FAQ
Our office is located in Miami, FL.
We offer both virtual and in-person appointments.
The majority of our clients are located in South Florida. However, we do handle multi-state accounts and can accommodate enrollment nationally.
The perfect plan for your company is one within your budget and that will create the least responsibility of payment for your employee.
To retain top talent, benefits are proven to help keep key employees happier longer than just salary increases. It also shows your employees that the team’s success is the priority of the company.
They are not cheap, but saving the money can be more expensive in training and turnover.
Our goal is to build you a package that is both convenient to use while also meeting your bottom line. Value is the most important piece.
Yes, we can include dental and vision insurance plans in your customized package.
We serve employers with 4 or more employees.
Yes! We offer a variety of benefits in addition to medical including dental, vision, disability and more. Visit out services page for more information.
We have been in business for over 30 years.
Our services include: benefits plan creation and implementation, human capital management services, risk management services, group retirement planning and wealth management services for individuals.
We realize we are competing with thousands of brokers, as a result we are always enhancing our services and include them at no additional cost to make sure you go nowhere else.
Our compensation is derived from the carriers and we reinvest it into the services we provide for long-term relationships.
Your carrier will bill you for your insurance policies.
We usually recommend no employer covers less than 50%. With our 100 years of combined experience, we have found that any less contribution from the employer reduces employee morale if made unaffordable for them to participate.
We offer a variety of retirement planning services including group retirement plans such as 401(k) and 403(b)..
Yes! We offer 4013(b) retirement plans for public schools and certain 501(c)(3) tax-exempt organizations
401ks are great plans for giving an incentive to your employees.
Offering a qualified retirement plan is an ideal way to sttract and retain highly qualified employees.
Health Insurance
The HMOs typically say as long as the injury or illness is permanently disabling or can be fatal – you’re covered worldwide.
Yep, all our plans come with emergency coverage but make sure to check your copay or deductible so that it is affordable for you.
Some HMOs do require referrals, however most have deleted that obstacle and the doctor’s offices are just used to asking for them even if your plan is open-access. Don’t hesitate to clarify for their insurance specialist.
Insurance companies require authorizations for medical procedures. It is accomplished by receiving medical records from your provider justifying the need for that service. It is a cost-savings measure implemented so that providers would not recommend procedures strictly for compensation.
All insurance companies have a list of medications named ‘formulary’. Formularies change every six months even if you’re not renewing and it could affect the medication you are currently taking. Usually the lower copays are generic and the higher copays are either brand name or injectables.
Yes, however you are only covered for emergency services.
No, you will need to contact your employer to assist you with how to submit your claims through worker’s compensation.
No, these fees are not recognized by your insurance.
Health Insurance : Claims
If you have not met your Out of Network Deductible then once the claim is processed; only the allowed amounts for the covered services will apply towards your out of network benefits which will usually be less than the total amount that you paid out of pocket. If you have met your out of network out of pocket then you will only be reimbursed the allowable/contracted rates for the covered service therefore you will not be reimbursed the total amount paid out of pocket to the provider.
No, please allow us the opportunity to review the bill prior to making a payment so that we can confirm how much you actually owe otherwise it can be very difficult to get reimbursed by the provider once the payment is already made.
Presenting relevant insurance ID cards to your provider.
Health Insurance : Gap
Gap insurance is a supplement plan that can be either employer paid or voluntary. Gap insurance exists for employers who opt for a higher deductible primary insurance plan, but want to offer supplementary GAP insurance to cover that deductible cost. Gap Insurance offers more flexibility with health plan options.
Even though you provide both your Medical and GAP insurance cards to a facility/provider, they might bill the primary but might miss billing your secondary.
No, GAP insurance does not cover medications from a retail pharmacy.
Yes, only due to accidents. Illness related ambulance rides are not covered.
Health Insurance : Vision
No, you would need Vision Insurance.
Health Insurance : Service
Yes, adjustments would reflect on the group’s invoice the following month.
Adjustments do not usually reflect during the same month of the termination request. The following month would reflect the adjustments, due to the invoice being already prepared by the time the deletion is received.
They can continue coverage through Cobra, however the employee will be responsible for the total cost of the premium as the employer contribution is no longer applicable.
No, only spouses, domestic partners, and/or children.
The employer will pay the group premium on a monthly basis and the employer will deduct the employee portion from their paycheck. Please see employer HR representative for more information (payroll).
Once the employee has met the waiting period requirement – Adding a new employee onto an insurance policy takes 3-5 business days from time of request received.
No, it does not cover PCP, Specialist or Medication copayments.
Usually there is a waiting period for employers to make sure the employee will be staying to avoid administrative hurdles.
Human Capital Management (HCM) is the optimization of an employee’s journey before they’re hired, to their final day with the company. HCM is a set of processes, procedures and strategies that ensures you are utilizing your company’s greatest asset, your human capital (aka your employees!)
Human Capital Management services provide an overarching business strategy and process that touches many parts of your business. This includes recruiting and onboarding, time and labor management, payroll and taxes, and more.
With the right HCM technologies, you are able to achieve your goals faster and more efficiently. Our team will recommend the right programs to further your business goals.
