Your Questions, Answered
Avance Health is a group Healthcare Management Platform that offers a Limited Benefit Health Insurance Policy with a Defined Wellness Benefit for employees. Avance combines the benefits of an insured Limited Benefit Health Insurance Policy, underwritten by Companion Life Insurance Company, with additional wellness services available through wellness program partners. This program is designed to supplement current medical/wellness plans not to replace them.
Companion Life Insurance Company underwrites and insures the Limited Benefit Health Insurance Policy. Companion is rated A+ Superior by AM Best. The rating represents an independent opinion from the leading provider of insurer ratings of a company’s financial strength and ability to meet its financial obligations to policy holders as of December 18, 2018. For the latest rating access, www.ambest.com.
An employee voluntarily elects to participate in the Limited Benefit Health Insurance Policy under Code Section 125 and pays a monthly premium for the insurance plan with pre-tax dollars (the cost of which may be offset through payroll tax savings*). The Limited Benefit Health Insurance Policy provides a fixed Wellness Indemnity Benefit payment when an employee incurs one of the wellness services defined in the policy. The policy allows up to one Wellness Indemnity Benefit per month and is not coordinated with other health plan payments.
AmWINS Group Benefits, Inc. (AmWINS) is a Third Party Administrator for Companion Life Insurance Company and is an industry leader in distribution, administration, and program management across the group benefits sector.
The taxation of benefit payments is determined on an individual basis. Generally, any claim payment from the Limited Benefit Health Insurance Policy that exceeds the costs of a participant’s out of pocket medical care expenses, as determined by Section 213(d) of the Internal Revenue Code, may be taxable. However, each participant’s individual tax situation is different, including each participant’stax deductions and itemized deductions on their Form 1040, as applicable. The Limited Benefit Health Insurance Policy is treated equally and operates in the same manner. Please note that Avance Health is not, and does not, provide tax or legal advice and each participant should consult with their own tax advisor, as each person’s situation is different.*
As with 401k plans, major medical, dental and vision plans, the employee’s premium for the Limited Benefit Health Policy is paid for on a pre-tax basis through the use of a Section 125 Plan. Given that an individual’s Social Security benefit is based on various factors, including an individual’s lifetime earnings and age when they started working and for how long they worked, each person’s calculation is different. Generally, however, the Avance Health platform should have a minimal impact as the premium amount for the Limited Benefit Health Insurance Policy is not large enough to impact over 20+ years of average earnings.*
You will not have an option to enroll until your employer’s next Open Enrollment period.
Yes, all information is kept confidential in accordance with HIPAA
No because this program is only available to active employees.
The plan includes coverage for Daily In-Hospital, Initial Hospital Admission, Health Screening, Emergency Room services and Ambulance services.
Generally, employees must enroll in the policy and platform 15 days prior to the policy’s Effective Date. Employees will be assisted in initial enrollment utilizing an online platform through Kersh Health.
Kersh Health is the wellness program partner for the Avance Health program. Kersh Health has been providing population health management for over 20 years across the globe. Employees will utilize the Kersh platform to enroll and complete their monthly Wellness Indemnity Benefit.
To ensure participation throughout the year, the health coaches (and online health coaching) utilize various methods of communication with the participant, including text, email, push notifications and phone. The licensed health professionals have been trained to reinforce the importance of participation in the platform.
Everyone’s clinical pathway to a healthier lifestyle will be different and specific to the individual and their path. For the most part the task will take 10 to 20 minutes each month.
Questionnaires, Health Modules, Coach engagement, Assessments, Goal Setting, etc
The premium deductions and Wellness Indemnity Benefit payments are proportional to your employer’s payroll cycle.
Your Health Optimization task is due by the 25th of every month. This ensures you will receive the Wellness Indemnity Benefit payment in your paycheck on the next payroll cycle.
The benefits payable by the Limited Benefit Health Insurance Policy will generally be paid directly to the employee. However, the Wellness Benefit is paid to the employee through the use of the employer’s payroll system via directly into the employee’s paycheck.
You will receive the Wellness Indemnity Benefit payment through your employer’s payroll system.
No, You are in the program for the full year under Section 125 rules unless you have a qualifying event under Section 125 and your plan rules.
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