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With California’s Trusted Source for Health Insurance
Group Health Plans
We can show you affordable group health insurance plans that will help your employees stay healthy, happy, and reassured.
- We are able to sort through a multitude of quotes to find those that might meet your group’s needs and budget.
- We deal with all California insurers and we assist the group through the entire change and set up process.
- We also provide daily customer assistance for a wide array of issues.
Individual Health Plans
If you are looking for an individual plan, we can also help find the plans that best fall into your budget and the plans your doctor accepts.
- Doctor choice is important for small employers and individuals.
- Prior to changing your health plan, we will make sure that the doctors you desire are members of the plan you select.
- We also work to make sure that important prescriptions you may be taking are included in plan formularies.
Why Use a Local Broker?
We understand your needs better
In the age of the internet, we all want information quickly. It is quick and sometimes convenient. However, in the world of insurance, where you are buying an intangible product, things are different.
Individual Health Insurance
Feel relief, you're covered!
HMO vs PPO
Health Maintenance Organization (HMO):
- Have access to doctors and hospitals in a network established by the insurance company.
- Need a Primary Care Physician
- They will give you the referrals to in-network specialists
- No coverage is offered for out-of-network physicians
- Typically have a lower premium
Preferred Provider Organization (PPO):
- Have access to doctors and hospitals in the established network and also providers outside of the network.
- No need for a Primary Care Physician, you can use any doctor you would like
- No need for a referral from a Primary Care Physician
- You are able to receive coverage from an out-of-network physician
- You must still file a claim for an out-of-network provider
- Typically have higher premiums based on the flexibility of the plans
Group Health Insurance
Small & Large Group Options
The Affordable Care Act does not require companies who employ less than 100 full time equivalent employees to offer health insurance coverage. The key here is the term full-time equivalent. To arrive at the full time equivalent number, you need to sum the total monthly hours of all full and part time employees and divide it by 120 hours.
Things to know
- To be considered a large group, there be over 100 employees.
- Full-time employment is defined as a minimum of 30 hours per week.
- The maximum wait period for new hires is 90 days before they are eligible for enrollment.
To begin the process of insuring your employees, you must completed a Group Census.
Open Enrollment for 2017 ended January 31, 2017. You are no longer able to enroll in individual health insurance unless you qualify for a Special Enrollment Period. Open enrollment for 2018 will start in the Fall of 2017.
The Special Enrollment Period (SEP) events that are allowed throughout the year are:
- Loss of group coverage. You must apply for new coverage within 60 days.
- Aging off your parent’s health plan if you are turning age 26. Again, you need to select and enroll in a new health plan during the 60 day period.
- Your COBRA coverage ends.
- You no longer qualify for employer group coverage (work hours were reduced).
- You move into a service area that your health plan does not cover.
- Your employer discontinues your group coverage.
- Your employer no longer contributes to your group plan.
- You lose Medicaid coverage.
- The person you were enrolled under dies.
- Loss of your job.
- Your marital status changes in a separation from a spouse.
- You declare bankruptcy (chapter 11).
- The individual you were covered under becomes eligible for Medicare.
- A legal guardian dis-enrolls you from the Children’s Basic Health Plan.
- You become ineligible under the Colorado Medical Assistance Act.
If you do experience one of these special qualifying events, keep the letter to confirm and attach it to your application with the 1st month’s premium.