Below are some of our frequently asked questions. If you have any other
questions or concerns, please feel free to contact us.
| How do I apply for an insurance plan for myself and/or my family?
You are welcome to use the link on the Navigation tool on the left side of the Home page under Health Insurance Quote. You can also call or email us!
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| Why do I need an Insurance Agent?
An agent can assess your needs, explain complex benefits and/or policy riders, do employer meetings, do all the leg work gathering rates, available options and benefit information.
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| How much do your services cost?
Our services are at not cost to our clients. The insurance companies pay us commission for the policies we sell. Our commission does not change the amount you are charged for the premium. So let us do the leg work for you!
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| What carriers do you work with?
Everyone-within our office we have selected the carriers who are tried and true and present those to our clients. From our collective insurance backgrounds we have worked close with the carriers, and have eliminated the not so great and saved the best for you. We want your experience with a carrier to be the best out there!
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| What is the difference between Group and Individual coverage?
Individual coverage is underwritten, which means that the insurance company can either accept or decline your application based on your health history for the past 5 years (10 for Washington). The price is based off your specific age. Group insurance accepts anyone that is eligible within the group. The rate is based on the average age of the group, the number enrolling and how they are enrolling.
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| How many employees are needed to qualify for group insurance?
Group insurance for Oregon is available to a group of two or more employees who work at least 17.5 hours per week. For Washinton Group Insurance is two or more employees working over 30 hours per week. For the purposes of group insurance, owners are considered employees.
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| Who are eligible employees?
Eligible employees are those employees who have been hired as full-time, work 17.5 hours or more per week and have sastisfied their waiting period.
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| How long do I need to be in business to have a group plan?
This varies with insurance companies in Oregon and Washington. Depending on the insurance company; you can be a brand new busines, or are required to have been in business anywhere from two months to one full year. We can help direct you to the plan(s) available depending on how long you have been in business.
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| Do you offer coverage for the Self-Employed?
If, by self-employed, you mean that you are the only person working for your business, then your only option would be individual coverage. We can certainlty help you look at all the individual options available. If you have at least one other person working for your business, and have tax documentation to support it, then you would qualify for group insurance.
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| Can I still get Group insurance for my employees even if one of them has a serious illness? Pregnant?
Yes, Group insurance is available without restrictions based on health of the group, and the rates are not affected by the health of the group.
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| How long will it take to get coverage?
Most carriers require that applications be submitted at least 3-4 weeks prior to the requested effective date. Group insurance can be effective on the requested date so long as all the required forms are completed and turned in by that carrier's deadline. Individual insurance effective dates may be delayed if the carrier needs to contact providers or yourself for detailed medical information.
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| I'm not eligible for Group insurance, what can I do?
You can apply for an individual plan. If you call and give us your age and whether you need coverage for just yourself or with your dependents, we can provide you with several rates and benefit information for insurance carriers around the area. You can also click on the left Navigation bar under Health Insurance quote and input your information there as well.
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| Is the owner of a company required to enroll?
Yes, the owner of the company is required to enroll, unless they have other medical/dental insurance elsewhere.
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| Do I have to offer insurance to all of my employees?
You need to offer insurance to all eligible, full-time employees. However, employees who have other insurance are usually allowed to decline and do not have to enroll.
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| What happens if my application(s) for individual coverage is denied?
If you have no other options for health insurance and you have been declined on an application for individual coverage on the basis of your health, you may qualify for Oregon Medical Insurance Pool (OMIP). This is a plan designed specifically for people who are unable to get individual coverage due to poor health. Please contact us to get more information about OMIP. We would be happy to dicuss rates/benefits over the phone as well as mail you out a packet.
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| Do you offer Dental and/or Vision coverage?
We do have a couple of carriers who offer a number of options for Individual dental and vision. Sometimes those two plans are combined into one product. We do show dental and vision on all of our Group insurance spreadsheets unless otherwise requested.
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| What is the difference between coinsurance and co-payments?
In general, a co-payment is a flat dollar amount you pay for a specific medical service. It is not based on the cost of the service. Coinsurance is generally your portion of the cost of a service, reflected as a percentage of that cost after your deductible.
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| Do I need to offer COBRA to my employees?
Yes, if you have twenty or more employees on payroll, regardless of whether-or-not those employees are eligible for the group health plan. Full-time employees are counted as one employee. If you have under twenty employees you will need to offer them State Continuation.
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| What is Conversion and Portability?
Conversion is a term used in the state of Washington, and Portability is a term used in the state of Oregon; which allos an individual who has been enrolled on a group plan to convert to an individual plan without proof of insurability. The Conversion or Portabilty plan may or may not be the same as the previous group coverage. It differs slightly between each carrier. To request Conversion or Portability plans/rates you would call the number on the back of your ID card for the carrier you currently have your group coverage through.
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| Where can I register a complaint or concern if I'm not happy with a health insurance carrier?
You can register a complaint or concern with a health insurance carrier by contacting the Department of Consumer & Business Services. They can be reached at (503) 947-7984 or (888) 877-4894.
Their website can be reached by the following link: Oregon Dept of Consumer & Business Services Website.
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