The Intelligent Agent
The Intelligent Agent
Built for Employee Benefits

Employee benefits answers grounded in the SPD and the regs.

Group medical, dental, vision, disability, life. ACA, ERISA, COBRA, Section 125 - we cite the regulation, the SPD, and the carrier doc, so your account manager isn't guessing.

Ask Ava about Employee Benefits, bottom right. She'll keep examples in this book.

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Does the named insured's umbrella drop down for an auto liability claim if the personal auto policy is exhausted?

Yes, on this insured's policy. Your Personal Umbrella endorsement [1] follows form to the underlying Personal Auto liability limits of $250k/$500k/$100k. Once those are exhausted, the umbrella responds up to the $1M aggregate limit.

Coverage is subject to the SIR of $250 for non-underlying claims [2].

[1] Smith_PUP_2024.pdf p.4[2] PAL_Endorsement_22.pdf p.2

The pain we take off your plate.

ACA reporting deadlines

1094-C vs 1095-C, when to file, what triggers an ALE - answered with the IRS instruction citation.

COBRA election windows

60 days to elect, 45 to pay first premium - but the qualifying event matters. We pull the rule.

Section 125 mid-year change events

Permitted election changes, how the carrier defines them, when QLEs apply.

What's in the brain.

Stacked across Employee Benefits - plus your own house knowledge once you upload it.

  • ACA employer mandate and reporting (IRC §4980H)
  • ERISA fiduciary and disclosure obligations
  • COBRA notice and election rules
  • Section 125 cafeteria plan rules
  • HIPAA privacy and special enrollment
  • State paid leave and continuation laws

Try a question.

Employee got married last week. Can she add her spouse to medical mid-year?
Yes - marriage is a HIPAA Special Enrollment Event under ERISA §701(f) and a permitted §125 election change. She has 30 days from the date of marriage to enroll the spouse, and coverage is typically retroactive to the date of marriage if the carrier permits. Confirm the SPD's window - some plans allow 60 days. [1] HIPAA §701(f) [2] Treas. Reg. §1.125-4 [3] Plan SPD §3.4 (your Knowledge Base).

"Our benefits team stopped Slacking compliance counsel for the same five questions. Huge."

- Benefits practice lead, brokerage

Ready to see it on your book?

Group medical, ancillary, and compliance - with the regs cited.