Frequently Asked Questions
Business Insurance | Employee Benefits | Personal Insurance
Business Insurance
Q: Who is required to provide workers' compensation coverage?
A: Any employer who employs three or more regular employees.
Note: Every executive officer selected or appointed and empowered in accordance with the charter and bylaws of a corporation is considered an employee of such corporation. For example, a corporation with two officers and one employee would be required to provide workers' compensation coverage. Any employer in which one or more employees are employed in activities which involve the use of or presence of radiation is required to have coverage. (source, NC Industrial Commission Website) http://www.comp.state.nc.us/ ).
A regular employee is not defined by the Statute. Therefore one should use the ordinary definition. Customary, usual, or normal. A business with employees who only works one week a month or one day a week, but do this on a usual or normal basis, would count those employees to see if they have three regular employees. The important thing to remember is not full time or part time, but regular employees.
What constitutes employment is not how someone is paid (1099) but the working relationship. Because many "independent contractors" are really "employees" under common law, many businesses should carry Workers Compensation but do not. The
following link has additional information about what constitutes an employee. http://www.irs.gov/businesses/small/article/0,,id=99921,00.html
Because this issue is so fluid and prevalent, you are advised to seek up to date counsel. We recommend, when in doubt carry Workers Compensation insurance.
Q: Does my Commercial Auto Policy cover a borrowed or rented vehicle?
A: If you auto policy provides Hired Auto Physical Damage coverage then damage to the rented vehicle from an accident would be coverage. Loss of use and other charges by the rental company may not be covered.
In general coverage for a borrowed vehicle would be limited to liability coverage and no coverage to the vehicle itself. To be certain contact us to discuss your specific situation.
Q: What happens if I loan my company vehicle to someone.
A. When you loan your vehicle you loan your insurance with it. In most states and situations the insurance is certified on the vehicle and not the driver. You should only let responsible drivers use your vehicle for reasonable purposes.
Q: Is my property in transit covered? If I keep property for others or have others keep property for me, is it covered?
A: This is three exposures. First your property, such as equipment, inventory, samples, or stock, would be covered if you carry some transit insurance. Some policies extend this coverage in limited amounts for a nominal premium as part of their package policy.
The second and third exposures are Bailees insurance, when you (Bailor) keep property for someone else or they keep property for you( Bailee). If you keep property for someone else your contents should provide coverage for this up to the limits of your policy. There could be limits, unless specific changes in the policy are made. If someone else is keeping property for you, you cover this under your policy or let the Bailor provide coverage. We recommend you contact us with the specific need for discussion to ensure you are properly covered.
Q: I have entered into a lease with some one. What should I look for?
A: Leases are full of pitfalls:
Is the Landlord an "additional insured" under my policy?
Am I responsible for parts of the building such glass or HVAC equipment?
Do I have to insure the building for my Landlord?
Each lease is different. We recommend that you consult with your attorney and our office to see just what you responsible for.
Employee Benefits
Q: What is a health saving
account (HSA)?
A: The HSA is an account that allows you to pay or be reimbursed
for certain medical expenses. An HSA can only be used in conjunction
with a high deductible health plan (HDHP).
Q: What is an indemnity dental plan, and how does it work?
A: With an indemnity dental plan, you may use any qualified dentist
you wish to receive covered services. Generally, your dentist
bills you directly and you file forms to be reimbursed.
Q: What is preauthorization?
A: Preauthorization is the process by which an HMO reviews the
proposed treatment and tells you and your doctor how benefits
may be paid. Generally, preauthorization care is paid at the
highest level of coverage.
You must obtain preauthorization for certain covered expenses
such as a hospital stay. If you do not get the required preauthorization,
your cost will be higher because the benefits payable by the
plan will be reduced or the expenses will not be covered at all.
Q: What happens in an emergency?
A: In a true emergency, get the care that you need as quickly as
you can. Assuming you are able, try to contact your HMO, even
in an emergency. However even if you are unable to contact your
HMO, get the care you need. Even if you need to seek care from
a non-HMO provider, your plan will cover emergency care as long
as you follow the plan rules.
Check to see how your plan defines a true emergency. Examples
typically include severe bleeding, chest pain, and unconsciousness.
Also check to see how soon after the onset of the emergency you
must notify your HMO in order to be covered.
Q: What is a Long-Term Disability (LTD) plan?
A: A Long-Term Disability plan is designed to work with other resources
of disability income to replace part of your income if you become
disabled as defined by the plan.
LTD plan benefits generally begin after an elimination period,
and end at the earliest of:
- When you are no longer disabled as defined by the plan,
or
- You leave your employer for any reason other than a covered
disability
- When you reach the limit for receiving LTD benefits, which
for may plans is an age limit, or
- Your death.
Q: What is a Short-Term Disability (STD) plan?
A: A Short-Term Disability (STD) plan replaces part of your income
if you become disabled as defined by the plan. Benefits generally
begin after an elimination period and end at the earliest of:
- When you are no longer disabled and defined by the plan
- When you stop working
- When you reach the limit for receiving STD benefits, or
- Your death.
Q: What is a health care Flexible Spending Account (FSA)
and hoe does it work?
A: A health care Flexible Spending Account (FSA) allows you to
set aside pre-tax dollars form you pay to cover eligible health
care expenses (medical, dental, vision, and hearing) for you,
your spouse and your eligible dependents.
Your company can call an FSA by another name, such as a reimbursement
account.
Q: What is the Consolidated Omnibus Budget Reconciliation
Act (COBRA)?
A: COBRA is a federal law that applies to most employers’ health
benefit plans with 20 or more employees. COBRA gives you the
right to continue group health care coverage for a limited period
for yourself, your spouse, and qualifying dependents if you:
- Lose coverage because of reduced work hours; or
- Lose your job for any reason other than “gross misconduct.”
COBRA also enables a spouse and dependent children to continue
coverage when an employee becomes entitled to Medicare, divorces
or dies. An employee’s children qualify for continued coverage
under COBRA if they lose “dependent child” status
under the rules of your health plan. You have 60 days after qualifying
for COBRA coverage to decide whether you want it. If you accept
it, you pay the premium, plus a two percent administrative fee,
out of your pocket. Depending on the situation, coverage may
continue fro 18 to 36 months.
Personal Insurance
Q: What happens if I loan my personal vehicle to someone?
A: When you loan your vehicle you loan your insurance with it. In most states and situations the insurance is certified on the vehicle and not the driver. You should only let responsible drivers use your vehicle for reasonable purposes.
Q: What happens if I borrow another vehicle?
A: The insurance on the vehicle you are borrowing will come first and your insurance would apply on an excess basis. It is important the vehicle you are driving have adequate insurance, especially if it carries passengers such as a church bus or van.
Q: Does my Homeowners policy cover my part time or home based business.
A: The Homeowners policy is primarily designed to cover personal activities and not business activities. There is limited property coverage on premises and very limited property coverage away from your home. Liability coverage is similar, limited on premises and very limited away from premises. As each business activity is different, please consult us to take care of your need.
Q: Does my Homeowners or Personal Auto insurance cover my ATV, motorcycle, moped, or other recreational vehicle?
A: Your auto policy usually only extends to licensed vehicles shown on your policy. Your Homeowners policy is not auto insurance. It should not be looked to for coverage. The Homeowners policy does extend to vehicles used for the upkeep of the premises, such as riding mowers.
Q: Does my Homeowners insurance cover my collection, such as guns, stamps, jewelry, art work, antiques, toy trains, or other unique collectible items?
A: The standard Homeowners policy is designed to cover items of ordinary living such as furniture and clothing. Items of particular value, such as jewelry and furs, have limited coverage. Items of unique value, such as paintings or antiques, could have limited coverage. These items can be scheduled or covered under a blanket policy. Call us for details.
Q: What are the levels of licensing in N.C?
A: License Eligibility / Requirements
Level 1 - Limited Learner's Permit involves parents, guardians and/or other responsible drivers in the training of young drivers.
- Must be 15 or older, complete driver's education and obtain limited learner's permit.
- For at least 12 months, the Level 1 driver must be supervised by parent, guardian or other approved licensed driver who has been licensed at least five years.
- All people in vehicle driven by Level 1 driver must wear a seat belt, and only the supervisor can ride in the front seat.
- For the first six months, a Level 1 driver may only drive from 5 a.m. to 9 p.m. with his or her supervisor.
- For the second six months, a Level 1 driver may drive at any time with his or her supervisor.
Level 2 - Limited Provisional License protects young drivers during the night time hours when they are most at risk.
- Drivers must be at least 16 years old, but less than 18.
- All passengers must be restrained by seat belt or child safety seat.
- Supervising driver must be seated beside the driver.
- You may drive without supervision from 5 a.m. until 9 p.m. and at any time when driving directly to or from work or any volunteer fire, rescue or EMS (emergency medical service), if you are a member.
Effective December 1, 2002, a new law (NCGS 20-11(e)(4) was passed regarding the passengers in a motor vehicle. The law applies to limited provisional licenses (Level 2) issued on or after December 1, 2002. The law allows for passengers under 21 in two scenarios:
- The number of passengers allowed in a motor vehicle under the age of 21 is restricted to ONE when the driver of the vehicle is the holder of the Level 2.
- If all passengers under the age of 21 are members of the driver's immediate family or member of the same household as the driver there is no under 21 limit.
If the supervising driver is in the car, this restriction does not apply.
Note: Before graduating to Level Three, you must keep this license for at least 6 months and have no convictions of moving violations or seat belt infractions within the preceding six months.
Level 3 - Full Provisional License rewards violation-free driving.
- Unsupervised driving is allowed at any time
- Level 3 driver is subject to all other conditions of provisional license.
|
