at Excepted Benefits

Understanding the What, How and Why

Employers of all sizes are looking to do more for key talent, whether that’s expand or shore up coverage or leverage a tax-efficient* way to compensate. How can you support them?

To start, when it comes to carve-out coverage, it’s important to have an understanding of excepted benefits. Why? Excepted benefits are exempt from many of the federal laws that regulate primary insurance health plans, such as nondiscrimination rules.

Four Categories of Excepted Benefits

In order to be an excepted benefit, the benefit must fall within one or more of four categories. Each category is separately defined and has different requirements. Multiple categories can be bundled and offered in a single contract of insurance.

Secondary or incidental Benefits

These are medical benefits included in other kinds of insurance.

Examples Include:

  • Automobile insurance
  • Liability insurance
  • Workers compensation
  • Disability income insurance
  • And more

Limited-scope benefits

As their name suggests, these are benefits that are limited in scope.

Examples Include:

  • Vision
  • Dental
  • Long-term care plans

Since multiple categories can be bundled and offered in a single contract of insurance, ArmadaCare’s dental and vision coverage offered in Ultimate Health would fall under this category.

Independent, non-coordinated benefits

These are benefits that provide hospital indemnity or other fixed-indemnity insurance.

Examples Include:

  • Critical illness insurance
  • Accident insurance
  • Workers compensation
  • Hospital indemnity insurance

Supplements to certain primary health coverage

These are benefits that supplement Medicare or TRICARE, or that provide similar supplemental coverage to an employer-sponsored primary plan.

Examples Include:
ArmadaCare’s supplemental expense reimbursed insurance solutions, specifically the supplemental medical coverage in Ultimate Health.

NEW:  You can pair the Ultimate Health deductible with an HDHP with the option to match the qualifying deductible.

Powerful Problem-Solvers

By leveraging excepted benefit insurance plans, employers can offer carve-out coverage to select employee groups whether they are executives, partners or hard-to-retain employees like nurses, system developers or skilled laborers. Offering such carve-out coverage can be a powerful way for employers to solve a number of benefit and business challenges.

  • Control health benefit costs
  • Reduce out-of-pocket (OOP) healthcare expenses
  • Lessen impact of primary plan changes
  • Enhance retention and reduce turnover
  • Increase employee satisfaction and loyalty
  • Provide meaningful compensation value with tax-efficient* benefits
*This is not local, state or federal tax advice as each person and company is unique. It is recommended that you seek the independent counsel of a professional tax adviser.

ArmadaCare’s Carve-Out Insurance Plans

Now that you know that ArmadaCare’s insurance plans can be carved out by employee class (as defined by the employer), it’s time to discover some of the other advantages of our unique employer-paid supplemental insured plans

  • Coverage for a broad range of routine and unexpected OOP healthcare expenses
  • Not tied to a specific type of condition or event to trigger coverage
  • Various types of coverage to fit different generational needs
  • Flexible start: Can be put in place before, with or after primary plan renewal

Interested in learning more about ArmadaCare’s market-leading supplemental health insurance products?

Get in touch with one of our experts. You choose the time that’s best for you, and we’ll do the rest!

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