Useful Links & Resources
Understanding your options shouldn't require a law degree or an insurance background. These resources are built for employers and HR managers who need clear, practical answers about group coverage, plan structures, and enrollment — whether you're setting up benefits for the first time or evaluating what you already have.
Deductible
The amount an employee pays out of pocket for covered services before the insurance plan begins to pay. Deductibles reset annually and vary by plan type and tier.
Coinsurance
The percentage of costs an employee shares with the plan after the deductible is met. Common structures are 80/20 or 70/30, with the first number representing the plan's share.
Out-of-Pocket Maximum
The most an employee will pay in a plan year before the insurance covers 100% of covered costs. Once this limit is reached, the plan pays the remainder.
Premium
The fixed monthly amount paid to maintain coverage, regardless of whether the employee uses medical services. Employers typically cover a portion of the premium as part of the benefit package.
SHOP Marketplace
The Small Business Health Options Program, a federal marketplace where qualifying small employers can shop for group health and dental coverage. Eligibility is based on group size and employee hours.
Open Enrollment
The annual window during which employees can enroll in, change, or waive coverage. Outside of open enrollment, changes are typically limited to qualifying life events such as marriage, birth, or loss of other coverage.
Qualifying Life Event
A change in circumstances — marriage, divorce, birth of a child, or loss of existing coverage — that allows an employee to make benefits changes outside of the standard open enrollment period.
EOB (Explanation of Benefits)
A statement from the insurance carrier showing what was billed, what the plan paid, and what the employee owes after a claim is processed. An EOB is not a bill — it is a record of how the claim was handled.
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How a Benefits Broker Supports Your Business Year-Round
Control Group Health Costs
Understanding your options shouldn't require a law degree or an insurance background. These resources are built for employers and HR managers who need clear, practical answers about group coverage, plan structures, and enrollment — whether you're setting up benefits for the first time or evaluating what you already have.
Control Group Health Costs
Working with a broker is not a one-time transaction. Summit's role includes plan design and carrier comparison at setup, employee education and enrollment support, claims guidance when issues arise, and renewal review every year. Employers in Jackson, Star Valley, and Idaho Falls get a local advisor who knows their team and picks up the phone when something needs attention.
