Call us at 1800-486-0419 or email us with your questions and concerns. We are here to help, guide and provide.

I have a new company. How can you help me acquire health coverage for my employees?

Most carriers require that a company have two or more employees and be open for at least six weeks. You may be asked for the following proof: payroll records, corporation papers, state stamped statement of information form; fictitious name filing or business license. Once we have this information, PBR can enroll you into any plan that is offered in California. Other states have similar requirements but may ask for additional information.

What is the minimum that an employer is required to pay towards an employee’s medical premium?

The minimum is typically 50% of an employee premium on the lowest rate plan the company offers. Some insurance carriers will accept a defined benefit of $100 or more per employee as a minimum.

What percentage of employees are required to go on the medical plan?

Each insurance company is a little different. The majority want 75% of “eligible employees” to participate. An “eligible employee” qualifies as a full-time employee who has met their probationary period and who does not have coverage through their spouse.

I have been hearing a lot about H.S.A. plans. Can you explain them?

H.S.A. stands for Health Savings Accounts. They were enacted by the Medicare Modernization Act of 2003 to give consumers a tax-efficient way to manage their health care expenses. An H.S.A. is an individually owned savings account, similar to a 401(k) plan except that money is used to pay current and future health care cost. Contributions are tax deductible and employer contributions are not subject to FICA or FUTA taxes. The funds can be invested and earnings are non-taxable. The funds can roll over from year to year to build for future medical expenses. These plans must be used in conjunction with a H.S.A. compatible, high deductible plan.

My premiums have doubled in the past three years. What options do I have?

There are many components to risk and underwriting of health insurance. We will need to analyze your current situation and understand your company’s objectives to advise you on appropriate solutions. There are many options available to you.

Is there an advantage to having a group health insurance plan over an individual plan?

It depends on your personal health situation and your company’s goals. For an individual plan, the primary advantage is that it’s portable. On the downside, other insurance companies can turn you down in underwriting if you don’t meet their standards. Group plans, in comparison, are always guaranteed issue so you don’t have to worry about being turned down based on your health. Continuation of group coverage is limited to a total of 18 months and in some states an additional 18 months are allowable, after you leave the company.

What if I have employees in other states besides California?

Usually this situation is not a problem. Most insurance carriers require that 51% of all your employees reside in California, to meet eligibility for California-based plans. There are some carriers who will provide coverage for out of state employees but they may require underwriting. Another viable option we recommend is to obtain a separate plan in that particular state for those employees.

My company’s employees are currently covered with an employee leasing company. I would like to return our employees to my payroll and benefits plan instead. Can I qualify for benefits right away?

Yes. Some insurance carriers will make concessions to accommodate a company regaining their employees. The guidelines are different depending on the insurance carrier. We can help you navigate your options.