Voluntary and ancillary benefits: dental, vision, life, and disability
Ancillary benefits are the coverage that sits beside medical: dental, vision, group term life, and disability. Some employers pay all or part of the premium. Some offer the coverage as a voluntary benefit the employee can buy through the group. Either way, the work is to build a program that is coherent with the medical plan or HRA, not a stack of unrelated policies.
For companies with 2 to 50 employees, these benefits are often how the package feels complete when the medical contribution is already set. They are also useful when medical coverage is an ICHRA or a QSEHRA, because dental, vision, life, and disability are issued as their own policies and do not have to travel with the individual medical plan an employee selects.
This page does not rank carriers and does not quote premiums.
Dental and vision
Group dental and group vision plans can be offered with a group medical plan, or on their own next to an HRA. Some employers contribute. Others offer the plans on a voluntary, employee-paid basis.
If you enroll through SHOP, HealthCare.gov describes SHOP health and/or dental insurance. Whether a dental-only SHOP plan is available depends on the state. We will check that rather than assume medical is required.
Employee contributions for eligible group dental or vision premiums can often be taken pre-tax through a Section 125 premium-only plan, when the cafeteria-plan rules allow it.
Life and disability
Group term life and short-term and long-term disability are covered in more depth on the group life and disability page, including the $50,000 group term life tax exclusion under Internal Revenue Code § 79 and the tax treatment of disability benefits. Those benefits can be employer-paid, employee-paid, or a mix.
How we put a package together
A typical review for a company in this size range looks at:
- The medical structure you are using or considering — group, level-funded, SHOP, ICHRA, or QSEHRA
- Which ancillary lines you want the company to pay, and which should be voluntary
- Eligibility: who is covered, and whether waiting periods will match the medical plan
- Payroll: pre-tax deduction where the Code allows it, and a clear explanation where it does not
- Multi-state issuance, so a line is not promised in a state where it cannot be written
We will present ancillary coverage as part of one proposal, not as an afterthought at enrollment.
Frequently asked questions
Can we offer dental and vision if medical coverage is an ICHRA or a QSEHRA?
Often yes, as separate group policies. A QSEHRA, however, is not available if you offer a group health plan to any employees, so whether a particular dental or vision arrangement is a "group health plan" for that test should be confirmed before you adopt both. We will flag the issue.
Do employees have to take ancillary coverage to get medical coverage?
Not as a federal rule we would rely on here. Eligibility and any participation rules are set in the policies and, for SHOP, in the applicable SHOP requirements. We will not design a package that forces a medical election through an ancillary product.
Can ancillary premiums go through the cafeteria plan?
Eligible group dental and vision premiums often can, through a premium-only plan. Life and disability treatment depends on the policy and on whether you want the tax result described on the life and disability page. We will map each line before the first payroll deduction.