GROUP BENEFITS - FAQ

CAN WE SHOP FOR BETTER RATES, MID-YEAR, OUTSIDE OUR CURRENT RENEWAL?

Yes you can!  Any group is typically able to shop (and change plans) mid year.  Most Carriers will give full credit for all dollars paid on existing plan, so there's typically  not a barrier to moving to a new plan.  We'll happily provide a no-pressure proposal to show you what else may be available to you.  

how do we know what plans/programs we are eligible for?

That's our job.  You are likely eligible for more programs and plans that you've previously seen.  We wills hop the ENTIRE market for you, including Association Health Plans, as well as Carrier-Direct plans.  We will compare all options & bring you the best.  If by chance your current plan IS the best option, we'll give you our honest opinion on that too.

how is pro benefits different?

We're intentionally a smaller agency.  We enjoy have the personal interaction with our clients, and getting to know not only the group admin or owner, but also your employees.   We pride ourselves in being responsive and creative.  We strive to always do the right thing for our client -- regardless of how that affects our commission.

what are health savings account (HSA) limits for 2018?  

Single Individual: $3,450

Family (2+ individuals): $6,900

Catchup Contribution 55+:  $1,000

can we give employees a stipend, or pay their individual plan premium?

Yes and No.  You can certainly give your employees extra income which they could use to buy an individual plan.  The downside of that is those dollars DO count as income, are taxable (both to the employee and the business.)  So those dollars don't go nearly as far as they would if those same dollars were paid towards a Group plan.  The Carriers prohibit groups from paying for employee's Individual policies.  

INDIVIDUAL & FAMILY - FAQ

When can i enroll in an individual plan?

With a Qualifying Event:  1st of any month (though the Application deadlines are often the 15th of the month prior.)

Without a Qualifying Event: The Individual 'Open Enrollment' begins November 1, 2018 and ends December 15, 2018 for coverage beginning January 1, 2019.

what is considered a qualifying event?

The following may qualify you to enroll in an individual plan outside the annual Open Enrollment window.

-Involuntarily losing group/employer coverage.

-Turning 26 & aging off parents' plan

-Exhaustion of COBRA 

-Permanent move from previous service area

-Birth or adoption

if I'm offered coverage through an employer, could i still be eligible for apple health or a subsidy?

Possibly, but generally not.  If your employer-sponsored plan is available to you at a cost less than 9.5% of your household income (for just your own coverage), that is considered an 'affordable' plan, and makes you ineligible for a subsidy through the WAHealthPlanFinder/Exchange.  

The exception to this is there are instances where someone qualifies financial for Medicaid (Apple Health).  If that is the case, you may be able to waive your employer-sponsored plan in favor of Apple Health.

what is apple health?

Apple Health is Washington State's Medicaid health insurance product, which can be enrolled in through the WAHealthPlanFinder or through the State Health Care Authority.