Frequently Asked Questions

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Q

How many employees do I need to have to receive a quote?

A
You must have at least 2 employees.  Most carriers will require that the second employee is a W-2 employee that is not the spouse of the owner.
Q
Do small business plans cover pre-existing conditions? 
A
Yes. Additionally, carriers cannot increase premiums based on pre-existing conditions.
Q
What factors are used to determine the monthly premiums for a small business medical plan? 
A
Under the ACA’s reforms, issuers and carriers may vary the premium rates charged to a non-grandfathered plan from the rate established for that plan based on age, family size, geographical region and/or tobacco usage.  All other factors are prohibited.  This means that several factors commonly used by issuers to set higher premiums prior to 2014 (such as health status, claims history, duration of coverage, gender, occupation, small employer size and industry) can no longer be used.
Q
When can I start my health insurance plan for my Small Business?
A
You can start a new insurance plan any month of the year and most insurance companies begin coverage on the first of the month. Some carriers will allow coverage to begin on the 15th of the month and every carrier has a deadline on when your submission documents have to be received in order secure the effective date you are requesting.
Q
How long are rates guaranteed for?
A
The standard rate guarantee period for medical premiums 12 months. Ancillary coverages such as vision or life insurance can have longer rate guaranteed periods.
Q
What is a waiting period?
A
A waiting period is the period of time that must pass before coverage for an employee is eligible to enroll in your company-sponsored benefits.
Q
What is the maximum waiting period I can add to my benefit program?
A
For plan years beginning on or after January 1, 2014, the Affordable Care Act (ACA) prohibits any group plan and group health insurance issuers from applying a waiting period that exceeds 90 days.
Q
What is the permitted orientation period? 
A
Employers may impose a one month orientation period as a condition for eligibility for coverage under a plan.  During this time both parties could evaluate whether the employment situation was satisfactory and standard orientation and training processes would begin. The waiting period would begin once the orientation period ended. Employers are not required to select an orientation period.
Q
When will I receive a copy of my small business renewal?
A
Carriers will release a copy of your renewal between 30 and 60 days prior to your renewal date. Your renewal date is typically 12 months from your plan effective date. If you have not received a copy of your renewal, please reach out to your benefit service team using one of the options listed at the bottom of the page.
Q
What is a Qualifying Life Event (QLE)?
A
This is an event that will trigger a special enrollment period during the plan year that will allow you to make midyear changes to your benefit elections. Examples of a QLE are: Loss of other coverage, gain of other coverage, marriage, divorce, birth or adoption, death of a dependent or Medicare/Medicaid entitlement.
Q
How long do employees have to make a midyear enrollment change if they experience a QLE? 
A
All QLE’s must be reported and processed within 30 days of the QLE Event Date.  If the request is submitted after 30 days, the employee will need to wait for the annual open enrollment period in order to make changes.

 

 

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