Much as you use an accountant or an attorney, so too should you use a professional insurance advisor with an employee benefits practice to assist you in the development, design, installation, and administration of all employee benefit programs. You should begin by using your benefits advisor to answer questions about what is available to you as an employer. You should be able to set realistic goals and begin a process of selection and evaluation based on the input, ideas, and recommendations of your advisor. This can take time, and has nothing to do with "getting a quote". Plan designs change almost daily, regulations are updated and statutes rewritten every year. The process of discovery and due diligence brings you up-to-date with current market conditions and prepares you for making decisions based on what is currently available.

Some of the questions you may have, or that may come up, are covered in our Employer F A Q. Other questions and concerns may be based on your specific situation. As advisors, we spend a great deal of time getting to know you, your business, and the goals you need to meet with your benefits package. We will educate you as much as possible during this process to avoid potential problem areas and difficulties. We may make general recommendations to you at the conclusion of this process, before moving on to the process of plan development and selection.

Plan development and selection is a joint project, based on your input and the advisors professional expertise. It is important to choose an advisor who represents your interests first and has access to all plans and products in a given market. While it is easy to assume that all plans are commodities, or that all carriers are alike, nothing could be further from the truth. Networks, payment arrangements, coverage areas, plan specifics, and numerous other variables distinguish the differences between health plans. Careful attention should be made to plan limitations and exclusions, particularly with dental coverage's.

Once general guidelines have been determined, accurate offers must be solicited so that you can determine what plans are best at meeting your goals. A census is gathered; this information is kept strictly confidential, and will include names, ages and/or dates of birth, gender, and family status (employee only, employee with dependent children, employee with spouse, employee with family). This census is used to generate pricing information for all of the plans under consideration. Position title, date of hire, annual salary, and notification of key employee status is often needed as well. Private health information can be requested to give you the best rates available. Some employees may have key doctor-patient relationships that may need to be maintained, and a list of key physicians can be helpful.

Once all of this data is developed, a comprehensive analysis is done of the different plan details which, together with pricing and other pertinent information relative to your unique situation, will give you an idea of what plans you should look into further.

Once you've reviewed the plans and made a selection that best fits your needs, now begins the process of enrollment and installation. Your advisor should, at a minimum, fully explain the process to you, including any documentation you may need, the different forms that will be needed to be completed, the time frame in which the process will be undertaken for a specific effective date, and any required documentation you should have made available to you, such as Plan Description Forms and a Summary Plan Document, or a specimen Certificate of Coverage. The advisor also needs to review with you the benefits you are purchasing, any optional coverage's available, and any limitations or exclusions that are present in the plans. We enroll each employee individually, explaining the benefits and completing all required forms, including waivers if necessary. We explain any preexisting conditions stipulations, and provide complete benefit counseling to your employees. In Colorado, you will need a UTR-1 (Unemployment Insurance Tax Report) or similar documentation submitted with your request for coverage. Other states have different requirements.

While carriers are no longer allowed to decline small business groups for medical conditions, medical underwriting does pay a role in the approval of a medical plan. Your rates will be based on the overall health of your employer group, as disclosed on the individual employee applications. Once all required forms and documentation is completed, your advisor will submit your request for coverage and monitor its progress through the underwriting process.

Once the required approvals and documents have been received, the advisor will install your plan, making sure that employee ID cards are correct, initial coverage's are guaranteed, and any additional notices or requirements are met. We monitor all new case issues for the first ninety days to ensure your satisfaction and to iron out any issues that inevitably crop up during that time. [Back to Insurance 101]

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