Health Insurance in Fresno

Professional Benefits Team Inc is your top choice for health insurance in Fresno. As a local insurance broker, we develop tailored solutions to give you the coverage you deserve at a price you can trust. Whether you’re looking for an individual insurance plan, group insurance for your staff, or extended coverage for your family, you can count on us to find a plan that works for you—all while saving you time and money.

Call us at (559) 275-7706 today to schedule a no-obligation consultation.

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Is Health Insurance Coverage Required by Law in California?

Yes, health insurance coverage is required by law in California for most residents. This mandate went into effect in 2020 and applies to individuals. Most residents must have Minimum Essential Coverage (MEC) or face paying a penalty when filing their state taxes.

Exemptions may apply to:

• Those with an income filing below the set threshold
• Those with a short coverage gap (typically 3 consecutive months)
• Those who qualify for a hardship exemption
• Those who are incarcerated
• Certain non-citizens
• Citizens living out-of-state or residents of another country

What Is Minimal Essential Coverage?

California adheres to the federal guidelines for MEC established by the Affordable Care Act (ACA).

Here are the basic standards a health insurance plan must meet to qualify as MEC in California:

Comprehensive Coverage

Your plan must provide coverage for a defined set of essential health benefits.

These benefits typically include:

• Ambulatory patient services
• Emergency services
• Hospitalization (inpatient care)
• Maternity and newborn care
• Mental health and substance use disorder services
• Prescription drugs
• Preventive and wellness services (including immunizations)
• Rehabilitative and habilitative services and devices (therapies and equipment)
• Laboratory services
• Pediatric care (dental and vision for children under 19)

Minimum Standards for Each Category

Your insurance package must not impose annual or lifetime dollar limits on these essential health benefits. This ensures coverage for necessary medical services regardless of cost.

No Exclusion for Pre-Existing Conditions

Your insurer can’t deny coverage or charge more based on pre-existing health conditions. This protects individuals with chronic illnesses or prior medical history from being denied coverage.

Affordable Premiums

Your coverage should be considered affordable relative to your household income. California considers affordability through a concept called the Adjusted Gross Income (AGI) subsidy for qualified individuals who purchase coverage through Covered California, the state’s health insurance marketplace.

These are the core standards for MEC in California. It’s important to note that specific plan details and covered services can vary among different insurance providers.

What Doesn’t Qualify as Minimum Essential Coverage?

The following health insurance options generally don’t qualify as MEC:

• Stand-alone vision or dental plans: These provide limited coverage and don’t meet the minimum standards for MEC.
• Workers’ compensation: This covers work-related injuries and illnesses, not comprehensive health insurance needs.
• Accident or disability insurance: These provide financial benefits in case of accidents or disabilities but don’t cover medical expenses.

Should You Have Additional Health Insurance Coverage if You Have MEC?

Although MEC covers essential health services, it falls short of offering comprehensive coverage, leaving gaps for those who may need extra support. Some of the limitations of MEC include:

Limited benefits: Plans that only cover specific conditions or services may not qualify as MEC.

Limited coverage: MEC often covers preventive services like vaccines, screenings, and some doctor visits, but may not cover other essential health benefits like hospitalization, prescription drugs, or specialist care. Additional insurance might be needed to handle these larger expenses.

Out-of-pocket costs: MEC plans can have high deductibles, co-pays, and co-insurance. A supplemental plan or more comprehensive insurance could reduce out-of-pocket costs for treatments not fully covered by MEC.

Limited access to specialists or better networks: Some MEC plans might limit access to certain healthcare providers or specialists. More comprehensive insurance plans often have larger provider networks, allowing greater flexibility in choosing doctors and hospitals.

Uncovered prescription drugs: Some MEC plans offer very limited prescription drug coverage. A more robust plan would typically offer better drug coverage, especially for those with ongoing medication needs.

Lack of catastrophic coverage: In case of a major health event, like surgery or a long hospital stay, MEC might not cover enough of the costs. Additional coverage helps protect against financial burdens in such situations.

No vision, dental, or mental health coverage: MEC might not cover services like dental, vision, or certain mental health treatments. Many people seek separate plans for these services.

While MEC provides a baseline of coverage, many individuals opt for additional insurance to ensure they have broader, more comprehensive protection, particularly in the case of high medical costs or specialized care needs.

Professional Benefits Team Inc’s Health Insurance Services

Look to us for the answers to all your questions about health insurance services. We’ll connect you with a suitable policy that’s personalized to your unique situation.

Our services include:

• Public insurance plans
• Private insurance plans
• Individual health insurance
• Supplemental coverage
• Prescription coverage
• Dental and vision care
• …and more!

Helping You Navigate the Wide World of Health Insurance

Understanding health insurance is not an easy task, and approaching it can be intimidating. With so many acronyms and new languages that you'll have to familiarize yourself with, finding and getting the health insurance plan you need can seem like an uphill battle.

We're here to help you navigate the process of finding the right insurance plan. We have you covered if you need help understanding which insurance packages will suit your needs, whether you're an individual or a group.

Entrust our team as many others have and see why we are so highly regarded in the area as the team that can provide clients with the health insurance coverage and plans they need.

We Offer Personalized Health Insurance Plans

Choosing a health insurance policy can't be a roll of the dice when you need reliable coverage and something more than a generic plan that may or may not adequately address your needs.

Insurance, at its core, should be built to cater to your unique situation and the experiences you'll encounter during your lifetime. Based on this principle, Professional Benefits Team Inc offers a wide range of tailored health insurance plans that provide coverage for individuals and families in Fresno.

Whether you're seeking coverage for preventive care, doctor visits, prescription medications, or specialized treatments, we have the right plan for you. Our insurance professionals know the available plans and will guide you through personalizing your plan to capture the most value.

With our support, navigating the insurance marketplace is easy because we’ll explain the benefits of each policy and fine text so you can make an educated decision that best suits your situation.

Allow us to understand your health conditions, consider your budgetary requirements, and present you with multiple options to safeguard your well-being. Phone our team to reserve an appointment.

Family Health Insurance to Cover Your Loved Ones

As a responsible head of the family, making sure your loved ones are covered during their most trying times is your top priority. Let us make this easier with comprehensive insurance policies to protect your entire family's healthcare needs.

We understand the importance of coverage options that provide adequate protection when your loved ones face unexpected medical expenses. Our team will collaborate with you to assess your family member's age, the types of illnesses they may encounter, and the prescribed medical solutions to address them.

We'll then assist you in optimizing your budget and exploring various benefit options, including family doctor appointments, hospitalization, minor sickness therapies, and long-term illness treatments. Our goal is to connect you with a family health insurance plan that offers coverage for all your family members and their potential health risks.

When Should You Get Family Health Coverage?

One of the best times to consider purchasing family health insurance is during major life changes, like getting married or having a child. These events often bring new healthcare needs, such as pediatric visits for newborns or maternity care, which can be costly without adequate insurance. Young and growing families have unique healthcare needs that make family health coverage particularly beneficial. Children require regular check-ups and vaccinations, and as they grow, their healthcare needs include dental and vision care, which family plans can offer.

Health coverage becomes even more crucial if someone in your family develops a chronic condition, requires regular treatments, or if you foresee the need for specialist care. Family health plans often provide better coverage for such needs.

Even if your family is currently healthy, having coverage ensures access to routine checkups, vaccinations, and preventative care, helping to maintain long-term health and catch potential issues early.

Who Is Considered a Dependent for Health Insurance?

For health insurance purposes, a dependent is defined as a child, spouse, or domestic partner. Children can retain dependent status until they reach the age of 26 in the state of California, regardless of marital status, financial dependency, or whether they live with their parents or guardians. However, they’ll need to have lived with you for at least six months to meet eligibility criteria. In specific instances, adult children with disabilities can remain on their parent’s insurance beyond the age of 26. Spouses and domestic partners can be covered as dependents with no age restrictions.

How Do You Add a Dependent to Your Health Insurance Plan?

Adding a dependent to your health insurance plan typically involves following these steps:

• Gather documentation: You’ll need proof of dependency to verify your relationship with a birth certificate, marriage certificate, adoption papers, and, in some cases, a Social Security card.
• Contact our insurance specialists: Contact us directly, and we’ll guide you through our enrollment process.
• Enrollment: We’ll help you determine if your plan has a designated open enrollment period and when it is, as well as how to enroll a dependant if you miss this timeframe. Certain qualifying events, including marriage, the birth of a child, or adoption, may qualify you for a special enrollment period outside the open enrollment window.

Self-Employed Health Insurance for Small Business Owners

For self-employed individuals, finding the right health insurance is of utmost importance. Any jeopardy to the health of an entrepreneur directly impacts personal well-being and the prosperity of the business.

We offer self-employed health insurance plans with extensive coverage, including access to a vast network of healthcare providers and flexible options for managing medical expenses. Our team will evaluate your current medical conditions and align you with a customized plan that covers all the medical care and services you may need.

Safeguard Your Business and Your Health With Insurance Options for Entrepreneurs

We aim to provide policy options that safeguard your finances and self-employment income in case of unforeseen circumstances. As a small business owner, we understand that your health is your wealth, and we're here to support you. To do this, we offer self-employed health insurance plans catering to entrepreneurs' specific insurance requirements.

We understand that choosing the right insurance coverage can be difficult, which is why we're here to assist you. Our team of experts is always available to help you select the self-employed insurance plan that best supports your entrepreneurial journey, even in times of health crises.

Self-Employed Health Insurance Options

It can be challenging trying to choose the right policy and coverage when you’re self-employed. We’re here to demystify your self-employed health insurance options. Whether you’re looking for personal coverage or coverage for your small team of employees, there are plenty of options to choose from.

Here are the coverage plans we can help you secure:

• Group health plans
• Prescription coverage
• Group dental coverage
• Group vision coverage
• Disability insurance
• Accident insurance
• Life insurance

You may find that one of these plans sufficiently meets your needs, or you may opt for more robust protection by enrolling in multiple plans to cover all aspects of your vision, dental, and health. In either case, we’ll help you select the plan options, fees, deductibles, and other essential details to ensure you can access the coverage you need when you need it.

Self-Employed Health Insurance for Family Members

Being self-employed brings its own unique set of challenges. One of the biggest things to consider is choosing the right health insurance options for yourself and your family.

Self-employed workers are eligible for a wide range of private insurance plans and can also qualify for premium subsidies based on their income. Our family plans provide coverage for spouses and children, ensuring the entire household is protected under one policy.

When you choose our broker services, we’ll help you find an insurance policy that satisfies your budget and fully covers all your dependents.

No Obligation Health Insurance Consultations

The first step is finding out exactly what your needs are before setting up the perfect health insurance plan to meet them. That's why we've created a detailed consultation process at the beginning of every client interaction. This consultation allows us to get to know our clients on a personal level, understand their insurance needs and lifestyle, and enables us to ensure you, your family, or your employees are effectively covered.

We'll always be happy to discuss these things with you over the phone, but in our experience, setting a scheduled time to speak in person is much more effective. We want to ensure that no information is overlooked or left on the table.

By the end of the consultation, we'll be able to draft you an accurate quote on the health insurance plan you need. We also reserve time at the end of the meeting for questions, as this can be quite an information overload. Don't hesitate to ask questions you have prepared or that you think up during the conversation, as our team is more than willing and able to answer them.

Full Range of Health Insurance Plans

We offer a full range of health insurance coverage and plans. We boast an incredible team of insurance brokers who are all experts in their fields. They'll help you assess your health insurance needs, present you with comparative packages, and help you put together a comprehensive health insurance plan.

Most insurance companies will offer a cookie-cutter insurance package not us. We ensure the insurance plan you receive is customized, includes add-ons, and is as specifically tailored to your needs as possible. The insurance plan we help you design should fit into your day-to-day so seamlessly that you don't even notice it until you need it. Still, you can be confident it's there for you in a crisis.

Streamlined Health Insurance Claims

If you need a smooth health insurance payout, our plans are the best option. When working with us, submitting a claim couldn't be easier. We'll be here to assist you with filing a claim because hassle-free service is what we offer. If documents need to be gathered, inspections ordered, or other parties consulted, we'll be there to negotiate the process with you and assist you in receiving the payout you're entitled to.

We'll explain things clearly to you, so you feel in the loop and receive an agreeable sum for your troubles. Do you have any questions? Please contact us today.

Individual Health Insurance

Protect Yourself—and Your Loved Ones

Need health insurance for yourself or your family? We offer a complete range of insurance plans from a variety of insurance providers. Our client-focused approach means we work with you and your budget to find an appropriate plan that meets your needs while driving down costs.

As an independent health insurance broker, we let you shop the best products on the market, helping you compare policies to find the best one for you. Whether you’re looking for primary health care insurance, extended coverage, or both, look no further than our team to help you find it.

We can help with:

• Primary health care insurance
• Vision care
• Dental care
• Disability coverage
• Mental health coverage
• Secondary health care coverage
• Cosmetic procedure coverage
• Physiotherapy coverage
• …and more

We can help you find the right insurance plan tailored to your needs and the kinds of coverage you want. To learn more about our options for individual and family health insurance plans, don’t hesitate to contact us today.

Group Health Insurance

Comprehensive Coverage for All Staff Members

We offer comprehensive group health insurance plans. We work with your company to find the right plan for you and your staff and to keep fees low for all. Whether you’re looking to extend your coverage, find lower premiums, or improve coverage for essential care, our team is sure to be of assistance.

Learn about all your options for group health insurance. Our extensive network of industry contacts lets us connect you with leading insurance plans from a wide range of providers. Once we’ve identified what you’re looking for in a group plan, we can help you narrow your options to find the right plan for you and your team. With our tenacious negotiation tactics, you can rest assured that we’ll get you the best terms and conditions for your insurance plan.

Premium Dental Insurance

Not all health insurance plans will be able to cover your dental needs, but when you work with us, you can keep your teeth healthy and clean with our additional coverage. We provide a range of supplemental dental insurance options for individuals, families, and businesses.

Whether you need regular cleanings and check-ups covered or have a more extensive and expensive dental surgery to worry about, we have packages that will allow you to have complete coverage when you need it.

To learn about our dental packages that you can add to your general health insurance, reach out today! We’ll be happy to discuss your options and find you a solution that works.

Are There Different Types of Dental Coverage?

Dental coverage can be tailored to meet different needs, offering flexibility in the types of services covered and the level of coverage provided.

For instance, individual dental insurance plans are designed for single persons who may not receive dental benefits through an employer.

Family health insurance that includes dental coverage will cover a wide range of services suitable for different age groups, including pediatric dental care and orthodontics for children. This can also include specialist services like periodontics, along with various preventative treatments for adults.

If you’re an employer, dental coverage may be part of a broader employee benefits package. These types of group packages will generally depend on the size of your organization, the level of coverage you wish to provide, and the specific needs of your workforce.

Comprehensive Vision Care

As people age, many of their functions, including their vision, will deteriorate. Your insurance should always include access to vision coverage, helping you be protected as your eyes need more help.

We offer access to the best vision plans around, which can be added to your general health insurance. When you need an eye exam, new glasses, or an eye procedure, you won’t have to worry about whether you can afford it—we’ll design an eye care insurance supplement that will keep you covered.

If you’re interested in adding our premium vision insurance to your health insurance coverage, don’t hesitate to contact us. We’ll be here to review your options and find solutions that match your needs and your budget.

What Services Are Covered in Vision Care?

The services covered in vision care can vary based on your specific needs and, of course, the type of vision plan you choose.

Some plans focus on basic eye health, while others include more comprehensive benefits like corrective procedures or specialty lenses. Typically, plans will include routine eye exams, prescription glasses, and contact lenses. You may also want to explore advanced coverage for things like progressive lenses or anti-glare coatings. For those with specific conditions, coverage may extend to medical treatments.

If you’re shopping for group coverage, then you’ll have the standard benefits plus the option to add coverage for specialized treatments or procedures. In terms of individual benefits, start by considering the frequency with which you might need vision care services.

Expert Guidance for Health Insurance

With so many different health insurance options on the market, it can be challenging to know where to begin. With our brokerage, you won’t ever have to wonder—we’ll help guide you in the right direction. Our expert brokers know all the plans that you qualify for and will be there to answer any questions.

We pride ourselves on being experts for all our clients, as we help them find solutions to their health insurance needs and problems. We care about your well-being first and foremost and will always do everything we can to make you feel more at ease.

Call us today to work with a health insurance broker who cares about you and your coverage! An expert will help you with any concerns or questions you have about coverage options.

Insurance Solutions Tailored to Your Needs

Professional Benefits Team Inc is on a mission—a mission to change the insurance industry for the better.

We strive to provide a personalized service tailored to meet your needs and wants. We take the time to get to know you, providing thoughtful, insightful guidance and finding practical solutions to your insurance needs. We want you to feel confident in our hands. We want you to feel confident in your insurance policy, and to feel secure knowing your health is taken care of. With our tailored solutions and comprehensive broker services, you can rest assured: You will.

Competitive Rates on Health Insurance

When you’re looking for an insurance company to cover your health care needs, it’s essential that you can afford the premiums. We’re always happy to work with you to find health insurance options that suit your budget and your healthcare needs. We don’t want to leave you uninsured for anything that could come up, but we also think you shouldn’t have to break the bank to get your coverage.

As a broker, we partner with many providers for our insurance coverage. This means we have a wide selection of options that could work for you, depending on what you can afford. To find a health insurance option that’s right for you, contact us and speak to an expert! We’ll be able to guide you towards a plan that meets your needs while being within your budget.

Medical Insurance Made Easy

Have you ever felt overwhelmed by the complexity and cost of health insurance? With so many coverage options available, how do you know which one is right for you and your employees? Fortunately, our company is here to help make this process easier.

We work alongside our clients to address their needs and help them find the ideal health insurance plan for their situation. We offer services for both individuals and employers, so you’re guaranteed to find a plan that provides the coverage you’re looking for—nothing more, nothing less.

How We Help You Find the Best Health Insurance Coverage

There are many health insurance companies out there vying for your business. Knowing which business is trustworthy can be challenging, but that's where our company comes in. We're here to help you and your employees get the best coverage possible, putting your best interests at the top of our priority list.

Professional Benefits Team Inc is proud to be a local insurance company with a history of excellence and many long-term clients. We got to where we are today by ensuring that our clients have all their questions answered and don’t have any doubts before they commit to any of our insurance plans. We’ll always be happy to personalize our services to meet your needs, and we promise to be polite and professional throughout all our interactions.

Health Insurance Quotes You Can Trust

When you’re searching for affordable health insurance, it can be difficult to narrow down your options. You want to make sure you're getting the best coverage for you and your family, but you also want to make sure you're not overpaying. Our team of specialists can help you find the right plan that suits your needs without requiring a higher premium than necessary.

Our company specializes in helping people find the best health insurance coverage for their needs. We work with a wide network of trusted providers, so we can compare plans and prices to find the perfect fit for you. We'll also help you understand all the different options and coverage levels, so you can make an informed decision about what's best for your situation.

Getting health insurance quotes is easy with our help. Just give us some basic information about yourself or your organization, and we'll get to work finding the right plan for you. We'll even handle all the paperwork and phone calls, so you can focus on what's important.

Health Insurance Claims Made Simple

After enrolling in one of our health insurance plans, you can start using your benefits immediately. We work hard to ensure a quick and efficient claims process for all our clients, so you can access the funds you need for your medical expenses as soon as possible. If you ever have any questions about your coverage, our customer service team will always be there to help.

We believe that everyone deserves access to quality health care, and our simple claims process is just one way we make that happen. So, if you’re looking for an easy way to get coverage for yourself and your employees, look no further than our company.

Complete Prescription Coverage Included in Health Insurance

With prescription drug prices often prohibitive and out of reach, many who shop for health insurance with our company are looking for a way to make their medication costs more affordable. Every insurance company differs concerning the total percentage covered and what prescriptions can be added to their plans. This variety is why we prefer to conduct a personalized consultation with you to assess your unique needs and match you with the best provider.

Many Americans require prescription drug insurance for the following reasons:

• Hypertension/high blood pressure
• High cholesterol levels
• Insulin for diabetes
• One-off prescriptions for cold/flu/injuries
• …and other chronic illnesses

Most insurance companies can add prescription drug coverage to a policy, giving the policyholder a comprehensive health insurance package. If you’re searching for the perfect plan, we recommend speaking with us about adding prescription coverage.

How Does Prescription Insurance Work?

When you have prescription insurance, you typically pay a portion of the medication cost, known as a co-pay, while your insurance covers the remainder up to a certain limit. Some plans also have a deductible, which is an amount you pay out-of-pocket before your insurance begins to cover expenses.

For example, let’s say your plan includes a $20 co-pay for generic medications and a $200 deductible. If you need a medication that costs $150, you would pay the full amount until you meet your $200 deductible. After that, you would only pay the $20 co-pay for each prescription.

Comprehensive Medicare Health Supplement Plans

Medicare is a federally regulated and dispensed health insurance program for Americans 65 or older. Retiring at 65 will leave you reliant on a fixed income that may not satisfy your medical expenses, let alone cover your prescription medication. If you’re looking for expert advice to help you manage your Medicare coverage, we would like to assist you with exploring your options for Medicare supplemental health insurance.

Access to comprehensive coverage that includes perception medications will take the burden off your income and give you peace of mind that you won't need to forgo your health priorities. Medicare supplements can help with the following:

• Dental and vision
• Prescription drugs
• Care assistance costs
• Mental healthcare
• Travel insurance
• …and more

Coverage may also be extended to the following groups (restrictions may apply):

• Those living with a disability
• Those with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant)
• Those with ALS disease, also known as Lou Gehrig's disease

If you want to learn more or know if you qualify, don't hesitate to contact our office to speak with one of our insurance broker agents.

Health Insurance Broker Providing Comprehensive Solutions

When you partner with Professional Benefits Team Inc as your health insurance broker, you’ll receive premium service, timely responses, and many customizable options. Here is how you’ll benefit from choosing us to streamline your insurance policy search:

• We work with many insurance companies making it easier to pair you with the best plan.
• We’re licensed in the state of California.
• Our team of brokers is fully certified and highly trained.
• We assign you a broker who will act as your personal agent, finding you the best policy and rates.
• Your time and health matter to us, so we get to work directly after meeting with you in search of the best policy for your budget and needs.

Receive Free Quotes Instantly

With Professional Benefits Team Inc, we help you compare and save on affordable health insurance policies. Our agent will gather your personal details and other relevant information and, in a short time, will have a list of quotes from companies. You can compare many low-cost health insurance quotes and choose the best various option. Between our vetted and curated individual and family plans, there will be many options on the table that stand out to you.

Save time and money when you partner with our brokerage. Call today to schedule a personalized consultation and get access to renowned health coverage for you and your dependents.

Fresno’s Leading Local Health Insurance Broker

Get in Touch Today

Find the right insurance plan with Professional Benefits Team Inc. We’ve helped countless clients in Fresno and beyond save time and money on health insurance, and we know we can help you do the same. Professional, dependable, affordable: Consider us the go-to choice for local health insurance services.

Contact us today to schedule a no-obligation consultation.

Looking for health insurance in Fresno? Contact us at (559) 275-7706.