Q) Which type of plan is best for my family?
A) There are many factors that should be considered when selecting a plan. If you are looking for a comprehensive medical plan with more predictable medical expense costs, an HMO may be a good plan choice. Many people select an HMO plan because these plans tend to offer the widest range of coverage with a little or no deductible. Most HMO’s include maternity coverage and well baby care. If you are a single person or couple without children, consider a PPO plan with a higher deductible and a predefined flat office co-pay fee. This type of plan design will allow you to visit the doctor for routine visits for a moderate $25-$50 office charge. Well woman exams and annual physicals are often included.

Q) How many people does my business need to apply for true group insurance coverage?
A) Usually 2 employees (W-2) or an owner and one employee can purchase group health insurance. For other products such as Disability Income, or Dental coverage, you may need between 3 and 10 employees. Each carrier may have different requirements.

Q) My spouse is younger than me. Which person should be the primary insured?
A) The younger person.

Q) My husband and I are Realtors. We are incorporated with no employees. Can we qualify as a small group?
A) In most situations “Yes”. The key question is: Are you both officers of that corporation? If so, run both quotes for Group and Family Coverage. Group does not always mean “less expensive”, but it can offer “Guaranteed Coverage” in many situations.

Q) My local realtor association offers a medical plan. What are the pro’s and con’s of this type of coverage.
A) Every year during “open enrollment” you can participate and may be accepted with pre-existing medical conditions. This is a pro. The cons are many. This benefit comes with a hefty price tag. The younger and healthy often tend to subsidize expenses as everyone tends to pay more that what he/she would likely pay for coverage in an open market. Additionally, there are fewer company and plan selections available. You may be paying for benefits that are not important to you.

Q) I am a broker and I am interested in providing benefits for my team. What rules apply?
A) Generally speaking, you may offer benefits to all corporate officers and W-2 Employees. Some insurance carriers will consider coverage for 1099 Independent Contractors, while others will not. You will need approximately 70% participation of all eligible employees. Some individuals may “opt out” as they may have coverage through their spouse’s employer. As an employer you will need to decide whether or not to include part time employees and as a general rule you will need to pay for a majority of the employees cost of insurance. You can elect to pay for all, some or none of the employees dependent coverage.

Q) Are group plans always less expensive than individual plans?
A) No, in many cases individual plans are actually less expensive. For a very small group, assuming everyone is healthy, you should compare products and features. Group means access to coverage, not necessarily “less expensive”