Variable premium amounts per coverage level based on covered amount or payroll.

All rates in iSolved are determined by monthly values and then broken up by pay schedule to determine per-pay deductions for running payroll.

Rate Table Structure

1. What coverage levels exist for the plan? ex. Employee, Spouse, Child(ren)
2. Are the rates cost-banded? ex. costs vary by Age; Salary; Tobacco Use
   • How are the cost bands set up?
3. What are the monthly rates (not dollar amounts) for employees and employers for each coverage level and cost band?

Coverage Amount    

This section is about determining the benefit amount that an employee receives.

1. What is the coverage amount? ex. $50,000; 70% of Annual Salary; Increments of $2,000
2. What is the minimum coverage? ex. $5,000; 10% of another plan's coverage
3. What is the maximum coverage? ex. $250,000; 50% of another plan's coverage; 150% of Annual Salary
4. Is there a grandfathered maximum coverage amount from a previous plan?
5. Does the coverage amount decrease with age?
   • When is age measured? ex. As of Beginning of Plan Year; As of Jan 1st; As of 1st of Month After Birthday
   • How much is the coverage amount reduced by? At what ages? ex. Reduce to 65% at Age 60 and to 50% at Age 75

Premium Amount

These questions help answer how the employee and employer contributions are calculated.

1. Is the premium calculation based on the covered volume or the covered payroll?
2. What unit value is the premium cost based on? ex. Rate per $1,000
3. Which coverage amount should the contributions be based on? ex. Actual Coverage; Requested Coverage
4. Is there a rounding rule? ex. Calculate Benefit Amount, then Round Down, apply Age Reduction, then Round Down again

Guaranteed Issue

This is the coverage amount an employee can receive before Underwriting or Evidence of Insurability is required by the provider.

1. What is the maximum guaranteed issue amount for new hires? ex. $50,000; 70% of Annual Salary
2. Are employees allowed to increase their coverage amounts during open enrollment?
   • What is the maximum amount for late entrants? ex. $50,000; 70% of Annual Salary 
   • How much can previously enrolled employees increase their coverage amount? ex. To $58,000; By $8,000
3. Are employees allowed to increase their coverage amounts during a qualifying life event?
   • Which life events allow increases?
   • How much can previously enrolled employees increase their coverage amount? ex. To $58,000; By $8,000

Example Rates (with cost bands)