Frequently Asked Questions

We’ll have a short Discovery meeting (or conference call) to find out your goals. Some goals might include: 1) Better Employee Retention, 2) Helping Specific Employees with Health Care, 3) Maximizing Tax Reductions, or 4) Lowering Worker’s Comp.

Next, we’ll assess your $ Budget during this time, even if it’s zero ($0).

Then, we’ll get a Census of your W2 employees (working more than 30 hours per week). This includes Name, Birth Date, Zip Code, and email address.

The insurance carrier needs proof your payroll has real W2 employees. This is done with a Quarterly Wage Report on Form DE9C (or equivalent). You can get this from your payroll provider.

Finally, we’ll create a Proposal. Once we have approval:

Employees fill out applications (as well as waivers) via our enrollment services

The Company will sign the Group Application

The Company will complete a Payment (ACH) form

We’ll send everything to the insurance carrier. ID cards are issued within 7-10 business days, so we always recommend completing before the 20^th of the month.

Then we’ll work with your Payroll provider to place deductions into your account. The first month’s premiums are paid in advance. After that, employee contribtions are “withheld” and remain in the company bank account.

It’s a simple stroke of a pen on company letterhead. You would appoint WellWorks as the broker-of-record on your account. We’ll even supply the letter template.

For small groups, it’s typically (but not always) 70% of eligible employees. But keep in mind this is after you subtract valid waivers. A valid waiver doesn’t count toward your total.

Yes! In fact, it’s probably cheaper than what you are paying now if you purchase directly from the carrier, or if you get coverage through a spouse. It’s also fully expensed to the business.

You don’t have to. Changing broker representation doesn’t require you to change your insurance. The change simply allows us to service your account.

We have found that employees elect into insurance when 1) It’s required by law (which health insurance is), 2) when someone else is paying for it, and 3) when they have proper education about it. Regardless of what your employees earn, we can present options thoroughly and allow them an informed choice – even if the company doesn’t fund it.

The only contribution required by the insurance carrier for medical insurance is either a flat $ dollar amount of ~$100 per month or a fixed % percentage based on a “reference” plan. And this only applies to those who participate. This means if you chose $100 per month, and seven of ten employees participated, your monthly cost is $700.00.

But consider: Many employees may already have insurance through a spouse or parent. Some also qualify for Medi-Cal or Medicare. These are considered “valid” waivers. So even if you have ten employees, your cost may be far less.

Every dollar your employees contribute toward their benefits – if deducted pre-tax – will reduce your (the employer’s) contributions to FICA. Currently, that’s 7.65% or about 8 cents per dollar. But when you add up hundreds of dollars your employees contribute – after the employer’s share – that adds up to a big amount. For example, if ten employees each pay $100/month on pre-tax benefits, that’s $76.50 per month in fewer taxes you pay – or $918 per year!

Once the benefits plan is fully issued and payroll deductions are set up, the payroll-deducted employee-share will remain in the company bank account. At the beginning of each month, the combined total shall be sent to the insurance carrier. 

With New Hires, the company would simply need to let us know when someone is newly hired as an eligible full-time employee (meaning 30+ hours per week). We will request their basic hire information (Name, Birth Date, Zip Code, and E-mail Address) and send them their onboarding materials to self-enroll and/or schedule a benefits counseling appointment.

We can do as much ongoing, or as little, as you prefer. At the bare minimum, we will 1) Provide customer support for any member-level questions from your employees, and 2) handle new hires, and 3) hold open enrollment each year.

For Medical Insurance, the Affordable Care Act does not permit employee “carve-outs,” meaning you cannot offer a plan to some but not others within the same full-time employment status. If there is a substantial difference in job classification, we can talk about how to define offerings based on job classification.

However, you can “carve-out” Aflac Traditional benefits, because they are an “individual” product. You can also “carve-out” individual life and disability.

Small businesses (< fewer than 50 full-time employees) are not legally required to provide medical insurance. However, by installing benefits, you strengthen your compensation offer and increase retention. As long as you have fewer than 50 full-time employees, simply maintain the contribution amounts and remain consistent on your waiting periods. Make sure all employees are offered the plan, even if they verbally tell you they don’t want it. The web portal ensures that everyone enrolls or declines online – and no one can say they were discriminated against or were otherwise not offered benefits.

Your payroll company does not automatically send premiums to the insurance company. Instead, we can setup an auto-pay with most carriers so that the automatic deductions in payroll simply remain in your account – and the deducted employee-portion simply gets drafted automatically through auto-pay. However, it’s important to notify us whenever you have a termination, furlough, or leave-of-absence, so we can provide instructions on how to reconcile this with your insurance carrier.

Small business accounts with fewer than 20 employees are subject to Cal-COBRA, which automatically communicates with your terminated employee with the option to continue coverage. There is typically a 10% administrative fee on top of the full cost of the insurance. The employee also has the option to go to Covered California.

If you have more than 20 employees, the account is subject to Federal COBRA. This means you would need to initiate their options for COBRA, and then the employee would pay their premium with a 2% administrative fee on top of the full cost of the insurance. This premium would be billed to your account, but the premium transaction would be processed through Federal COBRA. The employee also has the option to go to Covered California.

We try not to share names of our clients without their consent, but for small groups, we represent a number of organizations including private schools, construction / electrical / and HVAC companies, family-owned restaurants, a few fitness studios, various professional service companies (private equity, finance, insurance, architecture, design, and legal firms), and multiple substance recovery organizations.

For large groups, we also represent several fast-food franchises including McDonald’s, as well as some large hotel chains.

This is pure speculation because we don’t know. We also don’t know who will win the election. But the reality is rates are based on claims in a geographical area. This is why insurance is more expensive in California than in other places (and some zip codes are more costly than others).

With COVID-19, many insurance carriers are absorbing the cost of testing –some are even eating the cost of treatment. This means the insurance companies are paying more, and in future years the rates may increase. I think it’s the right thing to do right now. But it’s also why in future years– as costs continue to rise– it’s vital to have an advisor in your corner, not just somebody who will tell you the rates. A machine can do that.

With some insurance brokers, your “agent” is a machine already. You deserve better.