Benefits Terms and Conditions

Terms and Conditions

Employer Adoption Agreement

You have reviewed, understand and accept the entire group insurance benefits and/or flexible benefits product offering that is being made available to you and your employees through your co-employment relationship with Engage PEO as defined in the Client Service Agreement.  All of the health and welfare benefits offered to you through Engage PEO are component parts of the Engage PEO Health and Welfare Plan, of which Engage PEO is both the Plan Sponsor and the Plan Administrator.  In addition, these benefits are made on either an employer-paid basis (if you so elect), employee/employer-paid basis (if you so elect) or on a voluntary employee pay-all basis based on the rates and coverage levels indicated in the Engage Benefit Plan Offering and the Group Supplemental Benefit Plan Offering, which have been completed in accordance with the insurance carriers' rates (inclusive of any applicable Fees), underwriting requirements and specific individual and group benefit plan terms and conditions.  It is your responsibility to appropriately identify and disclose any and all related companies, common ownership and control group situations; all employees who are eligible for said benefits; to ensure that all regulations are adhered to in accordance with the law; and to complete the owner affidavit and comply with instructions provided on the Engage Benefit Plan Offering.

You understand that the following benefits will be made available to each employee who is eligible for benefits at your company (please note employees must be "co-employed" in order to be eligible for these benefits). Refer to the applicable insurance carrier Summary of Benefit Coverages or Certificates of Coverage provided for full details of plan guidelines and available benefits.

All full-time employees may be eligible for the benefit plans as outlined in these Terms and Conditions which may be on an employer/employee cost basis:

  • AETNA Medical Plans
  • AETNA Group Dental Options (employer contribution optional)
  • AETNA Group Vision Plan (employer contribution optional)
  • Kaiser Permanente Medical Plans
  • MetLife Group Life, Long-Term Disability, or Short-Term Disability (employer contribution optional)
  • Employee Assistance Program (EAP) for all Engage Medical, Dental or Vision enrolled employees
  • Health Advocate Advocacy Services for Engage Medical, Dental or Vision enrolled employees
  • Engage Flexible Benefits Program (includes Pre-Tax Premium Plan and Flexible Spending Accounts)
  • Health Care Flexible Spending Accounts (Full and Limited) - subject to IRS Code Section 125
  • Dependent Care (Day Care) Flexible Spending Account - subject to IRS Code Section 125 and Section 129
  • Health Savings Accounts (HSAs) - pre-tax - subject to IRS Code Section 125
  • Transit and Parking Commuter Benefits - subject to IRS Section 132(f)

All full-time employees may be eligible for the following Ancillary/Supplemental plans which may be on an employee pay-all basis:

  • MetLife Employee Paid Group Accident insurance
  • MetLife Employee Paid Group Critical Illness insurance
  • MetLife Group Hospital Indemnity Insurance (SHOP)
  • MetLife Pet Insurance
  • CHUBB Hospital Buffer
  • Prepaid Legal Employee Paid Group Legal Services Plan
  • Pet Assure Employee Paid Pet insurance

Once your elections have been finalized, they are valid through the end of the Plan Year (December 31, 2022). You may not drop or stop offering benefits mid-year without a regulatory approved qualifying event. The next time that you may make any changes to the benefits offered will be the Plan's next Open Enrollment period for January 1, 2023 effective date.

Disclosures

By your signature on the Engage Benefit Plan Offering and your acceptance of these Terms and Conditions, Client acknowledges that it has exercised independent judgment in selecting the benefit options as indicated on the Engage Benefit Plan Offering and the Group Supplemental Benefit Plan Offering, and that Client has reviewed and approves all fees and other amounts (such as commissions) related to such options (“Fees”), including with respect to those payable to Engage PEO and/or a related entity (and which Fees may equal or exceed the actual costs of providing and/or administering such benefit options and are in addition to any expenses that are otherwise permitted to be charged against the respective Plan or Trust).  For the Aetna Medical and Kaiser Medical plans offered, a benefits administrative fee of 2.5% will be charged against plan assets as reasonable compensation to Engage for its provision of plan-related services. For the Aetna Dental and Vision plans offered, a benefits administrative fee of 3.0% will be charged against plan assets as reasonable compensation to Engage for its provision of plan-related services.  For all MetLife Supplemental/Ancillary or Voluntary plans offered, a benefits administrative fee of 4.95% will be charged against plan assets as reasonable compensation to Engage for its provision of plan-related services. Client acknowledges that these Fees are being incorporated into the applicable insurance carrier rates and are reasonable and appropriate.

ACA Compliance

Client understands that if it averages 50 or more full-time or full-time equivalent employees during the prior calendar year, it is subject to the provisions of the Patient Protection and Affordable Care Act (ACA).  Client acknowledges and agrees that Client is responsible to comply with the ACA, including but not limited to, determining its Applicable Large Employer (ALE) status and IRS Controlled Group entities, complying with IRC Sections 6055 and 6056 tax reporting provisions, and paying any assessed IRC Section 4980H Employer Shared Responsibility tax penalties.

Client-Sponsored Plans

Client understands, agrees, and acknowledges that Client is the plan administrator and named fiduciary of any employee-benefit plans that are established or operated by Client as well as, to the extent applicable, any Internal Revenue Code (“Code”) Section 125 plan established or operated by Client, and that Engage cannot and will not be considered to be a fiduciary, plan sponsor or plan administrator of any such plans or any such Code Section 125 plan; Client assumes and retains any and all liability related to such plans and any such Code Section 125 plan; and Client waives any rights it may have or assert against Engage and/or any Engage entity with regard to such plans and any such Code Section 125 plan.  Furthermore, Client understands and agrees that to the extent that Client requests that any pre-tax salary deferrals, within the meaning of and for the purposes established under Code Section 125, for any Client-sponsored plan be made through any Engage “cafeteria plan” under Code Section 125, Client assumes any and all liability related to such deferrals and the Engage Section 125 “cafeteria plan” (to the extent related to such deferrals), and Client further acknowledges and agrees that it waives any rights it may have or assert against Engage and/or any Engage entity (including Engage-sponsored employee benefit plans) in the event of any Client liability related to such deferrals and the Engage Section 125 “cafeteria plan” (to the extent related to such deferrals).