Common Questions & Answers

Q: Why Use An Independent Broker?

A: Nefouse & Associates has strong relationships with the best insurance companies in the country. We leverage our existing relationships to get you what you want. Because we are independent, we aren't limited by any one company's choices.

Additional Reasons:

1. Brokers like us can take care of stuff for you and we make sure the insurance companies follow through promptly.
2. We get to know you and your unique insurance needs. We will find the best benefits solutions for you.
3. We are local and active in the community. You just can't beat the personal service a local company offers. You can stop by our offices at any time.

It's also important to point out that buying directly from an insurance company will not save you any more money than we can save for you. Brokers are paid a commission from the insurance company but insurance companies offering the same products at the same prices are simply pocketing the commissions.

Q: How Do I Get Health Insurance?

A: There are a few ways to get health insurance. First, if you belong to a business or organization they may offer group health insurance. If you cannot get group health insurance, you can purchase individual health insurance through a broker, like Nefouse & Associates.

Q: When can an individual enter a group plan?
A: Open enrollment or within 30 days of a qualifying event.

Q: Can an employee come onto the plan outside of the open enrollment?
A: No - there are no late entrants.

Q: At what times throughout the year can a spouse or child be added to the plan?
A: Open enrollment or a qualifying event, such as loss of coverage, birth/adoption or marriage. The request for coverage must be made within 31 days of the event.

Q: When can a baby be added to the plan?
A: The insurance company must be notified within 31 days of the child's birth in order for the child to be added to the plan.

Q: At what age must children come off of group insurance?
A: The age varies from plan to plan. It is generally between the ages of 19-24, if the child is a full-time student and qualifies as a federal tax exemption.

Q: What is a pre-ex?
A: Pre-ex is a term used for a pre-existing condition that will not be covered by your insurance plan for a defined period after your enrollment date.

Q: What is a deductible rollover?
A: When a member incurs covered medical expenses during the last 3 months of a Benefit Period, which are applied against that year's deductible, those expenses may be carried over and applied against the deductible for the next Benefit Period but not to the out-of-pocket limit.

Q: What qualifies for a group plan?
A: You must have 2 employees on a W-2 and both must take coverage.

Q: Can I move my group health plan mid year?
A: Yes. Groups can move any time of the year.

Q: Is there a lapse in coverage when moving from one group plan to another?
A: No, as long as you have had current group coverage for over 1 year.

Q: I have two companies. Can I group them together for health insurance?
A: Yes, as long as you own both companies (IRS Code 414).

Q: What amount, as an employer, must I contribute to an employee's health premium?
A: You must contribute 25 percent of the total bill; 50% of employee medical only.

Q: How many of my employees must participate for group coverage?
A: 50% to 75% must participate in group coverage.

Q: Can I insure my 1099 employees?
A: Yes, as long as you have 2 employees on a W-2. Also, what you do for one 1099 employee, you must do for all.