Frequently Asked Questions

We handle everything from enrollment and eligibility management to premium billing and FSA/COBRA administration. You gain back valuable time and resources. Our in-depth benefits renewal analysis and market knowledge give you a strategic advantage in negotiations, securing better rates and terms.

Primary Care Insurance Solutions (PCIS) can help evaluate recruiting, onboarding, performance-management and benefits-administration tools. Start with payroll integration, employee count, reporting requirements, security needs and budget, then compare providers against the same checklist. Confirm implementation responsibilities and ongoing fees before choosing.

We conduct comprehensive audits of your benefits programs to identify and address any compliance gaps. We stay informed about new and changing regulations, ensuring your plans, documents, and processes are always up-to-date.

We offer ongoing support for ACA compliance, including reporting and calculations. We provide guidance on FMLA, plan documents, and legislative changes. We even offer medical advocacy services to help your employees navigate complex healthcare issues.

An Applicable Large Employer may owe an employer shared-responsibility payment if it fails to offer the required coverage, or if an offer is unaffordable or does not provide minimum value, and a full-time employee receives a Marketplace premium tax credit. Different payment rules apply to the different failures. Liability depends on the coverage month, workforce and applicable year; confirm the calculation with legal or tax counsel. Source: IRS, Employer shared responsibility provisions.

A wrap document supplements carrier certificates and benefit booklets with ERISA terms they may not include. It can also bring several welfare benefits under one plan document and Summary Plan Description. PCI can help gather current materials, identify changes at renewal, and coordinate document preparation with the appropriate provider.

Federal COBRA generally applies to employer group health plans when the employer had 20 or more employees on more than half of its typical business days in the prior year. Texas continuation may apply to eligible fully insured plans, including some smaller groups. Eligibility, notices, and coverage periods differ, so PCI helps coordinate the applicable process with your carrier or administrator.

A properly established Section 125 plan can let employees pay eligible health premiums before taxes. This can reduce employee taxable income and may lower the employer’s payroll tax exposure. Savings vary, and the plan requires written documents, consistent administration, and nondiscrimination testing. PCI can coordinate those steps with your payroll and plan-administration partners.