Frequently Asked
Questions

General

What is Triada?

Triada is an insurance company that offers group benefit solutions that provide excellent coverage at an affordable price, with policies that are easy to understand and even easier to use. Using state-of-the-art technology, Triada educates and engages customers, so they feel comfortable utilizing their insurance.

What is GAP Insurance?

GAP insurance bridges the divide between what your health insurance will cover and what you’re expected to pay as the result of an injury or illness. It can reduce or even eliminate the out-of-pocket expenses you or your family might face. To learn more, watch our video.

What is GAP+?

Like traditional GAP insurance, GAP+ bridges the divide between what your health insurance will cover and what you’re expected to pay. GAP+ not only provides you with the same protection as a traditional gap policy, but it also provides unique benefits that reward you for taking an active role in managing your health. To learn more, watch our video.

What is a Hospital Indemnity Plan?

HIP is a great solution if you either don’t have a major medical coverage or you participate in a high deductible health plan with an HSA (Health Savings Account). While health insurance pays your provider, benefits from your hospital indemnity plan are paid directly to you. A hospital indemnity plan is an insurance policy that pays a fixed amount for a specific medical occurrence. Benefits include ambulance transportation, hospital admission, and a daily benefit for each day you are in the hospital.

What is HIP+?

HIP+ is a great solution if you either don’t have a major medical coverage or you participate in a high deductible health plan with an HSA (Health Savings Account). Benefits include ambulance transportation, hospital admission, and a daily benefit for each day you are in the hospital — regardless of cost. It also provides unique benefits that reward you for taking an active role in managing your health. To learn more, watch our video.

Is enrollment in GAP+ and/or HIP+ voluntary?

Yes. Both GAP+ and HIP+ are voluntary programs. However, if you enroll in either program, monthly participation is required to receive a benefit from the policy.

Will an employee have to make any changes to their major medical plan?

No. Triada does not require any changes to major medical plans. It is designed to complement and enhance your current coverage—not replace it.

Claims

How much does this cost?

The unique design of Triada’s GAP+ and HIP+ programs allow you to generate tax savings to fund your policy. Though your paycheck from your employer is reduced, you can earn claim payments each month for participation in the Triada HRM, which will allow you to either partially or even fully fund the cost of your policy. To learn more, click here.

What do I need to do to get their claim payment?

You must participate in Triada HRM on a monthly basis to receive you claim payment. The Triada HRM program consolidates a variety of healthcare services like a personal dietitian, a prescription discount plan and health advocacy that you can utilize to receive your claim payment each pay cycle.

Are the claim payments taxable?

No. Because employees earn a claim payment from an insurance policy, specifically for a medical treatment from the Triada HRM medical staff or other licensed provider.

How do I receive my claim payment?

There are a wide variety of qualifying triggers that you can complete each month to generate your claim payment. Of these, the most common are consulting with your health coach, prescription drug adherence and utilization of the Triada HRM clinical services.

When will I receive a claim payment?

If you engage in the Triada HRM program on a monthly basis, your will get your claim payment on the same day you receive your paycheck. The claim payment will be direct deposited into your bank account. If you do not have a bank account, your claim payment may be loaded onto a prepaid Triada debit card.

Do I have to participate in Triada HRM if I choose to enroll in GAP+ or HIP+?

To qualify for the benefits from the policy, you must engage in the Triada HRM program on a monthly basis. You will be assigned to a Triada Health Coach when you enroll in the program and they will help you comply with the program each month.

Health Risk Management

What is Triada HRM?

Triada Health Risk Management (HRM) gives employees access to qualified healthcare professionals and clinical services to help improve their health. Triada HRM can help employees manage chronic conditions like diabetes or hypertension, give them an outlet to manage anxiety or stress, help them develop a meal plan and workout routine to lose weight, or even help them quit smoking.

Why should I participate in Triada HRM?

Triada HRM is a unique program that helps provide you with coverage while encouraging you to live a healthier lifestyle to reduce health risks. Not only will you feel better in and out of the workplace, but you’ll be more productive and better equipped to manage any chronic condition that you may have. People can pay hundreds of dollars a month for the consolidated services that are provided by Triada HRM.

What happens if I sign up and don’t participate in Triada HRM?

Your health coach will reach out to you several times each month and you will also receive reminders automatically within your portal. We work diligently to ensure you maintain compliance! If you do not participate in 60 consecutive days, we will work with you and your employer to determine the best solution for you. Our goal is to provide resources to employees to help them maintain or improve their health. Monthly participation gives us both the best chance for success.

Who are the health coaches?

The Triada HRM health coaches are qualified healthcare professionals who have been educated and certified in various specialties to provide comprehensive health information and resources to participants in the Triada HRM program.

Can I create my own health goals?

Yes. We encourage you to work with your health coach to create a customized health plan to help you meet your personal objectives. Your coach will help you track your progress and provide feedback and encouragement along the way.

Can my family participate?

Yes. When enrolling in GAP+ or HIP+ you will have the option to choose to cover your spouse and/or child(ren). If you choose to cover dependents, we encourage as many covered family members as possible to participate in Triada HRM. The stronger your support network both in and out of the workplace, the more likely you are to achieve your health goals.

If employee’s purchase GAP+ or HIP+ through Triada and chooses to cover dependents, do they also have to participate in Triada HRM?

While every covered family member is given access to all services provided through Triada HRM, only the policy holder needs to complete the monthly participation to receive the claim payment.

Will my employer see my information?

No personal health information is shared with your employer.

Legal

Can I opt to pocket the tax savings generated from the policies?

Our enrollment portal is designed to only allow up to 1% of additional income to the your gross income. Additional savings beyond that threshold could create imputed income and you would receive a 1099 for the additional income.

How does this affect my tax return?

This program lowers taxable income by allowing you to pay your premiums on a pre-tax basis, just like your health insurance. This in turn lowers the amount of taxes deducted from your paycheck and the amount of taxes you will owe on an annual basis. Historically this program has had very little impact on tax refunds. We encourage you to consult with your tax advisor if you have specific questions based on your individual circumstances.

Will employees need to file any additional tax forms if they enroll?

No. You will not need to file any additional forms if you enroll. All changes will be reflected to your taxable income on your W-2.

Is this ACA Compliant?

Yes. All our products are ACA compliant. However, GAP+ and HIP+ are supplemental to health insurance and not a substitute for minimal essential coverage.

Are the policies COBRA eligible benefits?

GAP and GAP+ are the only COBRA eligible benefits if the you elect COBRA benefits on your employer’s major medical insurance.

Does HIP+ and GAP+ fall under Section 125?

Yes. Both HIP+ and GAP+ fall under Section 125 (also known as a Cafeteria Plan) of the IRS Code. Meaning, both programs are voluntary and both policy premiums are pre-taxed.

Does a company need a Section 125 to implement HIP+ and/or GAP+?

Yes. Your company will need to have a Section 125 plan in place to set up HIP+ and GAP+. Your company will most likely already have a Section 125 plan in place, however we can implement a Section 125 if needed.

Since this product is under Section 125, can I make changes or be removed during the year?

No. Section 125 plans are annual elections. Unless you undergo a qualifying event (marriage, divorce, birth, death, etc.), changes or drops can only be made during open enrollment.

Resources

Videos

Explanation of Benefits
Health Risk Management
The Benefits of Gap+

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