Frequently Asked Questions

Most business owners and managers have enough on their plates without trying to be benefits experts for their employees. That’s where we come in.
Individual plan applications with Group Health must be submitted by the 20th of the month in order to receive a first of the following month effective date. Regence BlueShield applications must be received by their office in Idaho by the last day of the month for an effective date the first of the following month. Lifewise of Washington also accepts applications through the last day of the month. The earlier the applications are received, however, the sooner you will have your ID numbers, contract information, and receive your first billing from the carrier.
Applying for individual coverage is easy. There are two forms involved: the application and the Standard Health Questionnaire. We can set up an appointment for you to come in and complete the application process, we can mail you the application and questionnaire, or you can apply online. If you are in the market for a group plan for your business, we will help you complete a paper application. Depending on the size of your group, you may also be required to submit tax return documents for the past year. With most carriers, there is no health questionnaire to complete for group contracts.
If your business has a group plan, all employees who are working more than the set number of hours in your contract need to be offered coverage when they become eligible, and again at open enrollment annually. There are some contracts that are established for owners only or managers only, but we would need to review your specific situation to determine if that is an option. Remember that the carriers have the right to audit/request tax documentation, so any employee listed on your wage reports who is covered on your plan must be working the required number of hours. Alternately, employees working the required number of hours must be either enrolled or have a waiver of coverage on file.
Businesses with 2 or more employees may qualify for a group health insurance plan. At least one of those employees must be working at least 20 or more hours per week. Please contact us with your current census to discuss the options for your business.
Health insurance agents are able to show you a variety of plans through a variety of carriers. With individual plans and small-group plans (less than 50 employees), the rates are consistent no matter through whom you purchase the plan. That means that you would pay the same price if you went directly to the carrier as if you buy a plan through one of our licensed agents. However, we can offer you the added benefit of being a local, face-to-face contact whenever you have questions or concerns about your coverage. We’ll make contact with you if there are changes to your coverage due to new legislation, or if your rates may be changing due to an annual renewal. We are here to be an advocate for you, our client.
There are two types of coverage available to individuals in Washington State: catastrophic and comprehensive. Although the term “catastrophic is thrown around a lot, there are actually legal qualifications that make a plan fall into either category. In general, catastrophic plans have higher deductibles, do not cover prescriptions or maternity-related claims, and do not offer “portability of pre-existing conditions. What that means is that if you decide to switch to a comprehensive plan at a later date (whether individual or through your employer), you will have a waiting period at the beginning of the new plan for any pre-existing conditions. Comprehensive plans, however, will allow portability, so that any waiting period will be credited depending on how long you’ve been on the plan.
The HSA plan advantage: Health Savings Accounts (HSAs)
With a HSA benefit plan you can enjoy quality, affordable health care coverage and the chance to take control of your future health care spending. Health Savings Accounts are special tax-exempt savings accounts dedicated to your health care expenses. As you contribute to the account, your money grows tax deferred. And as long as you use the account to pay for qualified medical expenses, your contributions are deducted from your gross income at tax time, saving you money.

How it Works
First, you purchase an HSA-qualifying medical insurance plan. That allows to you open the account itself at a local bank. The IRS annually reevaluates contributution limits for individuals and families on an HSA plan. For example, the limits for the 2010 tax year are $3,050 per individual or $6,150 per family. (Contribution limits are prorated for the number of months the plan is in force. Additional contributions may be allowed if you are over 55 years old. Please consult your tax advisor for specific tax information.)

For instance, you can use your HSA to:

  • Pay your health plan deductible, coinsurance and other qualifying health care expenses.
  • Invest in mutual funds or other options – with any interest or other earnings accumulating tax-free
  • Or, let your account build up through savings account interest. Any unused funds in your Health Savings Account are yours to keep and will carry over from year-to-year.