Employee Benefits FAQs

• The rates for Small Group Fully Insured plans (1-100) are based on the ages of those enrolled and the zip code of the business.  Large Group Fully Insured plans (100+) are experience-rated and are based on the overall age and health of the group, as well as claims history.
• If the plan is level-funded or self-funded, then generally speaking the more participants you have enrolled, the more competitive the rates will be.  The overall age, health, and prior claims data are also taken into consideration when determining the rates.

Generally speaking, no. Since the adoption of the ACA, the IRS and DOL have discouraged and penalized this practice. 

Individual coverage Health Reimbursement Arrangement (ICHRA) and the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) are two potential ways employers can reimburse employees for their individual coverage but they must be properly administered and aren’t always a fit for every employer. Talk to us about the best ways to achieve your goals!

If you have 50+ Full-Time equivalent employees in California, then you are an Applicable Large Employer (ALE), which means you have to offer minimum essential coverage that is considered affordable by the IRS. If you are under 50 Full-Time Equivalent Employees you are not legally required to offer health insurance under the ACA.*

• If you have any employees that work in San Francisco (even if they are working from home) you may be required to offer a health plan or contribute a set amount based on the hours worked to Healthy San Francisco or a Medical Reimbursement Account for the employee to use as needed. 

We are appointed with over 140 different carriers, including Kaiser Permanente, Anthem Blue Cross, Blue Shield, United HealthCare, Health Net, Covered California, Cal Choice, Cigna, Sutter Health Plus, Aetna, Guardian, Delta Dental, VSP, MetLife, Standard, Mutual of Omaha, Principal, SunLife, and many more. With these carries we have plans such as: HMOs, PPOs, HSAs, HRAs, HDHPs, FSAs, EPOs, HSPs, POSs, Vision, Dental, Group Term Life, Short and Long Term Disability, and a host of voluntary products. 

In some instances, companies can offer multiple carriers and plans for different lines of coverages. If you are curious about what your company can offer, schedule a time to discuss your unique situation with us. 

Open Enrollment is the time of year when your plan options renew and your employees can make changes to their enrollment elections. 

Open Enrollment is unique to each company, and AEIS tailors assistance based on the needs of each company.  AEIS can provide an online tool to facilitate open enrollment to distribute all required documents and collect enrollment data, or AEIS will provide the client with all of the required annual notices, Benefit Summaries, and carrier forms that are required for the completion of open enrollment to the client in electronic or hard copy formats as well as hold educational sessions for the staff so they can be sure they understand their benefits package and utilize it to their best advantage.

In advance of their renewal, each of our clients receives a detailed analysis of the available plan options that best compare to their current plans and meet their desired outcomes for the coming plan year.  This analysis is done every year to be sure the client is matched with the plans that are best suited for them and their current needs.

When you become a client, we pair you with one of our qualified and experienced Personal Account Managers.  Our Personal Account Managers are industry specialists who help you with the day to day issues that may arise and assist you throughout the entire enrollment and renewal process.  They are your go-to source for any problems or questions that you or your employees have.  Should any questions require more knowledge surrounding strategy or industry trends, our President and Benefits Consultant are at hand.  In the case of compliance or legislative issues, our Compliance Officer’s expertise is called into action.

At AEIS, we believe insurance is just the beginning. Our role is to be a strategist, advocate, and advisor working in your best interest. We customize business solutions to fit your needs. We utilize a personalized network of partners that help with compliance, HR, payroll, benefit administration, legal and life insurance solutions. We believe in helping you to streamline administrative issues in order to save you money and give you back your time.

Many of the carriers we work with provide nationwide coverage.  We have many clients that have employees in various states and we are well versed in making sure they are adequately covered and that the client is well informed of and complies with specific regulations in those states.  If you have questions regarding your out-of-state employees, schedule a call with us to learn more.

A broker is more than a salesperson selling an insurance policy.  We believe as brokers we are there to work with you as a partner to help strategize, design, and implement the best coverage and benefit plans for your team.  Our brokers at AEIS prioritize service and desirable outcomes, advocate for our clients when necessary, and help to remove the complexities of the health insurance system.

Plan rates are set by the carrier and are the same whether you have a broker, or not.  So if you don’t have a broker, you are not taking full advantage of what you are paying for.  

Schedule a consultation to see how we can help you.

United Benefit Advisors is an organization consisting of 140+ independent benefit advisors from all over the US, Canada, Ireland and the UK. This collection of many independent advisors empowers our agencies to offer tools that most independent brokers cannot access while also providing nationwide expertise to serve our clients in the best ways possible wherever they may be. 

Learn more about UBA!

Group health insurance brokers work with their employers to implement benefits solutions that maximize their opportunity to attract and retain talented employees in the most economically efficient way.

Brokers also assist in solving many administrative problems for their clients such as:  simplifying the process of enrolling/terminating employees from the benefit plans, resolving carriers' clerical errors and claims disputes, improving employees perception and appreciation of their employers' benefits, alleviating costly renewal increases and unnecessary expenditures, mitigating legal and compliance risks, and much more!

AEIS does not charge our clients any fees. Some insurance brokers may charge fees, but the vast majority do not because brokers are typically compensated by the insurance carriers whose plans they sell.