Frequently asked questions
Straight answers to the questions we hear most from employers, employees and families.
Working with us
How much does it cost to work with The Foxhound Group?
For most employer health plans, individual plans and Medicare plans, there is no fee to you. Carriers pay us a commission that is already built into the premium, so you pay the same rate whether or not you use an advisor. If a project calls for a separate consulting fee, we tell you up front.
Where are you located, and do you only work in Colorado?
Our offices are at 2511 31st Street in Boulder and 1336 Oakridge Drive in Fort Collins. We serve clients nationwide: employers, individuals and families in any state. Many are here in Colorado, and we also work with companies based elsewhere and with employers whose people are spread across several states.
What size employers do you work with?
We work with small groups of a few employees up to large self-funded and level-funded employers, with dedicated small-group and group benefits divisions.
Can you help my employees with claims and billing problems?
Yes. Our team is on call for your employees' plan and claims questions and regularly negotiates mis-billed claims with providers and carriers.
How do I switch my benefits to The Foxhound Group?
Schedule a free meeting. If you decide to work with us, we file a broker-of-record letter with your carriers; your plans and coverage don't change, only who is advocating for you.
Employee benefits
What's the difference between fully insured, level-funded and self-funded health plans?
With a fully insured plan, you pay a fixed premium and the carrier takes the claims risk. A self-funded plan pays employees' claims directly, usually with stop-loss insurance to cap large claims. Level-funded plans sit in between: a fixed monthly payment with a self-funded structure, and part of any unused claims money may come back to you. We model all three with your data before you choose.
When should we start preparing for our renewal?
Ideally 120 days before your renewal date. That gives time to collect claims data, go to market and negotiate without rushing your employees through open enrollment.
Do you charge employers a fee for benefits consulting?
For most fully insured plans, no. We are paid by carrier commissions that are already in the premium. For some self-funded arrangements or special projects we may propose a flat fee, and we always disclose our compensation.
Can a small business offer group health insurance in Colorado?
Yes. In Colorado, small-group coverage is generally available to employers with 1 to 100 employees, and options like ICHRAs and level-funded plans can make benefits more affordable. We'll show you what fits your size and budget.
Who has to offer COBRA?
Federal COBRA generally applies to employers with 20 or more employees on more than half of the typical business days in the prior year. Colorado's state continuation law covers many smaller insured groups. We help you figure out which applies and handle the notices.
How long does an employee have to elect COBRA?
Qualified beneficiaries generally have at least 60 days from the later of the loss of coverage or the date of the election notice to elect COBRA, and coverage is retroactive once they elect and pay.
Is your HR software really free?
Yes, for Foxhound Group benefits clients. There are no hidden costs or per-employee fees.
When does open enrollment happen?
For employer plans, open enrollment usually runs two to four weeks before your plan renewal date. Individual Marketplace open enrollment in Colorado typically runs November 1 through January 15.
What does a good benefit guide include?
Plan summaries and costs per paycheck, contribution tiers, eligibility rules, key dates, required notices and who to call for help. We build guides for each client, and can include age-banded rates where they apply.
HR & benefits compliance
Do small employers need an ERISA plan document?
Yes. Almost every private employer that sponsors a health or welfare plan, regardless of size, is subject to ERISA and needs a written plan document and Summary Plan Description. Carrier certificates usually don't satisfy the requirement on their own, which is why many employers use a wrap document.
What is a POP (premium-only plan) and do I need one?
A premium-only plan is a simple Section 125 cafeteria plan that lets employees pay their share of health premiums before tax. If employees pay premiums through payroll pre-tax, you need a written Section 125 plan document.
Which employers must file ACA Forms 1094-C and 1095-C?
Applicable large employers, generally those with 50 or more full-time employees including full-time equivalents in the prior year, must file Forms 1094-C and 1095-C. Smaller self-funded employers file Forms 1094-B and 1095-B.
What is PCORI and who pays it?
The Patient-Centered Outcomes Research Institute fee is an annual per-covered-life fee paid by sponsors of self-funded health plans and HRAs, filed on IRS Form 720 by July 31. For fully insured plans the carrier pays it.
Do employers with fewer than 10 employees have to participate in FAMLI?
Yes. Small employers still have to register, collect and remit the employee share of the premium and provide job protection for eligible employees. They just don't have to pay the employer share.
Can an employer use a private plan instead of the state FAMLI plan?
Yes. Employers can offer an approved private plan, insured or self-insured, if it provides benefits at least equal to the state program and doesn't cost employees more.
Does FAMLI run at the same time as FMLA?
It can. When an absence qualifies under both, the leave may run concurrently, so the employee doesn't automatically get both entitlements back to back.
Individuals & families
When can I buy individual health insurance in Colorado?
During annual open enrollment, which typically runs November 1 through January 15 in Colorado, or within 60 days of a qualifying life event such as losing employer coverage, moving, marriage or having a baby.
Does using an insurance agent cost more?
No. Premiums for individual health plans are the same whether you enroll on your own or with an agent. The carrier pays our commission.
Can you help if I already have a plan?
Yes. We can help with billing problems and claims disputes, and we'll review your plan at the next open enrollment.
Medicare
When should I sign up for Medicare?
Your Initial Enrollment Period is the seven months around your 65th birthday: three months before, your birthday month and three months after. If you're still working with employer coverage, you may be able to delay Part B without penalty; we'll check your situation.
When can I change my Medicare plan?
During Annual Enrollment, October 15 to December 7, you can switch Medicare Advantage or Part D plans for January 1. From January 1 to March 31, people in Medicare Advantage can make one change during the Medicare Advantage Open Enrollment Period.
Should I choose Medicare Advantage or a Medicare Supplement?
It depends on your doctors, travel, budget and health. Supplements cost more each month but offer broad access and predictable costs; Advantage plans usually cost less monthly but use networks and have copays. In Colorado, switching from Advantage back to a Supplement later can require medical underwriting, so it's worth getting this decision right.
Does it cost anything to work with you on Medicare?
No. Carriers pay us, and plan premiums are the same whether or not you use an advisor.
Commercial P&C
What insurance does a Colorado business need?
Colorado requires workers' compensation for nearly every employer with even one employee, and commercial auto for business vehicles. Most businesses also carry general liability and property coverage, often bundled in a business owner's policy, and many contracts and leases require specific limits.
What is a business owner's policy (BOP)?
A BOP bundles general liability, commercial property and business interruption coverage into one policy, usually at a lower price than buying them separately. It's a good fit for many small and mid-sized businesses.
Do we need cyber insurance?
If you store customer, employee or health data, or rely on email and online payments, a cyber policy helps cover breach response, ransomware, lost income and liability. It's one of the fastest-growing claims areas for small businesses.
Can you handle our benefits and our business insurance?
Yes. Our commercial P&C team and our benefits team work together, so one group handles your employee benefits, compliance and business coverage.
Schedule a commitment-free meeting
Tell us what's working and what isn't. We'll review your benefits or coverage and give you an honest plan, at no cost.