Groups & Businesses

Generally you need to provide documentation of the legitimacy of your business and sufficient payroll history to show you've been around at least a short while. The types of documents usually include a business license, proof that you are registered with the California Secretary of State's office, a Statement of Information listing business owners and address, and any DBA (Doing Business As) paperwork if applicable.

Will setting up a group plan mean my employees cannot buy private coverage if they want to?

In some instances, a group plan will not consider an individual or family plan a qualifying reason to waive coverage. We can help you sort out the factors in play and find the right solution.

Can I reimburse my employees to buy individual plans on the open market?

Except in one particular circumstance, you cannot. This is specifically prohibited under the ACA and carries stiff tax penalties of up to $36,500 per year per employee if you are shown to be reimbursing for open market plans.

Am I required to provide a group plan to my staff?

If you are a small group between 1-50 employees, you are not required to put a plan in place. However, the plan options available for groups are substantially more comprehensive than those available on the individual and family market.

Why isn't my doctor in network?

Not all doctors contract with all plans, it's best to use these provider links and to double check with your doctor before scheduling any visits.

What do you charge to help me get set up?

Nothing. A broker's services are always free to the consumer. We are paid by the insurance vendors, and it is a large part of our job to service your account and help resolve any issues that may arise.

Is there a deductible for the plans you offer, and what is a deductible, anyway?

It varies depending on the plan. Similar to your insurance, a deductible is the amount you pay in full up front before the insurance company steps in and pays the lion's share of the costs. However, there are some services that you pay for on a strict copayment structure that you do not need to meet the deductible for. These include almost all basic medical visits.

What is a copay?

The amount you typically pay for office visits, laboratory tests, X-rays and prescriptions. After you pay the copay for these services, the insurance company typically pays the remainder. There are different copays and limits for out of network care, so try to stay in network whenever possible.