Small Group Health Insurance Buyers Guide

We are a licensed insurance broker.  There are no fees for our services. You will pay the exact same premium as if you went directly to the carrier without the assistance that we provide to you and your employees.  We will secure the quotes from the best insurance companies and present them to you for your approval.  We will then assist you and your employees in providing and completing the documentation necessary to secure the coverage of your choice.  We are also available for service after the issuance of the policy.

We represent all the major carriers of group health insurance.  If you have an insurance company that you would like us to present, please advise us so we can prepare quotes for you.  We will show you the major small group players with cost and benefit comparisons.

California state law says if a qualified company employs 2 or more full time (30hours per week) employees , partners, or owners, they can qualify for guaranteed coverage with any insurance company.  This program is known as the guaranteed issue program.  This allows small employers to provide health insurance coverage to all employees (present and future) regardless of their health (or family members).

Companies that employ five or fewer employees can have an RAF of 1.10 (highest) with most insurance carriers.  The RAF is a factor that considers both the size of the group and the overall health of the group.  The RAF is a factor that is multiplied times your base rate in order to determine your final premium.  Make sure the proper RAF factor has been applied so you do not have a surprise later on.  A company with ten employees in good health could expect an RAF of .90 to .95. 

For groups under five, all eligible employees must join the program.  An eligible employee is one that does not have health coverage from a spouse’s plan or another group plan.  Most insurance companies require the employer to contribute at least 50% of the employee’s premium.  Employers can contribute beyond that for both the employee and their dependents. 

There are many reasons an employer would want to sponsor a group medical plan.  It is an excellent way of attracting and retaining quality employees.  The premiums are tax deductible for the business.  Having a group medical plan for your employees is the right thing to do for the people that make your business prosperous.

What is an HMO? An HMO is a health maintenance organization.  The basic way an HMO functions is by having your personal physician (gatekeeper) your sole contact.  This doctor authorizes referrals and who those referrals are.  Generally there are not a lot of primary care physicians to choose from in an HMO network.  It is even more difficult to get to specialists that you want or hospitals out of your area.

PPO coverage is comprised of a preferred provider organization that allows you to choose any provider (specialist or not) from this large network of doctors and hospitals.  Most people prefer this type of coverage.  Many people feel they get better medical treatment and in a more timely manner than with HMOs.  One drawback of PPO plans is that you will have more out of pocket for any given medical procedure. 

Association Medical Plans can be a good alternative to regular medical plans in some cases.  If  the terms of these plans seem to good to be true, they probably are.  Some plans have very limited coverage and can leave you and your employees with large out of pocket expenses.  These same plans promise to return premiums at some future date.