FAQs

Health

Each carrier has different requirements, but usually they ask the employer pay 50% of the employee only premium.

Please refer to the health quote page of our website.

Group size and location will alter the time it takes to get a quote. Usually about 1 week for groups under 50; groups over 50 up to 2 weeks, and all groups over 100 about 3 weeks.

No. You should never cancel your insurance coverage until you receive an approval letter from the new carrier. Questions may come up during the enrollment process that may cause delays with the coverage.

Generally, contracts can be broken at any time but there are exceptions. It is critical that you check your contract before these decisions are made.

No. Plan design and census are critical to the quoting process. On groups under 50 employees, all brokers will get the same rates but will not design the same plan. We at DD&A specialize in plan design and service separating us from the rest.

Groups under 50 lives are protected by HIPPA to get health insurance coverage but the premium may increase from the quote. A carrier may decline groups over 50 lives. Please contact DD&A for a review of you current situation.

At DD&A we specialize in Health Reimbursement Account (HRA’s) and Health Savings Account (HSA’s) health care quotes. There are several alternatives including self-insured and partially self-insured as well as HRA’s and HSA’s.

Health Reimbursement Account. A type of insurance plan that reimburses employees for qualified medical expenses, just as an insurance plan will reimburse covered individuals for the cost of services incurred.

Health Savings Account (Also known as Medical Savings Account) are accounts used to pay for unreimbursed healthcare expenses. These accounts accumulate tax-deferred interest. Funds are controlled and owned by the account holder. The employee or employer makes contributions to the account. Savings are rolled over every year and are portable. Any funds withdrawn to pay for non-medical expenses may be taxed.

Healthcare reform law now mandates that all plans provide dependent coverage up to age 26 for all individual and group policies.

You have 30 days to inform the insurance carrier of your baby's birth and name. We recommend you fill out a new insurance application including your new dependent and relevant information.

Your Human Resource Representative should have (or have given you) a plan summary or benefit page. A full certificate of coverage should be available on your carriers website or by direct request from the carrier.

If your company employs more than 20 employees, federal law requires that group health plans give employees and their families the opportunity to continue their health care coverage when there is a "qualifying event" that would result in a loss of coverage under an employer's plan. Depending on the type of qualifying event, "qualified beneficiaries" can include the employee covered under the group health plan, the covered employee's spouse, and the dependent children of the covered employee.

Health Insurance Portability and Accountability Act of 1996 (HIPAA), a federal law designed to ensure the privacy of personal and health information that took effect April 14, 2003.

No, wait for an Explanation of Benefits (EOB) from your insurance carrier. The EOB will list the services billed and the patient responsibility. The billed amount from your doctor and/ or hospital should match the Explanation of Benefits patient responsibility.

In most cases, a group will establish a minimum hourly requirement and a new hire waiting period. Upon completion of both requirements, employees would be eligible. Contact your HR representative for more information.

The Health Insurance Portability and Accountability Act (HIPAA) has redefined "Special Enrollment Period" for dependants. HIPAA requires group health plans, which have dependant coverage to have a special 30-day enrollment period for dependents, whenever an eligible employee experiences a "Family Status Change" such as a marriage, birth, adoption or placement for adoption. During this special enrollment period an eligible employee may join the heath plan if he/she has not enrolled when initially eligible. At this time the eligible employee may also enroll a previously eligible spouse and/or dependent(s), or a new spouse and/or dependent(s). These enrollments must occur within 30 days following the family status change. If enrolled within the 30-day limit, these special enrollees are considered timely additions to the group and HIPAA's 12-month pre-existing condition limitation applies to them.

Other situations in which a special enrollment period applies are:

  • Subscriber, spouse or dependent moves out of the service area
  • Spouse's employer terminated coverage
  • Spouse terminates employment
  • Spouse passes away
  • Spouse has a change in hours or a change in position (e.g., switching from full-time to part-time)

Note: A qualifying event does not allow an already enrolled member to switch plans it only allows them to add to their current plan.

Most states have continuation laws in place similar to COBRA which allow certain employees, spouses and dependent children the right to continue employer-sponsored health benefits. For example, all Illinois employers offering fully insured group health plans are subject to Illinois ‘mini-COBRA’, regardless of size. State Continuation rules and regulations vary by state.

Employers with 50 or less employees must use the new the Standard Application for medical plans. Some carriers, such as BlueCross BlueShield of Illinois are allowing the application for employers up to 150 employees. Most ancillary carriers are still using their company specific application.

>> Click Here for the new Illinois Standard Application

Whether you are the employer or employee, healthcare reform will be affecting us all in various ways. Please contact us and we would be more than happy to discuss individual circumstances and affects of healthcare reform.


Life

If you have dependants or a spouse that would not be able to make ends meet without your income. If you have debts and liabilities that would fall onto others. If your company would suffer a loss without you or some of your employees, think about life insurance.

No. Different types of life insurance have separate requirements. In most cases blood, urine, height, and weight are taken. There are several carriers that guarantee issue, however, usually this insurance is extremely expensive.

The amount will vary from person to person for several reasons. Insurance is an emotional and financial decision, individual comfort level, cash flow affordability, and financial need all must be considered. It is important to meet with a financial professional to help you make the appropriate decisions to protect your family and their future.

We may represent over 50 carriers all “A” rated companies. We also have access to the substandard market if necessary.

If you read the fine print, you will notice that all term carriers give the same rates to all brokers.

It is our job to not only help define your needs but to help throughout your life in all situations. We recommend recurring reviews to assure your insurance will still cover you family’s current lifestyle and will always be here to assist in placing a claim through the difficult time.

The most common variables include, face amount, age, gender, health, tobacco use, and type of insurance (term or permanent).

Life insurance has multiple purposes and is not limited to death benefits. Some life insurances may supplement your retirement with alternative options that provide more flexibility than qualified plans.

The term policy holds no value and is usually retired. It is possible to renew the policy on a yearly basis without new health underwriting, however it is usually very expensive to do so.