Diamond Certified Companies are Rated Highest in Quality and Helpful Expertise.

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Diamond certified companies are top rated and guaranteed

Why Trust Diamond Certified Health and Employee Benefits Insurance Firms Rated Highest in Quality?

Photo: Bay Area Health Insurance Marketing, Inc. (2017)

Only the best health and employee benefits insurance firms in San Mateo County have earned the Diamond Certified award by scoring Highest You are the customer. If your goal is to choose a health and employee benefits insurance firm that will deliver high customer satisfaction and quality, you’ll feel confident in choosing a Diamond Certified employee benefits and health insurance company. Each has been rated Highest in Quality in the most accurate ratings process anywhere. And you’re always backed by the Diamond Certified Performance Guarantee. Here’s why the Diamond Certified ratings and certification process will help you find a top-rated employee benefit and health insurance company and is unparalleled in its accuracy, rigor and usefulness:

 

1) Accuracy: All research is performed by live telephone interviews that verify only real customers are surveyed, so you’ll never be fooled by fake reviews.

2) Statistical Reliability: A large random sample of past customers is surveyed on an ongoing basis so the research results you see truly reflect a Diamond Certified company’s top-rated status.

3) Full Disclosure: By clicking the name of a company above you’ll see the exact rating results in charts and read verbatim survey responses as well as researched articles on each qualified company.

4) Guaranteed: Your purchase is backed up with mediation and the Diamond Certified Performance Guarantee, so you can choose with confidence.

Click on the name of a Diamond Certified company above to read ratings results, researched articles and verbatim customer survey responses to help you make an informed decision.

More than 200,000 customers of local companies have been interviewed in live telephone calls, and only companies that score Highest in Quality in customer satisfaction–a 90+ on a 100 scale–as well as pass all of the credential-based ratings earn Diamond Certified. By requiring such a high score to qualify, the Diamond Certified program eliminates mediocre and poorly performing companies. Read detailed information about the ratings and certification process.

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DIAMOND CERTIFIED EXPERT CONTRIBUTORS IN THE San Mateo County – Insurance – Health & Employee Benefits CATEGORY

Bob Vinal is president of Bay Area Health Insurance Marketing, Inc., a Diamond Certified company since 2011. He can be reached at (650) 273-0330 or by email.

Bob Vinal

diamond certified contributor profile and expert article

Bob Vinal: A Great Communicator

By James Florence, Diamond Certified Program Reporter

MENLO PARK — Following college, Bob Vinal wasn’t entirely sure how he would apply his communications degree in the professional realm, but after accepting a job offer in the insurance business, he found it to be a perfect fit. “My brother was selling life insurance and needed someone to help out with employee benefits,” he remembers. “As a communications major, I’ve always been one for gab, so when I got into insurance, I really enjoyed having the opportunity to talk with people on a daily basis.” After gaining further industry experience over the next few years, Bob decided to strike out on his own and founded Bay Area Health Insurance Marketing, Inc. in 1987.

A resident of Santa Cruz (where he lives with his wife, Trudy), Bob expresses his appreciation for the Bay Area’s characteristic attributes. “I love the weather and the people here—plus, as a sports fan, I love watching all the Bay Area teams.” Outside of work, some of Bob’s pastimes include coaching high school football, surfing, golfing, and barbecuing with friends and family. He also likes to keep in touch with his and Trudy’s three grown children: Therese, who works for the San Francisco Giants; Michelle, who is earning her master’s degree at Cal State Fullerton; and Matt, who recently graduated from University of Las Vegas.

In his life and career, Bob espouses the importance of treating others fairly and honestly. “Our main credos at Bay Area Health Insurance Marketing are to be honest with our clients and treat them as we’d want to be treated,” he affirms. “We don’t want to be the kind of brokers who make a profit at their clients’ expense; rather, we genuinely want to help our clients and give them good, sound advice.”

When asked the first thing he’d do if he were to retire tomorrow, Bob says he’d do some surfing, both at home and abroad. “Living in Santa Cruz, there’s plenty of good surfing, but I also like going to Hawaii, which is one of our favorite vacation spots. However, I know my wife wants to see some new places as well, so we’d probably do some more extensive traveling.”

Ask Me Anything!

Q: What’s your favorite sports team?
A: It depends on the time of year. During baseball season, it’s the San Francisco Giants; during football season, it’s the San Francisco 49ers; and during basketball season, it’s the Golden State Warriors.

Q: Are you a dog person or a cat person?
A: A dog person. I have two dogs, Bruschi and Bella.

Q: What were you most known for in high school?
A: I played football and was the rally commissioner.

Q: What’s your favorite snack?
A: Popcorn.

Q: What’s your favorite season?
A: Fall, because football starts.

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A 2015 Tax Credit for Small Business Owners

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MENLO PARK — If you’re a small business owner with less than 25 employees, you may be eligible for a 2015 tax credit. Under the Affordable Care Act, there’s a new program that rewards employers who offer (or continue to offer)… Read more

Communicating Employee Benefits

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MENLO PARK — If you’re a small-business owner, you’re likely spending thousands of dollars each month to provide benefits for your employees. However, if you aren’t taking the time to communicate to your employees about their benefits, they may not… Read more

Expert Video Tip

Video: Communicating Employee Benefits

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Complete Video Transcription:

MENLO PARK — Host, Sarah Rutan: If you’re an employer, make sure your employees understand what your benefits are and how to use them. Today we’re in… Read more

SELECTED PHOTOS FROM THESE TOP RATED COMPANIES

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INDUSTRY INFORMATION AND RESEARCHED ARTICLES BY THE DIAMOND CERTIFIED RESOURCE

  • Kaiser Permanente

  • Blue Shield

  • Health Net

  • Allied

  • California Choice

  • Guardian

  • Lincoln Financial

  • Blue Cross

  • Liberty Mutual

  • Anthem Blue Cross

Health Care Service Corporation (HCSC)
American Family Insurance
Assurant Health Insurance
Unum Insurance
Medicare Insurance
Aetna Insurance
Cigna Insurance
Blue Shield Insurance
Highmark Insurance
Anthem Blue Cross
Humana Insurance
Aflac Insurance
Unicare
United Health Insurance
WellPoint Insurance
Medicaid Insurance
Medi-Cal Insurance
Kaiser Foundation
Western Health Advantage Insurance
Kaiser Permanente
The Hartford Insurance
Guardian Life (GLIC)
American General Insurance

long-term health insurance
HMO (health maintenance organizations)
managed care insurance
fee-for-service health plans
POS (point-of-service) health insurance plans
workers’ compensation insurance
flexible spending accounts (FSA)
small business health insurance
self-employed health insurance
group health insurance
employee benefit health insurance
catastrophic health insurance
supplemental health insurance
PPO (preferred provider organizations)
dental insurance
medical emergency insurance
vision care
travel health insurance
individual health insurance plans
family health insurance plans
limited benefit health insurance
short-term health insurance
unemployment insurance

Atherton
Belmont
Brisbane
Broadmoor Village
Burlingame
Colma
Daly City
East Palo Alto
El Granada
Emerald Hills
Foster City
Half Moon Bay
Hillsborough
La Honda
Loma Mar
Menlo Park
Millbrae
Montara
Moss Beach
Pacifica
Palomar Park
Pescadero
Portola Valley
Princeton by the Sea
Redwood City
San Bruno
San Carlos
San Gregorio
San Mateo
Sharp Park
South SF
West Menlo Park
Woodside

94002
94005
94010
94011
94014
94015
94016
94017
94018
94019
94020
94021
94025
94026
94027
94028
94030
94037
94038
94044
94060
94061
94062
94063
94064
94065
94066
94070
94074
94080
94083
94096
94098
94128
94401
94402
94403
94404

California Department of Consumer Affairs (DCA) (www.dca.ca.gov)
National Association of Health Underwriters (NAHU) (www.nahu.org)
National Association of Insurance Commissioners (NAIC) (www.naic.org)
International Foundation of Employee Benefit Plans (IFEBP) (https://www.ifebp.org)
American Benefits Council (ABC) (www.americanbenefitscouncil.org)

Know What You Want
First, Determine What You Want from Health Insurance and Employee Benefits Providers

Before taking the time to interview and vet different employee benefits providers in San Mateo County, spend a few minutes thinking about what you and your employees want in terms of health insurance, other employee benefits, rates, packages and customer service.

Make a list of your wants and needs. To do this, ask yourself the following questions and write down your answers:

  1. Do I want a Diamond Certified health insurance and employee benefits company that is rated best in quality and backed by the Diamond Certified Performance Guarantee?
  2. What is my overall goal in getting health insurance and other employee benefits for my workers? (For example, employee retention, happier employees, lower cost than existing health insurance, better health insurance and employee benefits packages than existing plans, reward good employees, etc.)
  3. What is my budget for employee benefits and health insurance coverage?
  4. What kind of health insurance and benefits packages am I looking for? (This may include comprehensive health insurance, catastrophic illness coverage, disability coverage, unemployment insurance, HSA accounts, flexible spending accounts, vision care, dental care, COBRA, retirement or 401k plans, etc.)
  5. What type of care and services do I expect from San Mateo County employee benefits companies in East Palo Alto, Foster City, Pacifica, San Bruno and my town?
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What To Ask In Person
Meet with San Mateo County Employee Benefits Providers in Person to Talk About the Health Insurance and Benefits Packages You Need

Once you’ve found a few good San Mateo County health insurance and employee benefits providers you like that can offer the services and packages you need, you will want to meet with the standouts in person and ask a few more questions to help you narrow the field further.

Questions you may want to ask include the following. Add to these sample questions ones that specifically address your needs and wants.

  1. What plans do you recommend to meet my needs and budget and those of my employees?
  2. Do you coordinate with other San Mateo County insurance companies and employee benefits providers in Daly City, San Mateo, Redwood City, South San Francisco, San Bruno and other areas if you can’t offer all of the services and plans we need?
  3. Will we deal with you throughout the process, or will you hand off our service to another person within your company?
  4. How long will it take to get coverage for my employees once we sign a contract with your company?
  5. What information do you need from me and my employees to get the process started?
  6. What else should I know about your company that can help me make the best decision for me and my employees?
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  • What To Ask References
    Get Insight Into San Mateo County Health Insurance and Employee Benefits Companies from Their Former and Existing Customers

    It’s best to choose among Diamond Certified health insurance and employee benefits providers because all certified companies have passed an in-depth ratings process that most other companies can’t pass. If you want quality from an employee benefits provider in San Mateo County, you can have confidence choosing a Diamond Certified company. That’s because Diamond Certified reports are available online for all certified companies, and you’ll never be fooled by fake reviews since all research is performed in live telephone interviews of actual customers.

    If you can’t find Diamond Certified health insurance benefit providers within reach, you’ll need to do some research on your own. In that case, it’s wise to call references provided by the companies you’re considering working with. You should know, however, that references provided to you by San Mateo County employee benefits companies in Foster City, Daly City, Menlo Park, Redwood City, Burlingame and beyond are not equal in value to the large random sample of customers surveyed during the Diamond Certified ratings process.

    In fact, references given by companies to potential customers are usually cherry-picked instead of randomly selected from their entire database., meaning you will likely get only the names of a few customers that the companies know are satisfied.

    If you do call references on your own, ask for a list of the San Mateo County employee benefit companies’ 10 most recent customers. This will help avoid them giving you the names of only customers they know were satisfied.

    Then, call each of the references and ask questions to learn more about the insurance brokers and employee benefits providers you are considering hiring. Some questions you may want to ask are written below.

    1. Were you satisfied with the performance of _(company name)_ health and employee benefits company and their products?
    2. What type of insurance, employee benefits and services did they provide for you?
    3. Were you pleased with the turn-around time between when you signed up and when your employee benefits plans came into effect?
    4. Were they able to provide the employee benefits and health insurance packages that you hoped to provide to your workers?
    5. Was this employee benefits and health insurance provider able to work within your budget?
    6. Do you feel the price was fair for the packages you received?
    7. If your company is based in a smaller town such as Broadmoor Village, Atherton, El Granada, Moss Beach, Portola Valley, San Carlos, Princeton by the Sea, Sharp Park, was this San Mateo County employee benefits firm able to meet your needs?
    8. Were you happy with the communication from this San Mateo County employee health insurance provider?
    9. What is the best part of dealing with this company?
    10. Is there anything you don’t like about this company or their services?
    11. Would you contract with this employee benefits provider and employee health insurance company again if you had the choice?
    12. What else should I know about this company before making a hiring decision?
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  • Review Your Options
    Signing a Contract with the Best Employee Benefits Services in San Mateo County

    The Diamond Certified symbol has been awarded to companies that scored Highest in Quality in an accurate ratings process.

    Before deciding on the best health insurance and employee benefits providers in San Mateo County for you, it’s important to review your notes and consider the following questions.

    1. Is there one San Mateo County employee benefits company that stands out above the rest in terms of being able to meet your needs, budget, expectations and timelines?
    2. Did one local employee health insurance and benefits company seem to care more about meeting your needs than the others?
    3. Did one company offer a better range of packages or more complete set of choices for your employees?
    4. Do the employee benefits companies communicate clearly, quickly and effectively?
    5. Do you feel comfortable signing a contract with one of the San Mateo County health insurance and employee benefit providers you interviewed?
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  • How To Work With
    The Best Employee Benefits and Health Insurance Packages in San Mateo County

    Whether you’ve narrowed down your choices to the best San Mateo County health insurance and employee benefits company for you and your business, or are still interviewing a few good firms, follow the helpful tips below to get great package deals and the solid coverage you and your employees need and deserve.

    • Meet with the San Mateo County employee benefits and health insurance company representative and discuss your needs, those of your employees, and all of your expectations. Ask the insurance company whether they can meet your needs and how you can proceed to come up with a contract that address all of your needs, those of your employees and of the employee benefits company.
    • Ask for and carefully review the list of available packages and employee benefits menus. See that the cost and services meet your needs before moving forward.
    • Request a contract that will protect you and your San Mateo County health insurance and employee benefits provider, whether you’re in Daly City, Redwood City, South San Francisco, San Bruno, Pacifica District, East Palo Alto, Menlo Park, Foster City and Burlingame or another area.
    • Your agreement is final when you sign the contract, so never sign a blank or incomplete estimate, and don’t feel pressured to make a quick decision. While timely contracts are important to lock in rates and options and to start coverage for your employees, you should always have time to read over and feel comfortable with your options.
    • Find out how you and your employees should deal with questions, comments, concerns or coverage issues in the future, whether you’re in a large city like Foster City, Daly City, Menlo Park, Redwood City, Burlingame or La Honda, Loma Mar, Millbrae, Emerald Hills, Half Moon Bay, Palomar Park, Pescadero, Colma.
    • Ask if your San Mateo County employee benefits company will come in to your office to present the available packages (if your employees get a choice on which coverages they receive) or the details of the plans you’ve chosen for your workers.
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  • Be a Good Customer
    Easy Ways To Be a Good Health Insurance and Employee Benefits Customer?

    It’s the responsibility of your health insurance and employee benefits providers to put together health insurance and employee benefit packages that meet your budget and requests and still cater to the overall needs of your employees.

    But you also play a big part in the success of the employee benefits packages you choose. Here are a few simple steps you can take to be a good customer when signing agreements with San Mateo County health insurance and employee benefits providers in East Palo Alto, Foster City, Pacifica, San Bruno and the rest of the Greater Bay Area.

    • Be clear and upfront with the health insurance and employee benefits providers you’re working with. Let them know what you want from the health insurance and employee benefits packages you arrange for, the long-term outcome you’re expecting and specific ways they can satisfy your expectations.
    • Stay friendly, polite and focused on the job. Handle questions, concerns and even disagreements with professionalism and honesty.
    • Before you hire health insurance and employee benefits companies in San Mateo County, restate your expectations and goals, and reiterate to the health insurance and employee benefits providers representative your understanding of the agreement. Most problems with local health insurance and employee benefits providers occur because of a breakdown in communication. By being clear about your expectations and theirs, you can avoid most conflicts.
    • Ask your health insurance and employee benefits providers if you should call to check on the progress or if he will call you with updates.
    • Be sure your service representative has a phone number where they can reach you with questions and updates.
    • Return calls and emails promptly to keep the health insurance and employee benefits coverage on schedule.
    • Pay for the benefits and insurance coverage promptly.

    Why would you want to be a good customer?

    Local health insurance and employee benefits providers in San Mateo County appreciate customers who are straightforward, honest and easy to work with. Your good customer behavior sets the tone from your end and creates an environment conducive to a good relationship with employee benefits providers in East Palo Alto, Foster City, Pacifica, San Bruno and beyond. Things may very well go smoother and any problems may be more easily resolved.

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Check The Work
Review the Final Employee Benefit Coverage with Your Original Agreement

Before you send in the first payment or sign a final release, review the invoice from your health insurance and employee benefits company and ensure that you and your employees are getting all services, coverages and items promised in your original agreement.

Now is the time to address questions and concerns, and to make sure that you are getting what you were promised and that the services and packages arranged for meet your needs.

The invoice you receive should include the following for your protection.

  • The health insurance and employee benefits providers’ name, physical address and state license number.
  • A complete list of all services and packages provided.
  • The total cost for the health insurance, employee benefits, and other services or packages.
  • A written explanation of any warranties or guarantees.
  • A detailed document addressing cancellation or changes to the employee benefit packages if any can or need to be made by you, the broker or the insuring company.
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Written Warranties
Popular Kinds of Employee Benefits Available in San Mateo County and Beyond

You can often find any type of employee benefit or health insurance coverage you want from local health insurance and employee benefit providers in San Mateo County, including South SF, Daly City, San Bruno, Menlo Park, Foster City, Burlingame, Redwood City and Pacifica and other areas. The list below shows you which types of services and insurance coverages are most popular.

Individual Insurance Plans
These plans cover just the individual employee for health insurance matters and medical care. Their dependents and families are not eligible.

You can often find any type of employee benefit or health insurance coverage you want from local health insurance and employee benefit providers in San Mateo County, including South SF, Daly City, San Bruno, Menlo Park, Foster City, Burlingame, Redwood City and Pacifica and other areas. The list below shows you which types of services and insurance coverages are most popular.

Individual Insurance Plans
These plans cover just the individual employee for health insurance matters and medical care. Their dependents and families are not eligible.

Family Health Insurance Plans in San Mateo County
Family health insurance plans cover the employee, their spouse and their dependent children. These plans may be fully covered by the hiring company or a portion of the benefits may be paid by the employee themselves.

Dental Insurance Packages
Dental insurance is a popular coverage type, including care for the employee and their dependents. This may include preventative care, orthodontic care, oral surgery and other medically necessary dental care.

Vision Care Insurance Coverage Packages
Vision care, like dental insurance, isn’t covered under most medical employee benefit plans, but it can be added on to packages by employers. This will cover eye exams, glasses and contact lenses, eye surgeries and other vision care.

Unemployment Insurance
Unemployment insurance is a policy that guards against sudden or unexpected unemployment through no fault of the employee (meaning they cannot have been fired or let go for conduct, lack of work, etc.). These plans may be set up by employers to prevent employees from facing fiscal uncertainty due to downsizing or other factors that cannot be prevented by the employer or the employee.

Group Health Insurance for Businesses in San Mateo County
Group health insurance is the most popular type of health insurance available through employers. These plans are often set up through the employer at a discount to cover all employees and their dependents.

Supplemental Health Insurance
Supplemental health insurance plans are add-on insurance policies that take care of people who miss work due to accidental injury or unexpected illness. Some plans cover additional medical fees, while others pay out cash to help employees continue to pay for housing, food and other expenses they may have trouble covering if they are unable to work due to injury or illness.

Life Insurance
Life insurance pays out after the death of an individual to that person’s designated beneficiaries.

Flexible Spending Accounts (FSA)
FSAs allow holders to set aside pre-tax money for common medical costs. These funds must be used by the end of the term-year. Allowed services may include copays for doctors’ visits, hospital fees, medical test costs, rehabilitation, physical therapy, dental care, orthodontic care, inpatient rehabilitation care for alcohol and drug addiction, vaccines and immunizations.

Health Savings Accounts (HSA)
Health savings accounts allow holders to save for future medical costs. Money put in the account is not subject to federal income tax when deposited and can build up and be used in the future.

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Top 10 Requests
Popular Kinds of Employee Benefits Available in San Mateo County and Beyond

You can often find any type of employee benefit or health insurance coverage you want from local health insurance and employee benefit providers in San Mateo County, including South SF, Daly City, San Bruno, Menlo Park, Foster City, Burlingame, Redwood City and Pacifica and other areas. The list below shows you which types of services and insurance coverages are most popular.

Individual Insurance Plans
These plans cover just the individual employee for health insurance matters and medical care. Their dependents and families are not eligible.

Family Health Insurance Plans in San Mateo County
Family health insurance plans cover the employee, their spouse and their dependent children. These plans may be fully covered by the hiring company or a portion of the benefits may be paid by the employee themselves.

Dental Insurance Packages
Dental insurance is a popular coverage type, including care for the employee and their dependents. This may include preventative care, orthodontic care, oral surgery and other medically necessary dental care.

Vision Care Insurance Coverage Packages
Vision care, like dental insurance, isn’t covered under most medical employee benefit plans, but it can be added on to packages by employers. This will cover eye exams, glasses and contact lenses, eye surgeries and other vision care.

Unemployment Insurance
Unemployment insurance is a policy that guards against sudden or unexpected unemployment through no fault of the employee (meaning they cannot have been fired or let go for conduct, lack of work, etc.). These plans may be set up by employers to prevent employees from facing fiscal uncertainty due to downsizing or other factors that cannot be prevented by the employer or the employee.

Group Health Insurance for Businesses in San Mateo County
Group health insurance is the most popular type of health insurance available through employers. These plans are often set up through the employer at a discount to cover all employees and their dependents.

Supplemental Health Insurance
Supplemental health insurance plans are add-on insurance policies that take care of people who miss work due to accidental injury or unexpected illness. Some plans cover additional medical fees, while others pay out cash to help employees continue to pay for housing, food and other expenses they may have trouble covering if they are unable to work due to injury or illness.

Life Insurance
Life insurance pays out after the death of an individual to that person’s designated beneficiaries.

Flexible Spending Accounts (FSA)
FSAs allow holders to set aside pre-tax money for common medical costs. These funds must be used by the end of the term-year. Allowed services may include copays for doctors’ visits, hospital fees, medical test costs, rehabilitation, physical therapy, dental care, orthodontic care, inpatient rehabilitation care for alcohol and drug addiction, vaccines and immunizations.

Health Savings Accounts (HSA)
Health savings accounts allow holders to save for future medical costs. Money put in the account is not subject to federal income tax when deposited and can build up and be used in the future.

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Glossary Of Terms
Glossary of Employee Benefits and Health Insurance Coverage Terms

accumulation period
The period of time during which the insurance policy holder’s eligible medical expenses  count toward their minimum deductible.

Also known as: deductible period, deductible accumulation period

age limit
Some insurance policies, especially life insurance policies, have age limits above which they won’t accept applications for or renew insurance policies.

Also known as: insurance age limit, age limit for insurance policies, age limit for insurance eligibility

alternative medicine
Medical practices or forms of medical treatment defined as alternative medicine may include those not generally recognized by the medical community. Alternative medicine may include acupuncture, homeopathy, aromatherapy, naturopathy, and other Eastern or non-traditional medicines. Many insurance companies do not provide insurance coverage for alternative medical treatment.

Also known as: Eastern medicine, non-traditional medicine, homeopathy, homeopthic medicine, naturopathy, acupuncture, chiropractic care

ambulatory care
Medical care diagnosis, certain forms of treatment, surgery and rehabilitation that are provided as outpatient services. These may or may not be covered at different rates than other types of medical care.

Also known as: outpatient care, ambulatory medical treatment

annual coverage limit
The dollar limits insurers will pay over the course of a year. Most of these plans are being phased out and may not be permitted as of January 1, 2014.

Also known as: annual health insurance coverage limits, annual coverage limits, annual limits

approved health care facility or program
A medical facility, hospital, program or clinic approved by a holder’s health insurance plan. These approved health care providers, facilities and programs are authorized to provide specific services for specific medical conditions covered by insurance.

Also known as: approved health care program, approved health care provider

benefit
Any  medical service, treatment or supply (including prescription medications and equipment) covered by health insurance plans is known as a benefit.

Also known as: insurance benefit, benefit plan, insurance benefits

benefit level
The maximum amount the health insurance company will pay for a specific benefit.

Also known as: maximum health care benefit, maximum insurance benefit

benefit package
The package of medical and health-related services and supplies health insurance companies cover for holders of health insurance plans are benefit packages.

Also known as: insurance benefit packages, package of insurance coverages

cafeteria insurance plans
Cafeteria health insurance and benefit plans are those that allow employees to choose which benefits and insurance coverage they most want. Most insurance cafeteria plans available through employers show a list of prices and allow employees to choose whichever coverages they want as long as they fall under a certain total cost limit.

Also known as: cafeteria health insurance plans, a la carte insurance plans

COBRA
Federal legislation that allows employees and/or employees’ dependents to continue to receive group health insurance coverage through the employer’s health insurance plan, at the individual’s expense after termination of employment.

Also known as: Consolidated Omnibus Budget Reconciliation Act of 1985, COBRA insurance coverage

certificate of coverage
A document given to insured individuals that describes the benefits, limitations and exclusions of coverage provided by the insurance company.

Also known as: certificate of insurance coverage

co-payment fees
S
pecific charges insurance holders pay for medical services or supplies before insurance kicks in to cover the rest of the fees.

Also known as: co-pay, copays, copay

deductible
A specific dollar amount health insurance companies require insurance plan holders to pay before the health insurance plan begins to make payments. Not all health insurance plans require a deductible, but most do.

Also known as: insurance deductible, deductible amount

dependent coverage
Health insurance coverage for spouses and unmarried children of insured individuals. Age and other restrictions may apply.

Also known as: dependent health insurance coverage, coverage for dependents

drug formulary
A list of prescription medications covered by health insurance plans.

Also known as: approved drug list, prescription formulary

flexible spending account
FSAs allow holders to
set aside pre-tax money for common medical costs. These funds must be used by the end of the term-year. Allowed services may include copays for doctors’ visits, hospital fees, medical test costs, rehabilitation, physical therapy, dental care, orthodontic care, inpatient rehabilitation care for alcohol and drug addiction, vaccines and immunizations.

Also known as:  FSA

HMO plans
HMO plans require insured members to use providers from a certain list of primary care doctors. The primary care doctor will refer out to other HMO specialists if additional treatment or specialty care is needed.

Also known as:  Health Maintenance Organization

health reimbursement account
Health reimbursement accounts allow
employers to set aside funds for health care costs accrued by their employees. These funds reimburse covered services paid for initially by employees.

Also known as: HRA, HRA accounts, reimbursement medical plans

health savings account
Health savings accounts allow holders to save for future medical costs. Money put in the account is not subject to federal income tax when deposited and can build up and be used in the future.

Also known as: HSA, high-deductible health savings accounts

health assessment
A health survey that measures your current health, health risks and quality of life. Some insurance plans require holders to undergo a health assessment before coverage begins to establish a baseline for expected health care needs and costs.

Also known as: health assessment tests, insurance health assessments

long-term insurance
Health insurance coverage set over a set amount of time is known as long-term insurance.

Also known as: term insurance

medically necessary health care
Services, supplies or prescription drugs needed to diagnose or treat medical conditions are known as medically-necessary health care.

Also known as: medical necessity, medically necessary care

non-network provider
A healthcare provider who is not part of an insurance plan’s authorized provider network. Costs for care provided by out-of-network providers may be higher than in-network providers, or  may not covered by insurance providers.

Also known as: out of network provider, NNP, OONP, non-authorized provider

short-term insurance
Insurance that covers certain services for a set short time period, usually six months or less.

Also known as: short term insurance coverage, short term medical insurance plans

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Frequently Asked Questions
FAQ Pertaining to Employee Benefits and Health Insurance Coverage For Companies

Q: Why choose Diamond Certified health insurance and employee benefits providers?
A: Diamond Certified helps you choose a health insurance and employee benefits providers with confidence by offering a list of top-rated local companies who have passed the country’s most in-depth rating process. Only health insurance and employee benefits providers rated Highest in Quality earn the prestigious Diamond Certified award. Most companies can’t pass the ratings. American Ratings Corporation also monitors every Diamond Certified company with ongoing research and ratings. And your purchase is backed by the Diamond Certified Performance Guarantee. So you’ll feel confident choosing a Diamond Certified health insurance and employee benefits providers.

Q: How much will employee benefits cost my company?
A: That depends on the employee benefits and packages you choose to provide. Providing health insurance, retirement packages and other benefits is voluntary, but it can have both financial and non-financial results when it comes to recruiting and retaining top-quality employees. Talk with a local health insurance and employee benefit provider to find out which options are available to you and your employees and what these packages and menus cost. A good employee benefit and insurance provider will help you weigh the pros and cons of providing health insurance and employee benefits to your workers.

Q: What is COBRA?
A: COBRA coverage is a continuation of health insurance coverage after an employee leaves a job. It stands for the Consolidated Omnibus Budget Reconciliation Act, which became law in 1986. This program requires covered employees to be allowed to continue their health insurance, and those of their spouses and dependents, when they might otherwise be lost due to leaving a job or another circumstance.

Q: How can I save money on employee benefits and health insurance coverage?
A: Good employers can find better employee insurance rates by speaking with quality insurance providers about their needs and options. Cut-rate insurance companies will usually give you plans that are lacking in quality, so you may be happier and get a much better value by getting your employee benefits and health insurance coverage through a reputable company. Some ways employee health insurance and benefits companies can  help lower rates is by offering plans with increased deductibles, voluntary benefits that pay directly to employees, and tailoring plans to fit employee needs and wants.

Q: Am I required to provide health insurance for my employees?
A: No, small businesses with fewer than 50 employees are not required to offer employee health coverage. However, many do and it is possible to find affordable, quality employee health insurance plans that keep your workers happy and won’t break the budget.

Q: Do I have to cover the entire costs of my employees’ benefits?
A: No, and it may be a mistake to do so. Most employers choose plans that require employees to pay some deductibles and even contribute toward the cost of their insurance for dependents. This can help lower overall costs, as it encourages employees to use their benefits more wisely. Others ask employees to pay a co-pay or contribute toward the coverage of a spouse that makes more than a certain amount or who has insurance available through their own employer. You may well be able to afford better overall employee benefits and health insurance plans if you ask your employees to contribute sightly toward their rewards.

Q: Can I tailor my employees’ benefits packages to remove items they don’t want or value?
A: You may, in many cases. Talk with your insurance provider to see if there are plans you can choose among that offer only the services and benefits your employees want and use. Ask your employees which benefits they like and want, and see if you can stop paying for the less desirable benefits. It’s not worth paying for something no one wants. You may find that cafeteria plans, in which employees are allowed to choose their own benefits from a list with a fixed amount they may spend.

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