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1. Group Insurance policies are extremely complex. Not only is it time-consuming to sift through the myriad
of plans; but, deciphering the requirements and underwriting guidelines necessary to get your company insured is best handled by a professional.
2. There are many new laws in place today that Employers must be aware of. It is the Agent's responsibility
to communicate these regulations and ensure that Employers are in compliance.
3. A small group is defined as: a company that employs 2-50 full time, eligible employees. This type of Group
falls under "California Assembly Bill
AB1672" which forbids any insurer from denying Health Insurance to
any legitimate firm due to current health issues or pre-existing conditions within the firm.
4. AB1672
also regulates the premium rating practices of Insurance Carriers wishing to insure a small group. Carriers are prohibited from rating up the group's premium by more than 10% above the published
"Standard Risk Rate" despite health conditions within the
group. These rates are assigned by the Department of Insurance annually for each benefit plan design.
5. Currently, under state law, the maximum length of a pre-existing condition limitation is six months.
This means that a new employee's health coverage cannot be denied due to a pre-existing condition as long as the employee has had continuous medical coverage (Individual, Group or Temporary) for the preceding six months.
This law was dubbed "The
Health Insurance Portability And Accountability Act Of 1996 (HIPAA). This bill is popular among employees as it has helped eliminate the barrier to changing jobs. It simply made Insurance "portable".
Carriers must now provide certification of prior coverage upon an individual's request so that the employee is not denied Health Insurance do to a pre-existing condition.
6.
Cal-COBRA (California COBRA) is a state law which
allows continuation of coverage for all employees in a Group of 2 - 20 employees upon termination or reduction in hours.
7.
COBRA is a federal Law that allows
continuation of insurance coverage for all employees in a Group of more than 20 employees upon termination or reduction in hours.
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