What's wrong with this listing?
MLJ Insurance Services
2525 Arapahoe Ave Ste E4-836
Boulder, CO 80302
Uber
MORE PHOTOS
more
Individual
Testimonials
About Us
Group
Individual
Individual
Laurie Edwards: I have been extremely happy with the fast, reliable service of the entire team. They work together well to get the answers the client asks. I appreciate their efforts and involvement
Individual insurance refers to any health insurance policy that is paid for directly by an individual (versus employer or government) to purchase personal or family coverage.
ACA or Obamacare qualified insurance plans, what MLJ offers as permanent insurance, is available either directly from the insurance companies or through Connect for Health Colorado
Colorado's health insurance exchange (marketplace)
called Connect for Health Colorado is a government-run entity where individuals and families can shop for health care plans
Additional information about Individual Health Insurance options can be found on our FAQ Section
but we are always happy to offer a complimentary one-on-one consultation to assist you in determining which will best fit your needs
FAQs
When can I apply for Individual Health Insurance?
Open Enrollment is the period from November 1st to December 15th, 2017. During this time, anyone can apply for insurance, pay their binder payment, and receive a policy for a 1/1/18 start date. The remainder of the year one can apply when experiencing a Qualifying Life Event. Dates may be subject to change as we get closer to the Open Enrollment Period. (For more information, see the question below: "How do I apply for Individual Insurance outside of open enrollment?"). The 2017 Open Enrollment deadline was 1/31/17 and is currently closed
I missed Open Enrollment. What do I do now?
You may still have options to protect you and your family. Interim Insurance, known as Short-Term Medical, policies are a great way to protect you and your family in case the unexpected accident happens. Pairing a short-term policy with a supplemental plan may also help to reduce your financial risk in the event of an unexpected illness or accident. Contact us to go over options available to cover you until Open Enrollment. There are a variety of short term health insurance options for you
What's the difference between Individual and Group health insurance?
There are quite a few differences between Individual and Group health insurance. To help explain those differences, we've created this side-by-side comparison list
How do I apply for individual insurance outside of open enrollment?
There are limited options for applying for health insurance outside of the Open Enrollment Period. When a person experiences a Qualifying Life Event (QLE), a window of opportunity is opened. Some examples of QLEs are: Involuntary loss of coverage, such as loss of employment where an insured had participated in an employer-sponsored health insurance policy; Birth; Death; Divorce; Court-ordered support; Relocation, such as moving from one state to another; Exhaustion of COBRA. (NOTE: When an employer pays a few months of COBRA as a part of a severance package, the termination of their payment is not a QLE, and the applicant must wait until next Open Enrollment or when the COBRA period expires). A person who has a valid QLE has 30 days prior (with most application methods) and 60 days after the QLE to apply. This period is known as a Special Enrollment Period (SEP). The start date of the insurance policy applied for will be determined by the type of QLE and the timeline of the submission of the actual application. SEP applications must be submitted within the required timeframe and accompanied with the supporting documentation discussed below. Please know that the insurance companies can require documentation to support the QLE declaration. MLJ works diligently to make sure that all applications made through our office meet the criteria to be a valid application. Due to the fact that the documentation required varies by insurance company, event, and circumstances, we recommend a consultation with our Individual Sales Specialist to determine the required timeline and documentation
What is included in Individual Insurance?
All ACA qualified insurance plans (whether direct from the insurer or through the Exchange) must meet certain criteria, some of which are: Guaranteed issue -No applicant can be denied coverage due to their medical history. Essential Health Benefits -The health plan must include certain benefits, and those benefits must be included in the plan whether a specific individual requires the benefits or not. They include but are not limited to: capped deductible and out of pocket costs; prescription coverage; hospitalization coverage; maternity coverage; unlimited autistic coverage; chiropractic care; and pediatric dental and vision. Metallic level designations -All plans must meet a certain actuarial value set by the Federal government. The levels are Bronze, Silver, Gold, and Platinum. The value of the metal, poorer to richer, represents the 'richer' the plan or the extent of the medical expenses the insurer must cover. No Lifetime Maximum -When a person has accessed care, there is no limit to the amount of covered approved medical expenses
How are medical premiums determined?
The insurance company must file the next year's plans by March or April of the current year. They may use current plan's medical cost payout to prove the amount of money spent on healthcare costs. This is used to determine the amount of increase that the Division of Insurance (DOI) will allow. No rate increases or decreases are allowed by the DOI without substantial supporting proof being provided by the insurance company. The risk factors of increased age of population, increases in health care (new drugs, new treatments), and cost of the contracts for providers are also allowed to be included in the rate filings
What does the Division of Insurance (DOI) do?
The Division of Insurance (DOI) reviews health insurance premiums to make sure they are neither too high nor too low and makes sure that the plans meet state and Federal regulations. The DOI does not have the regulatory authority to set the insurance premiums. Premiums reflect the costs of healthcare — what doctors and hospitals and other providers charge for medical services.However, the DOI does not regulate doctors, hospitals or other healthcare providers and their associated healthcare costs
What financial assistance options are available for health insurance premiums?
Many people may qualify for Federal financial assistance based on income, which will reduce the cost of insurance premiums and out-of-pocket expenses, only available through Connect for Health Colorado. Federal tax credits are known as Advance Premium Tax Credits (APTC) and Premium Tax Credits (PTC) and can help make premiums more affordable. Eligibility for the APTC depends on a consumer's household income in relation to the Federal Poverty Level. The tax credit itself is calculated based on income, age, and the cost of insurance in a community. Financial assistance from the Federal government is only available for policies purchased through the Exchange or known in Colorado as Connect for Health Colorado. A person who receives a tax credit for their 2016 insurance, and who enrolled in the same plan for 2017, may see an average decrease of 11% for their subsidized premium, despite actual premium increases for plans. Contact us to request our How to Guide that explains how to consider assistance options as well as how to apply for that assistance
I am applying for financial assistance to help cover my premiums. What is the difference between an APTC and a PTC?
The Advance Premium Tax Credit (APTC) is the monthly amount of subsidy determined based on one year of income. For example, the monthly subsidy for 2017 is based on the amount of income the applicant expects to receive in 2017 when applying for financial assistance. To be eligible for the APTC credit, you must receive a denial for Medicaid. The credit is sent directly to the Insurance Company, and the insured will receive an annual statement for filing their taxes. I'm self-insured in Colorado The Premium Tax Credits (PTC) is the credit reflected on that year's tax return calculated from annual income and the money paid that year in health insurance premiums. For example, if you paid $12, 000 in premiums in 2017 when your current income level indicates that you should have paid less, you can elect to receive the difference as a PTC credit. For the PTC credit, the insured is required to pay the entire premium each month and will receive an annual statement for filing their taxes. The tax credit at the end of the year may increase the refund amount or lower tax liability. The APTC is also adjusted when filing your tax return for 2017. For example, if a person received $2, 400 in subsidy based on their estimated income for 2017 but their income actually dictated that they only receive $1, 000 in assistance, they will be required to pay some of that surplus subsidy back to the Federal government in the form of tax. APTC and other Federal financial assistance are only available for plans purchased through the state's health insurance exchange, Connect for Health Colorado. Note: The decision to elect either APTC or PTC is up to you. However, we recommend that those with a set, stable income elect APTC, while those with a variable income elect PTC
When shopping for health insurance, what should I be concerned about besides premiums?
Shopping for an appropriate plan is crucial. Current clients can often reduce their rate increase by consulting MLJ's sales associates to evaluate their needs and options for each year. It's important to look at more than just premiums when shopping for insurance. Consumers should consider the following as they work to make an informed decision about a health plan: Find out if a doctor or preferred hospital is in the plan's provider network. Seeing an out-of-network doctor will be more expensive, but if done on a limited basis and in coordination with an in-network doctor, it may allow you to enroll in a lower cost plan for the year. MLJ provides a free look-up tool to help with your search. Always look at the deductible amounts and out-of-pocket maximums in the plan you are considering. The tradeoff for lower premiums will likely be higher deductibles and out-of-pocket costs. Understand what will be paid for a doctor's visit and other co-pay or coinsurance amounts. Premiums and other out-of-pocket expenses, including deductibles, copays, and co-insurance, can quickly add up to thousands of dollars every year. Health care plans limit these out-of-pocket costs. For 2017, insurance policies are written so that insureds are not required to pay more than approximately $7, 150 per year and $14, 300 for covered medical expenses for a family. Once the out-of-pocket maximum is met, the insurance company covers all approved costs for the remainder of the calendar year. Closely review the network and pharmaceutical formulary (approved drug list) when selecting a plan, and refer to it every time before seeking treatment
Interim or Short-term Medical Plans
A short-term policy is a good option for an individual in a changing situation who needs health insurance coverage for a short period while in a gap between employer-based plans.
Others may not be eligible to enroll in a permanent policy
These policies are not ACA (Affordable Care Act) qualified as they do not meet Minimum Essential Coverages
therefor they will not protect you from a Tax penalty for not having health insurance
Pairing a short-term policy with a supplemental plan may also help to reduce your financial risk in the event of an unexpected illness or accident.
Supplemental Health Insurance
Supplemental health insurance is meant to supplement your current health insurance plan and it is not compliant with the Affordable Care Act law on its own.
Supplemental insurance is sold by private companies and can help pay some of the health care costs that your plan doesn't cover.
There are several supplemental health insurance options for individual and family health insurance.
Whether a supplement health plan is right for you depends on your medical needs and what plans are available to you
FAQs
Does My Health Insurance plan cover Dental and Vision?
This depends on your policy but most individual health insurance plans do not include coverage for dental and vision unless medically necessary. Pediatric dental is a requirement for ACA medical plans, which only applies to children up to the age of 19. We recommend discussing the actual Pediatric Benefits for the specific plan you are considering. Our Sales Specialist will be able to advise as to the specific benefit. You can apply for Dental and Vision plans at any time during the year. These types of plans are not restricted by ACA application deadlines. Please note that most true dental insurance plans have waiting periods for basic and major services. However, if you have proof of continuous credible dental coverage, in the last 60 days, certain plans will waive the waiting periods. For more information speak with a Sales Specialist Contact us
How do Critical Illness plans work?
The Critical Illness Insurance plans pays a lump-sum benefit upon initial diagnosis of a covered Critical Illness such as a heart attack, stroke, or invasive cancer. The lump-payout is to the insured directly and can be used for anything the person or their family needs: medical bills, uncovered services, household help, etc. For more information speak with a Sales Specialist Contact us
How do Accident plans work?
These plans would reimburse you up to your calendar year maximum for a covered accident. Our Accident plans can reimburse you up to your calendar year maximum for a covered accident, with proof of medical loss. Or another type of Accident plan pays a set amount based on the type of injury (or covered incident) you sustain. For more information speak with a Sales Specialist Contact us
Does my health insurance policy cover me while I am traveling?
While some medical insurance plans say, they cover worldwide, they have strict requirements before they will reimburse any medical claims loss. Purchasing a Travel Medical plan can be a low-cost, hassle-free way to have medical coverage out-of-country. Even in the United States, not all plans cover you outside of your region. For instance, certain plans may only cover certain regional providers in-network. We recommend to all our clients who will be traveling to purchase some form or another of Travel Insurance to protect you, your family, or your trip costs while traveling. For more information speak with a Sales Specialist Contact us
Provider & Prescription Information
Before making any decisions about purchasing an insurance plan
It's important to make sure that your plan covers your preferred doctors and providers.
Navigating through the insurance world can be challenging. Below you can find instructions on how to look up providers and prescription information for the following companies: Anthem, Bright Health, and Kaiser Permanente. If you have any further questions or need assistance, feel free to contact us at any time
Please note these search tools only apply to Individual plan offerings, and the results of any search is not definitive.
Doctor and facility contracts may change at any time throughout the calendar year
Anthem
Note: Your cost for a drug usually depends on what tier the drug is on. These lists group drugs into tiers, so find your drug, note the tier it's in. Typically, the higher the tier, the greater your cost. Choose the list for Colorado
How to make sure your doctor is in network if you are an existing member with Anthem
Go to Anthem
Under Search as a Member, enter your Username and Password or ID number and hit the "continue" Bottom
Select Medical Professional
Then select specialty
Enter your location and hit "search"
How to make sure your doctor is in network if you are searching as a guest
Go to Anthem
Scroll down and Under Search as a Guest click on 'Search by Selecting a Plan or Network'
Then select the drop down "Medical Care"
Answer the State
Select the network name in the plan you are enrolled in or deciding to enroll in:
Pathway/Pathway X Network; Mountain Enhanced/ Mountain Enhanced X Network (Do not use any of the plan/ network lists that have metallic levels indicated)
Enter your doctor's name at the next screen and type in your location, then click 'Search'
For a PCP search for the Pathway network or Mountain Enhanced networks, check off the "Able to serve as "Primary Care Physician (PCP)" box before clicking "Search". You will find the 6-digit PCP ID listed under the doctor's name
How to make sure your drugs are covered
Go to Anthem Pharmacy Information
ou want to scroll down to the Select Drug Lists (2018) and choose the Colorado Select Drug List (Searchable) for 2018.
Be sure to choose the link for Colorado under the section that applies to Individual Plans
How to make sure your doctor is in network
Go to Bright Health
Type Provider or Facility name and click 'Search'
How to make sure your drugs are covered
Go to Bright Health Prescription Coverage
Download document and do a search
Testimonials
Rob Kurtz
Having pre-existing conditions and being self-employed made my search for health care a daunting task. My situation left me feeling hopeless and overwhelmed at what I thought were only a very few options available. Mary Heidbrier was able to explain the carriers and packages available, and offer me not only affordable solutions, but solutions that are cost-effective and valuable to me and my family
Raquel Mulkey, Cow Wagon Express
It has been our pleasure working with Mary over the last several years. She is extremely knowledgeable, professional, efficient, and is always readably available. we highly recommend Mary for any of your insurance needs. She has been a valuable asset to our company
Matthew Gibble, LMT Raining Faith Massage
Thank you Mary. You have been outstanding to work with and I can't even imagine the time and effort involved on your part to stay current with the continuing changing climate of health insurance. I'm always happy to be a reference for you. Your help over the years has been invaluable navigating the crazy world of health insurance
Seth Ehlrich SOS Outreach
I've thoroughly enjoyed working with Mary and her team at MLJ Insurance. She brings significant experience and expertise to a difficult sector for us to manage. Throughout the continuous changes in the health care sector, she has consistently responded to the changes with solutions that support our employees and meet our budget. With Mary involved, I know that the needs of our organization are being prioritized and that we are in good hands. Thank you for all that you've made possible with us, Mary. Thank you for your support of SOS and the impact of our programs! I greatly appreciate your dedication to the organization and what you've made possible for us over the years. Your awareness of our needs is a primary reason that we're so content with your services and impact
Doug and Killian
Thank you so much for taking one of the more painful aspects of moving and making it as painless as possible. The time you took with us made us feel like we have the best solution possible!
Griffith Kundahl
MLJ Insurance Services has provided our family with excellent customer service. We have received superb advice from Antonia Kelly and others on the MLJ team not only regarding our own specific needs but also with ongoing updates and news pertaining to new laws and other industry developments
Maurene Flory
I referred a patient who was struggling to identify an insurance plan that he could purchase and would enable him to see his Boulder Medical Center providers to MLJ insurance last week and he called me to report an "excellent" experience. Said your team make it effortless, and that everyone was nice and polite. He recommended we continue to give your name out to patients. So thank you!! Thank you for your excellent service to the community!
Judi Rogers
Thank you again for your expedient service. I feel terrible for those who are under served or marginalized, as they do not have the understanding to advocate for self or directive on where to do. Live contacts are rare. Most often referred to automated phone systems or computer communication only to get lost in the tree of referrals. For this and many other reasons, I am grateful that Blake and I have you, our advocate. Thank you so much. It is not often you find someone who goes above and beyond and completes there promise. Again I thank you
Seth Ehrlich, SOS Outreach
MLJ Insurance has provided significant support to SOS Outreach and a quick response to any questions that we have had through our insurance transitions. Given the new complexities of health insurance, we appreciate having someone we trust to work with
Marty Maus
Earlier this year the Individual Sales Specialist at MLJ helped me make an informed health care insurance decision before any Health Care Reform law policy information was available. By working with MLJ I was able to lower my 2013 monthly premiums and was able to keep my policy so it is grandfathered under the new law. MLJ is continuing to follow up and provide me with the information I need to understand the new law, identify plan options (both inside and out of the Marketplace) for which I qualify. MLJ is my individual healthcare insurance policy partner who just happens to be a healthcare insurance broker!
Jeff Porter
Outstanding customer service. If something goes wrong, they make it right and they do so quickly
Ryan & Antonia Kelly
We have enjoyed working with Mary to meet our insurance needs. She is extremely knowledgeable and hard working. What we have appreciated most is how she takes our individual needs into account. She has been very conscious to provide us with the best coverage for the lowest price. Since insurance shopping can be an overwhelming task to say the least, she has helped us to shift through all the paperwork to find what will work best for us. She does not constantly try to promote new plans. However, when we had concern about rising premiums, she was quick to search for and provide a solution. Since my husband is self-employed, she obtained a policy to provide additional coverage for accidents. This has already proved to be a wise investment. When we have a concern, she is quick to help us to answer it. To sum it all up, we trust her advice and value her as an insurance broker
Callie Mitchell
Mary is exceptional at her business as a health insurance broker. She is knowledgeable and caring, helping her clients find the best product for their specific situation. I recommend Mary 100% of the time when I have a client, friend, or family member looking for health insurance. There is nobody better!
Rebecca Blackwell
Mary Heidbrier, founder of MLJ Insurance, is absolutely incredible to work with. She cares deeply about her clients and works so hard to find the best health insurance solution for their personal situation. Their office has helped my family out tremendously – especially this year, when I suddenly found myself without insurance. Mary worked with me to find the perfect solution. I can't recommend her highly enough. Don't try to maneuver your way through the health insurance industry without her!
The O'neals
When a friend heard we were having trouble finding the right insurance for our circumstances, and also having trouble signing up on the Connect for Health Colorado, she recommended we find an agent/broker to help us. In fact, she recommended Mary Heidbrier with MLJ Insurance Services, who had previously done a great job helping her. After our first 5 minutes on the phone with Mary, we knew we had found the right person to help us. She really listened to what we wanted, and quickly suggested policies that would meet our needs. Thank you, Mary, for helping us when we needed it, and helping us navigate the system. We highly recommend Mary and MLJ to anyone else needing assistance with health insurance
Julie S., Benefits Support for Financial Advisory Firm
I've worked with Mary as a peer and as a client. Mary and her staff have never disappointed. They are very knowledgeable and service‐driven. With all the uncertainties around health care I would highly recommend MLJ insurance
Alessandra Downey, Group Administrator
You are one of the nicest most knowledgeable agents, always on top of the latest changes, and always happy to help. I recommend you highly whenever I run into someone who is looking for assistance with their insurance
S M Barnes
We can't thank you and your team for all the work you have done, on our behalf, over the last 8 years. You are appreciated more then you know. We recently sent some clients your way. They too, are very impressed with your services. Thank you!
About
How are we qualified to help you find solutions to your insurance dilemmas?
Our clients are the sole reason we are in this business, and we are committed to our focus on providing exceptional customer service.
We are available to assist our clients throughout the year in managing their policy
From start to finish we strive to provide ongoing support to our clients to help them navigate the world of health insurance.
Our goal is to look at each individual, family and employer group as unique
By looking at each client and potential client as unique we can offer insurance policies that are the best fit for the current circumstances of the individual, family or employer.
Our business takes protecting your information seriously.
You can have peace of mind knowing that we are HIPPA compliant. We have made it our priority to keep your personal healthcare information confidential and secure. Any information supplied to us will be held in strict confidence. (For more information feel free to review our Privacy Policy through the link below)
MLJ Insurance Services takes pride in being a full-service broker agency for individual and group health insurance.
We are a bilingual office speaking English and Spanish. We evaluate each insurance company that we represent by looking at their financial stability, reputation and plan designs. We work to have excellent relationships with the insurance companies and their representative so that our clients are always afforded the best options available
Staff
Ryan Boykin, Atlas Real Estate Group: Put Simply: Professional. Prompt. HELPFUL. In an industry that is almost impossible to navigate, understand and time, Mary Heidbrier provided the most helpful assistance I have ever dealt with
Mary Heidbrier, Partner
Mary founded MLJ Financial Services in 2003. She is an innovative, self-sufficient insurance broker and has built MLJ Financial Services on the cornerstones of education and knowledge. Mary has been a member of the National Association of Insurance Underwriters (NAHU) since the beginning of her career as a broker, and is known for her up-to-date knowledge about the health insurance industry and the ever-changing legislature affecting health insurance. This knowledge has assisted MLJ in providing excellent ongoing counsel and advice to clients in an ever-changing environment. Mary has taken many additional courses in her desire to be knowledgeable in the insurance world. Below are a few of those certificates: LIMRA Certification; Employee Benefits Institute of America Seminar 2006; NAHU Consumer Directed Health Care Certification 2007; Broker Business Development Program 2008 (sponsored by Warner Pacific & Kaiser Permanente); NAHU Wellness Certification 2009; HealthCare Advisor Program 2013; LPRT Member since 2015
Small Group Employers
Beginning on January 1, 2014, small employer (under 50 employees) insurance is available through two different channels: Direct through an insurance company that meets the guidelines set forth by Colorado's legislature, or through Colorado's health insurance exchange (marketplace), Connect for for Health Colorado. Colorado's health insurance exchange, called Connect for Health Colorado is a government-run entity opening in October where individuals, families and businesses with fewer than 50 employees can shop for health care plans. Health insurance exchanges are part of the Patient Protection and Affordable Care Act (PPACA) that President Obama signed the into law on March 23rd, 2010 and upheld by the US Supreme Court ruling on June 28th, 2012. The Affordable Care Act is also know as "Obamacare" or "ACA".
An Eligible Employee is anyone that is reasonably expected to work at least 30 hours per week. This does not include employees who work on a temporary basis or partners without a W2.
Owners and partners are not considered Eligible Employees and may not participate in a small group plan unless they have at least one employee.
Small employers are NOT required to offer dependent coverage.
For plan years beginning on or after January 1, 2014, employers may not set a waiting period that exceeds 90 days.
If you have 25 of fewer employees, a small business tax credit may be available to you. There are certain restrictions that apply. Give us a call to find out more.
Questions Regarding Small Group Employers
What should I look for when choosing a group plan?
The plan you choose must accept all employees within a certain employee class, and employee family members if you offer dependent coverage - even employees and family members with health problems. However, health insurance companies cannot deny your application because of the health status of your employees or their family members. In addition, the health insurance coverage you choose will come with "guaranteed renewal" - meaning that it cannot be canceled because someone in your group becomes ill.
What are open enrollment periods?
Small employers can purchase a group health plan at any point during the year. For most of the year, insurance companies can decline coverage if the employer is unable to comply with contribution and participation rules. However, between November 15 and December 15 of each year, insurance companies must accept every application - even those that don't comply with contribution and participation rules.
What if I currently offer Health Insurance?
Was your group plan in effect on March 23, 2010? If your insurance company allowed, the plan may be "grandfathered" - which means that is it considered qualified coverage. You will not loose grandfather status if you continue to add employees and dependents to the policy. However, if your employer has allowed the coverage to be reduced, or your portion of the premium has increased, it may have lost it's grandfathered status. At that point, your employer would be required to select a new health care plan.
What if my business has less than 50 employees?
Then you might be able to purchase group insurance through the Small Business Health Options Program (SHOP). Unfortunately, the cost for purchasing health insurance is usually much higher for small businesses than for big businesses. SHOP allows small businesses to pool their risk and gain increased purchasing power. This might make it possible for you to offer your employees high-quality coverage for less. Not every small business will qualify for SHOP. Give us a call to find out more.
What if I would rather help pay for my employees individual health care plans rather than purchasing a group plan?
This is not allowed under new Health Care Reform laws, both the IRS & Department of Labor have issued bulletins and regulations coming out against use of employer funds to pay for any portion of individual premiums. You probably have better options anyway. Give us a call to find out what they are.
Your Rights as a Small Employer
The following is an outline of your rights as defined by Colorado law.
Guarantee Issue
Normally a health insurer must sell you coverage. You, as the small employer or business group of one must meet all their underwriting requirements. Must accept all eligible employees and dependents regardless of their health. Cannot exclude coverage of certain medical conditions.
Small Group Rates
Insurers are limited in the factors that they may use in setting premiums for your group. Insurers must explain in their sales and solicitation material how they determine the prices.
Other Key Protections
Insurer must provide you with a Health Benefit Plan Description form for any plan you are interested in purchasing. (We always provide these forms with any quotes we give you.) In most cases, insurers are required to renew your coverage, if you so desire. When changing insurers, the new insurance company must cover everyone within the eligible employee class. Small employers and health insurers may be required to allow terminated employees and their dependents to continue coverage at their own expense for up to 18 months or until they are eligible under another group policy.
Large Group Employers
Due to the complexity of the group insurance we recommend a one-on-one conversation to insure that all options have been explored. Please call 303.667.7123.
While the Affordable Care Act does not require employers to offer health insurance to their employees
Beginning in 2015, if you have more than 50 eligible employees and you do not provide health insurance, you will pay a penalty to offset the costs your employees pay buying their own insurance.
An Eligible Employee is anyone that is reasonably expected to work at least 30 hours per week.
This does not include employees who work on a temporary basis.
Large employers that don't offer coverage may face a penalty of $2,000 per full-time employee, beginning in 2015.
In addition if you offer health insurance that is considered "unaffordable" for your employees, you may also face a penalty. If your employees are required to pay more than 9.5% of their annual household income to cover premiums, coverage is considered "unaffordable".
For plan years beginning on or after January 1, 2014, employers may not set a waiting period that exceeds 90 days.
Questions Regarding Large Group Employers
What should I look for when choosing a group plan?
The plan you choose must accept all employees within a certain employee class, and employee family members if you offer dependent coverage even employees and family members with health problems. However, health insurance companies cannot deny your application because of the health status of your employees or their family members. In addition, the health insurance coverage you choose will come with "guaranteed renewal" meaning that it cannot be canceled because someone in your group becomes ill. Keep in mind that the insurance is not limited to keep premiums at a certain level, in large group they can increase rates when they see risk in the health status or financial status of a group that is applying or renewing.
What if I currently offer Health Insurance?
Was your group plan in effect on March 23, 2010? If your insurance company allowed, it may be "grandfathered" - which means that is it considered qualified coverage. You will not lose grandfather status if you continue to add employees and dependents to the policy. However, if your employer has allowed the coverage to be reduced or your portion of the premium has increased, it may have lost it's grandfathered status. At that point, your employer would be required to select a new health care plan.
What if I would rather help pay for my employees individual health care plans rather than purchasing a group plan?
This is not allowed under new Health Care Reform laws, both the IRS & Department of Labor have issued bulletins and regulations coming out against use of employer funds to pay for any portion of individual premiums. You probably have better options anyway. Give us a call to find out what they are.
Browse Nearby
General Info
Hours
Monday:
8:30am - 5:00pm
Tuesday:
8:30am - 5:00pm
Wednesday:
8:30am - 5:00pm
Thursday:
8:30am - 5:00pm
Friday:
9:00am - 4:00pm
Saturday:
Closed
Sunday:
Closed
About Us
MLJ Insurance Services takes pride in being a full-service broker agency for individual and group health insurance. We are a bilingual office speaking English and Spanish. We evaluate each insurance company that we represent by looking at their financial stability, reputation and plan designs. We work to have excellent relationships with the insurance companies and their representative so that our clients are always afforded the best options available.