Travel adds stress in emergency situations. Traveling overseas on a combined family vacation and business trip to seal a major client contract, Sharon's son became very ill. "We took him to a local clinic," Sharon says, " But... 
It was a great opportunity for the whole family, not just for me and the business. But we needed to make certain that our daughter had access to the care she needs. David says...
(Q.) Who is typically covered by the Executive Health plan?
(A.) The Executive Health program is designed for the key personnel of an organization as defined by the client. It typically includes those for whom they wish to provide an extra level of coverage and who are critical to protect, retain, reward or help recruit. The client can selectively define the class of employees without losing the tax advantages provided by IRS Section 105(h). Our array of plan designs for supplemental medical reimbursement and Executive Health allow clients the flexibility to tier programs for different groups of key personnel.
(Q.) Who is eligible for the plan?
(A.) Eligible members include employees, board members or the surviving spouse of an employee who is covered by the company’s core health plan and who has been named as part of the eligible class as determined by the company. In most states, Executive Health can be made available to retirees and provide supplemental benefits to both commercial health plans as well as Medicare.
All members of the defined class must be included in the program, but the company has complete flexibility in defining the participating class. Those selected, as well as their dependents, are eligible for coverage as long as they continue to be covered under the core health plan.
(Q.) What coverage type is available?
(A.) There are three coverage types: Employee, Employee plus One, and Family. The Executive Health coverage type must match the coverage type elected for the underlying health plan. For example, if the employee has elected family coverage in the corporate heath plan, then he/she must also have family coverage under the Executive Health program.
(Q.) What are the plan design options?
(A.) There are two plan design options available. Coverage options are based on the size of the covered
executive group. Click here for available plan options.
(Q.) What are the requirements for the underlying health plan?
(A.) Our product coordinates with virtually any underlying health plan design, thus providing companies full flexibility to supplement any core plan that meets overall business objectives, ensuring we are in step with contemporary health plan designs such as High Deductible Plans and HRAs.
(Q.) What is the minimum number of participants?
(A.) We offer plans for 3 or more participating executives and companies with 10 or more total employees (not participants). Certain States have small group regulations that prevent us from offering our products to small employers. Additional options are available for executive groups of 15 or more.
(Q.) Does the maximum annual benefit renew each anniversary?
(A.) Yes, the benefit is annual and starts anew when the client renews the policy. Our program does not limit the lifetime benefits.
(Q.) What expenses are covered?
(A.) Generally, expenses eligible under Section 213 of the IRS code are covered (See policy for more information.) The Executive Supplemental Reimbursement Plan extend coverages beyond the coverages, exclusions and limitations as provided for in the core health plan policy. The spectrum of reimbursable expenses provide attractive benefits to the executives and supports good health and wellness for the company. Each year there is also reimbursement for a high-end Executive Physical for a covered employee and spouse at a renowned facility.
Examples of covered expenses include:
(Q.) What expenses aren't covered?
(A.)There are some exclusions and limitations to the program as outlined in the plan policy. Exclusions under the policy include but are not limited to:
(Q.) How does reimbursement work?
(A.) Reimbursement is easy and fast. When a member receives an Explanation of Benefits statement for services from their health plan, he/she sends the EOB with a claim form directly to our dedicated claims center for rapid processing and reimbursement. Reimbursement generally takes 5 to 7 days from receipt and claims are continuously processed. To maximize convenience and speed of processing, a member may submit claims via mail, fax or e-mail.
(Q.) Is there a waiting period for pre-existing conditions?
(A.) There is no waiting period. There is no medical underwriting required for this plan.
(Q.) Does the maximum annual benefit, the maximum per occurrence benefit or the maximum per individual benefit limit the medical evacuation benefit as well?
(A.) No. The medical evacuation benefit is provided in addition to other coverages as described and is not subject to the overall or internal limits of the medical reimbursement component of the plan. The benefit is available when more than 100 miles away from home and up to two evacuations per family per year, domestically or internationally.
(Q.) How much does the product cost?
(A.) Pricing is actuarially calculated for each company and is based on a few simple parameters of the company’s core health plan, census demographics and location information of the covered group. To receive a proposal, contact ArmadaCare or complete the online Request for Proposal form on this web site.
(Q.) What are the tax benefits?
(A.) Because our programs qualify under IRS Section 105(h) employers providing this program to selective groups of employees are allowed to deduct the program costs (premiums) as an ordinary business expense and premiums paid are not included as W-2 compensation to the employee. This creates a powerful cost-value leveraging impact in addition to the enormous benefits of our programs.
As with any tax matter, we advise clients to consult their legal and tax advisors to determine federal and state tax ramifications.
*This is not local, state or federal tax advice. It is recommended that you seek the independent counsel of a professional tax advisor.
