Frequently Asked Questions

We never charge you for using our services. Our commission for assisting you comes from the insurance companies directly. There is never a fee or mark up for our consultation, ongoing support throughout the year, and the free benefits software that we give you to assist your accounting and HR departments.

I think the best way to answer that question is to see what our customers think about us.

The technical way to answer this question is that we are a broker. As a broker we shop all of the major/credible insurance carriers, guaranteeing you the best rate/outcome. We even negotiate with the carriers to get you even lower rates where possible. We do this not just in the beginning of the relationship to win your business, but we aggressively shop you year after year.

A pre-existing condition or illness for which medical treatment was sought before beginning your health insurance policy. The look back policy is typically 1 to 2 years.

99 percent of the policies we sell cover you regardless of these conditions. 

A deductible is the amount of money you have to pay before your health insurance begins to pay for major services. If you have a copay plan, the insurance company will give you first dollar benefits where the deductible does not come into play for services such as copays to the doctor, using your RX/drug card etc. If you had a $2,500 deductible, you would not receive any payments from your health insurer until you’ve spent $2,500. At that point the insurance company would pay in full or part if you had co-insurance.  It is important to note that the deductible is treated differently if you are in or out of network. If you are out of network on a PPO the risk deductible usually doubles. If you are on an HMO, unless it is an emergency, the insurance company will refuse to pay for services.

Co-insurance refers to the percentage of medical costs that you are required to pay after you meet your deductible and before you reach you plan limit. It is often represented as 80/20 or 70/30 or 50/50. The first number, for example 80 refers to the percentage of claim that the insurance carrier has to pay. The second number refers to what the insured owes. On major medical plans, once you hit the stop gap, your payments cease, typically for the rest of the calendar year.

It is the point of payment where your obligation ends, and the insurance company pays in full. So, if you had a $5,000 deductible with 80/20 coinsurance and a max out of pocket or $8,000, once you hit $8,000 your payments cease for the remainder of the year.

PPO stands for Participating Provider Option. It gives you the most freedom/flexibility of any kind of health insurance network. It means that you can go in and out of the network, even though for discounts it is always better to stay in the network. You do not need a referral to see a doctor. These networks also tend to be larger than ay other network type. With freedom and flexibility comes price, these plans tend to cost more than any other type of plan.

HMO stand for Health Maintenance Organization. These plans/networks are as restrictive as PPO’s are flexible. They have a set limited/directory of hospitals and doctors, and you have to stay in network, or they will not pay for services unless you have an absolute emergency. An emergency would be a car accident where you could not control where you were taken. You will also be given a primary care doctor that you will have to go to, to be referred out to see a specialist or get elevated treatment. In exchange for these restrictions the cost is less than a PPO, as these doctors and hospitals have agreed to treat you for less than they would charge in a standard situation.

An Exclusive Provider Organization (EPO), is a type of health plan that offers a local network of doctors and hospitals for you to choose from. An EPO is usually more pocket-friendly than a PPO plan. However, if you choose to get care outside of your plan’s network, it usually will not be covered (except in an emergency). If you’re looking for lower monthly premiums and are willing to pay a higher deductible when you need health care, you may want to consider an EPO plan.

It is important to note that we never charge you for using our services, our commission for assisting you comes from the insurance companies. We act as a broker and run quotes with all of the major carriers guaranteeing you the best rate for the benefits that best suit your needs as an employer.