Owners in San Diego ask us the same two things. Can a company this small offer health benefits, and what will it take? The answer is usually yes, and less than you expect. We handle group employee health benefits only, for employers in San Diego County.
The one employee rule
California lets a small group form around one eligible employee. Owners and their spouses do not count toward that one. A married couple with one hired worker usually clears it. We read your payroll list first and tell you where you stand.
What a group plan includes
Lines we place for San Diego employers
- Group medical for staff and, if you choose, their families
- Group dental, from cleanings through to crowns
- Group vision for exams, lenses, and frames
- Voluntary plans each worker elects through payroll deduction
That list is the whole of it. We do not place property cover, auto cover, liability cover, or workers compensation. We do not sell retirement plans, run payroll, or act as your HR department. Being clear about that saves everyone time.
You also set the split. Carriers require the company to carry a minimum share of the worker cost. Above that floor the decision is yours. The remainder comes out of each worker check through payroll deduction.
Networks matter more than the brochure
Your staff live all over the county. Some drive in from Chula Vista, La Mesa, or National City. An HMO keeps the network tight and routes care through one primary doctor. A PPO opens the network and skips the referral, at a higher cost.
An EPO holds a set network but drops referrals. The right answer depends on the doctors your people already trust. We check those names against each network before you commit. That one step prevents most of the complaints we see later.
Renewal season
A group plan is not a set and forget purchase. Rates move every plan year, and so do networks and drug lists.
What we do at your renewal
- 01
Gather
We pull your current plan, your census, and the renewal the carrier sent.
- 02
Re-quote
We take it back out to the carriers we hold and look at the whole field.
- 03
Model it
We show the cost to the company and the cost to each worker, option by option.
- 04
Decide
You choose. We handle forms, carrier contact, and the effective date.
Enrollment, step by step
We hold a short meeting with your staff on video or at your site. Every worker leaves with a summary and an election form. We set a firm deadline and chase the late ones. Your office manager stays out of carrier portals.
New hires get the same treatment during the year. Send us the name and the start date. We watch the waiting period and file on time. We work with employers from the 92101 and 92103 ZIP codes out to the inland edge of the county.
Staff who reach 65
Employer size changes what that worker should do, and a wrong step can cost them for life. Send them to Medicare in San Diego and loop us in.
Who to ask instead
We are licensed insurance agents, not attorneys or accountants. We do not give legal or tax advice on any of the following.
- Payroll software and deduction setup: your payroll provider.
- How the company contribution is treated: your CPA.
- Worker classification questions: an employment attorney.
- Retirement and savings plans: your financial advisor.
- Buy-sell and key person needs: an advisor who handles them.
Our business coverage page covers the wider picture, and your city page covers the rest of what we do locally. Call (714) 922-0043 or use the contact form. Our help costs your company nothing extra.
Group health benefits options for San Diego residents
Why San Diego residents work with us
- Specialized in TRICARE-to-Medicare transitions.
- Independent - we compare 12 carriers, not one.
- We work with you in English or Spanish, from the first call to enrollment.
- Same agent year-over-year - no call-center rotation.