FAQs from Employees
  • An HMO – Health Maintenance Organization, is a health care system shares the risks associated with providing comprehensive medical services to enrollees in a particular geographic region, usually in return for a fixed, prepaid fee. Services provided by health care providers outside the system (sometimes called networks) typically is not covered by HMOs.

  • A PPO – Preferred Provider Organization is a system that provides lower cost health care by providing incentives for members of the PPO to use health care providers who belong to the system but a PPO also provides some coverage for providers who are outside the PPO system.

  • Not necessarily. In most states, once notice is given in a predetermined time period, post accident drug testing can be required of all employees filing a workers’ compensation claim. This is to ensure that each individual is responsible for their own actions. Claims can be reduced or restricted when an employee tests positive. Procedures are in place to ensure accuracy and confidentiality. Post accident drug testing protects the system of coverage from abuse by the wreckless lifestyle choices of few.

  • Many employers have been challenged to provide cost effective solutions to their employees. Costs for care have continued to rise as medical technologies improve, malpractice costs soar and our population continues to age. Please know that most employers are sensitive to your pain and do the best they can for their employees. The cost for not having coverage when you need it is much higher. Consider choosing a lower cost option among those offered by your employer. If you are married, consider the plan offered by your spouse’s employer. Remember, most plans restrict entry at a later date.

  • Most employers record and recognize the original date of hire for determining employee service longevity.

FAQs from Employers
  • By transferring the employees to the PEO and leasing them back to the client, an insurable risk relationship is created between the PEO and the employee.

  • The contractual relationship frequently enables the client company to participate in insurance programs based on the cumulative size of the leased employee group. Large group policies for workers’ compensation can eliminate down payments, audits, and many claims related responsibilities. Risk management becomes a shared responsibility and the PEO has a vested interest in improving the safety record of its client companies. Additionally, the benefits to the employer can include access to “A” rated carriers, fewer lost days, better employee morale, and less hassles. Employee benefits can be made available in a PEO relationship. Some PEO’s negotiate and manage policies on behalf of their client companies, while others offer access to large group policies negotiated on the entire leased employee population. Available administrative tools track enrollment, contribution, billing and reconciliation. Frequently the PEO assumes the responsibility for renewal, COBRA and Section 125 administration. Ancillary products become less of a hassle and employers can offer group term life, dental, vision and disability insurance with fewer participation obstacles. These are great tools for attracting and retaining the best employees.

  • In most cases, the day to day responsibility is assigned to the client employer thus hiring, firing, setting wage and job performance standards remain in-house.

  • A professional employer, sometimes known as an employee leasing company, assumes certain rights, responsibilities and risks inherent to running a business with employees. The relationship is contractual in nature between the client company and the PEO. The relationship created by this contractual agreement allows the client company to take advantage of large scale purchasing in a number of important areas.

FAQs from Individuals Seeking Insurance
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