Employee and Employer Health Benefits Glossary

Understand group health insurance basics and options for small businesses, HR managers, and employees to optimize benefits and costs.

Learn how GCHRA (Group Coverage HRA) works for small businesses, offering flexible health benefits while simplifying employer and employee responsibilities.

Learn what a Fully Insured Plan is and how it impacts small business owners, HR managers, and employees in health benefits choices.

Learn how full-time equivalent (FTE) employees are calculated, why the count matters for ACA rules, and how part-time hours affect employer obligations.

Learn what Full-Time Employee (FTE) means and how it affects small business benefits, compliance, and health insurance options.

Learn how Form 8941 applies to small business health benefits and how it affects employer and employee tax credits and reimbursements.

Learn everything small businesses need to know about Form 720 and its impact on employer-provided health benefits and compliance requirements.

Learn how Form 5500 affects small business health benefits plans and what employers need to know about this essential compliance document.

Guide to dental insurance: coverage types, costs, employer obligations, compliance, and tips for choosing and using dental benefits.

How Direct Enrollment and EDE affect Marketplace subsidies, ICHRA/QSEHRA funding, employer compliance, and employee coverage.

Free help from Marketplace Navigators and Enrollment Assisters — what they do, who can use them, and employer/employee implications for ICHRA and QSEHRA.

Compare brokers, agents, and Marketplace navigators: how they differ, costs, compliance, and guidance for employers and employees.

Learn which preventive services the ACA requires plans to cover without cost-sharing, how no-cost coverage works, employer responsibilities, and employee tips.

Learn what a Primary Care Provider (PCP) is, how PCP selection works, employer responsibilities, costs, and FAQs for employees and employers.

Learn when health plans require medical referrals, how they affect coverage and employer costs, and what employees should do before seeing a specialist.

Understand step therapy: how medication step requirements work, who they affect, and what to expect when plans require a different medication.

Learn how prior authorization works, what employers must budget and administer, employee responsibilities, and steps for requests, denials, and appeals.

A practical guide to specialty drug coverage: costs, prior authorization, pharmacy networks, HRAs, and employer compliance for group and individual plans.

Understand drug tiers, formularies, and how prescription costs affect employees and employers, plus disclosure duties, exceptions, and HRA impacts.