> Exclusive Provider Organization (EPO) EPOs allow subscribers to visit any physician within the contracted network without prior approval or referrals. Services received outside the network may not be covered.
> Indemnity Indemnity plans are also referred to as “fee-for-service.” Unlike managed-care plans, indemnity plans allow absolute freedom in selecting physicians or medical facilities and permit self-referral to a specialist.
> COBRA Benefits COBRA stands for “Consolidated Omnibus Budget Reconciliation Act of 1985,” which requires companies with 20 or more employees to offer separating employees the option to continue their group health-care coverage at their own expense.
Rhode Island Insurance Advisors & Nationwide News:
COBRA Health Benefit Provisions
The landmark COBRA health benefit provisions became law in 1986. The law amends the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to provide continuation of employer-sponsored group health coverage that otherwise might be terminated. The Centers for Medicare & Medicaid Services (CMS) has advisory jurisdiction for the COBRA law as it applies to state and local government (public sector) employers and their group health plans.
The COBRA law generally applies to group health plans maintained by employers with 20 or more employees in the prior year. The law does not, however, apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations or the federal government.
Individuals who work for a state or local government employer, and their dependents, should be aware of their rights regarding COBRA. A good starting point is reading your summary plan description (SPD) booklet, if a state or local government employer distributes an SPD to its employees. Most of the specific rules on COBRA rights may be found there or with the person who manages your health benefits plan.
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LLC envelope offers substantial advantages over other entities
There are at least five common circumstances when a tax regime other than an S corporation may be more appropriate: 1) the business cannot qualify as an S corporation; 2) the one-class-of-stock limitation for S corporations cannot accommodate certain business terms agreed to by the parties; 3) the business involves appreciating assets (i.e., assets that have, or are likely to have, a fair market value in excess of basis), such as real estate; 4) the business has considerable debt and the owners anticipate significant losses;15 and 5) the wage-reduction tax strategy explained previously will not benefit the owners because either the primary income of the business is excluded from self-employment tax16 or, in the case of newly formed companies, one or more employee-owners already receive aggregate wages or self-employment income from an existing business in an amount which approaches the taxable wage base limitation
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