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Individual and Group Health Insurance

Benefit Agents is a privately owned agency focused on providing a broad array of services related to health insurance. We have employee benefit and insurance expertise for close to four decades. Located in San Francisco, California we focus on providing group and individual clients direct access to every insurance carrier. We are licensed and contracted with all of the major medical, dental, vision, life, disability and long term care providers to assist individuals and businesses on their behalf. We provide small businesses access to a consortium carrier – California Choice; in addition to California’s Health Benefit Exchange – Covered California. As health insurance experts, Benefit Agents focus is to provide the most competitive individual and employee benefit plans in California. We will provide you with a comparison between Covered California SHOP, California Choice and direct carrier rates. Benefit Agents will let you know if you are eligible for any government subsidies, saving you time and ensuring your eligibility. Call or contact us for a consultation today, as our service is provided without a fee.

Covered CA Small Business Health Insurance Tips  

Barack Obama – ACA is Here to Stay   

Recent News

Small Group 51-100 Transition

As of January 1st, 2016 the definition of small group has been expanded to include groups with 51-100 full time equivalent employees.  For groups that will be making the transition, the changes are significant and should be reviewed in detail with a small group specialist.  Since 70-80% of renewals will take effect in Q4 of 2016, it is imperative that you consider all options as soon as possible to familiarize yourself with the new ACA mandates. Rating Regions – Large group rating regions vary by each carrier. Small group consists of 19 regions that are standardized for all carriers. Rating Structure – Large group rates are composite (same rate for each member) and are generated based on the average of employee ages, tiers, genders, and zip codes. Small group rates are determined on a member level based on employer location, where employees and dependents are rated independently.  While age bands can vary by carrier, you will typically see the same rates for age 0-20, one band for each year between 21-63, and one band for age 64+.  Dependents under the age of 21 will be rated individually, up to 3 children. In addition, the ACA has imposed a 3:1 ratio for small group rates.  The rate difference between the youngest to oldest may not exceed a 3 to 1 ratio. The biggest rate increases will hit groups with good medical and SIC risk, and employees with dependents age 20+.  Conversely, young employees may experience rate decreases. Carriers release one set of rates and all groups receive the same standardized rates based on the enrollee’s age.  Rate negotiations are not...

Common Summary Plan Description (SPD) Mistakes

Subject to ERISA (Employee Retirement Income Security Act) the SPD (Summary Plan Description) is one of the most important documents that participants under a health benefit plan must receive.  The Department of Labor has increased its company audits, and more often than not employers are failing to provide their employees an SPD.   Some may consider the information distributed by their insurance carrier as sufficient evidence of coverage and benefits to satisfy their SPD distribution requirement.  Unfortunately, this is not the case, and the responsibility lies solely in the lap of the plans administrator (the employer that sponsors the group plan).   Every employer that sponsors a group health plan must comply with this important ERISA requirement, or they run the risk of facing a hefty fine.  Penalties of up to $110/day per participant or beneficiary for failing to provide an SPD or plan document within 30 days of receiving a request.  The penalty accrues daily from the inception of the policy, not from the date of notification to furnish.   It is considered a best practice to distribute the SPD to employees and maintain proper records that each beneficiary has in fact acknowledged receipt.  This can be accomplished by employing an online administration system that can track and organize specific notices, and ensure compliance under ERISA.   To learn more about how we can assist your company reduce its risk of an audit, and eliminate the risk of arbitrary penalties -please contact us via telephone or...

2016 Covered CA Open Enrollment

It’s almost that time of year again.  Open Enrollment begins November 1st, 2015 and continues through January 31st, 2016. Individuals that are currently enrolled and wish to continue coverage without any changes can simply continue to pay as billed. No further action is necessary. Beginning October 12th, individuals can make changes to their existing application and shop for new plans.  Any changes made will not be transmitted to the carriers until Novemeber 1st. Submissions from November 1st through December 15th will reflect a January 1st start date. Submissions from December 16th through January 15th will reflect a February 1st start date. Submissions from January 16th through January 31st will reflect a March 1st start...
Testimonials

Due to difficulties with the Covered California website, I thought I was never going to get healthcare coverage. I saw the website for Shop CA Brokers and the contact information. I connected with Bryan Bedrosian and now have health care. He sent me the application form for coverage and walked me through the entire process. He kept me up todate, along with giving me step by step instructions on the process. He was patient and informative. I highly recommend Ryan if you need any assistance!

Jane M.

San Francisco, CA

I spent a whole week trying to figure out how Obamacare actually worked through the Covered CA website. Just when I thought I had it all figured out with my subsidy and the plan I was going to choose, I DID NOT QUALIFY!  I couldn’t believe it, I spent at least 8 hours on the computer this past week doing everything I was requested to do, and in the end all it did was frustrate the living heck out of me.  I was about to give up and just go without insurance as I have in the past, but my wife randomly found the phone number to Benefit Agents and I was connect with Arman.  In 2 minutes he knew exactly what was wrong with my application and was able to walk me though the process of designating him as my agent.  He was then able to view my application through his computer and made the necessary fixes and got my wife and I enrolled.  5 minutes compared to 8 hours.  These guys deserve a lot more praise than any agent I’ve spoken to in the past.  5 star service, I highly recommend them to anyone.

Alex M.

Los Angeles, CA

I needed to have covered California insurance for my daughter and her family inasmuch is my son-in-law does not have the time to make the necessary inquiries due his work schedule. Ryan Bedrosian name came up on the computer screen and fortunately for me because he was able to facilitate the application to be submitted for covered California. Needless to say it was truly gut wrenching experience trying to contact covered California,however, we were able to resolve everything to my satisfaction. What I liked most was his willingness to accept all my phone calls, as busy as he is.

Martin C.

Palm Desert, CA

I submitted a new application on CoverCa website and was waiting for more than 3 weeks without any news or progress.

The application was stuck at Eligibility check stage. At that time I was desperate for help and called the CoverCa tool free number and waited over 1 hr and still cannot go thru. The same goes for their website’s chat that has 150 to 200 people waiting and would eventually kick you out of their system.

According to CoverCA health cost estimate tool, our family of 4 should be getting a few hundreds dollars of subsidies per month but after I went thru the whole online enrollment process at CoverCA, the system quoted me a ZERO subsidies per month!!!

So, thru. Google Ads, I found Bardia Farhadian from Benefit Agents. With my permission, he was able to see my case on his computer. He then step thru. all the info I have previously submitted and made a few minor but “critical” corrections.

Finally he performed the “M A G I C     T O U C H” by calling the broker’s dedicated support team / specialist inside of CoverCA and I got a call the next day with a Cover CA case number.

We were very happy that we also received the correct amount of subsidies and this alone is a great deal of money, over $4500 per year!!!

With this case number, I was told to wait about 5 days and call BlueCross for enrollment. I am now enrolled and have the peace of mind…

Overall, the process was very smooth, Mr. Farhadian was very professional and patient and informative. Thanks so much for your professional service!!!

p/s: He also saved me $400 (per year) plus for Auto Insurance!!!

I seldom give review but thru Yelp I was able to get very valuable consumer advises and save time filtering out the GOOD companies to do business with. Benefit Agents is definitely one of the good companies out there and one that will get the job done and save you a lot of $$$$ and time.

Joe A.

Rowland Heights, CA

If you have questions about Covered CA, the private insurance market or are thinking about making a change to your existing policy, then you need to call Ryan at SHOP CA Brokers.   He knows all the little details about Covered CA and the private insurance market that other agents won’t disclose to you or just do not know. I called at least five different San Francisco insurance agencies before I found Ryan. He streamlined the process in less than 15 minutes by asking if I qualified for subsidies through Covered CA. I am in between jobs at the moment and could still be unemployed in January 2014. At least I have the comfort of knowing that the government will help pay my premium if I cannot find work but then. In the meantime, Ryan helped me find a Blue Shield high-deductible HSA plan that is $130/month that will allow me to see all of my current doctors. Then toward the end of the year I will re-evaluate my situation. I am excited to have a new medical plan and wonderful new broker that will be there for me when my situation changes.

Also, it is important to note that Ryan did not try to push me off the phone when I kept asking questions.  I still email him from time to time to get his take on certain policy provisions and he still responds quickly (in less than an hour).  A+++++ Service.

Gwen O.

Oakland, CA

I’m so glad I selected Ryan to steer me through the process of signing my wife up for Obama Care via Covered CA. Even though the online enrollment process is FUBAR for both the federal and state sites I finally had success thanks to Ryan’s guidance.

Just as an example Covered CA asked for additional documentation regarding household income and citizenship for my wife who is Canadian. The site gave 3 methods  for providing this documentation: 1- Download to the site but the site does not have any provision to do so; 2- Snail mail (which wouldn’t work because the deadline for them receiving it was only 2 days from the date I received the request), and; 3- FAX it (but I have no access to a FAX machine since I am currently in Mexico)
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Ryan’s solution to this dilemma was for me to send him the documents as an attachment to an email to him which is what I did. In turn he Faxed all 6 pages to Covered CA before the deadline and Kaiser was able to accept the first payment and my wife is now a member there.

Bob D.

Chula Vista, CA

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Platinum 90

Gold-80-2016

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Gold 80

Gold-80-2016

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Silver 70

Silver 70

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Bronze HSA

Bronze-HSA-2016

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Bronze 60

Bronze-60

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Enhanced Silver 73 Policy

Silver 73

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Enhanced Silver 87 Policy

Silver 87

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Enhanced Silver 94 Policy

Silver 94

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Eligibility Chart

Your FPL must be between 138%-400% to qualify.

FPL chart 2016

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Your FPL must be between 138% -400% to qualify.

FPL chart 2016

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Qualifying Life Events

A Qualifying Life Event would be considered:

  • Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving outside your
    insurer’s coverage area, gaining citizenship, leaving incarceration.
  • Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or
    change plans once per month throughout the year.
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects
    eligibility for premium tax credits or cost-sharing reductions.
  • Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year
    in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar
    circumstances. Important: Voluntarily ending coverage doesn’t qualify you for
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