Frequently Asked Questions
How can you offer fixed rates on group health insurance? Nobody else can.
We are a PEO or Professional Employer Organization. When you buy health insurance through us, you are entering into a co-employer relationship. Nothing changes in regard to how you do business. But, the simple answer is that you are looked at as being an employee of the PEO (as well as an employee of your own company). Therefore, you are eligible to participate in our group health insurance plans, which we get at rates that are generally much lower than you can.
I do not understand. Am I working for the PEO?
No, you still work for your company. If you are a group of three or more we generally take over payroll and offer the health insurance that way. If you are a group of one or two, we actually pay you for 20 hours of work a week to permit you to use our group health insurance.
But, this is not employee leasing. You still work for whomever you work for. Everything is completely transparent to you and your workers. Except for better coverage at a lower cost, nobody will even notice the change.
I am self-employed. Can I still purchase one of your plans?
Yes, there is no size limit for a group. You can even take advantage of all of our other benefits such as 401K, disability, etc.
We have employees in multiple states. Will the coverage extend to these employees?
Currently, we are licensed in 18 states. We can cover your employees in any one of them. If you are in a state we are not currently licensed in, please let us know. We are expanding all the time.
How do I get a quote or enroll in the plans?
Unlike most group health insurance plan, you can view the rates online and get a sense of what the plan will cost your company each month. We will do a more precise proposal, but the rates for the health insurance do not change.
The enrollment process is still manual (a form packet) but will go online shortly.
What are the fees?
The fees work a little different for the one or two person group then they do for a group of three or more employees.
With the one or two person group, you are sending us a check that will be used to pay you. We then deduct the cost of the health insurance and applicable payroll taxes and send you the rest.
The amount you send us (actually it is deducted from your account around the 13th of the prior month) depends on which plan you take and how many family members will be on the plan.
There is an initial setup fee of $200 and then an annual fee of $120 that we charge each December 1st.
We will send you a detailed chart that shows the monthly fees, salary, taxes, etc.
How does all this work in regard to taxes? Can I deduct it all?
Generally, you can deduct the entire amount you send us as a PEO fee. However, we are not accountants (actually we are but we do not give tax advice). To help you in this matter, we went to a prominent tax attorney and had a tax advice memo prepared. If you would like to view a copy of this so you can print it and give it to your accountant, CLICK ON THIS TAX ADVICE LETTER link.
Are there any underwriting requirements?
The law requires that to purchase medical insurance from us, at group rates, we have to be the employer or co-employer of the self-employed individual or small business owner. In order to do that we have to be hired by the employer or self-employed person.
The self-employed individual or small business owner must be actively working, devoting at least 20 hours a week to his/her business. We recognize that in some cases there is variation in a person’s hours each week, but they should be actively working at such business at least 90 hours a month.
The person retaining us and his/her employees must have a legal right work in the U.S. and must have a valid Social Security number.
A self-employed individual must receive 1099 income or be an owner, partner or member of an LLC, Partnership, Sub S, or similar corporate structure.
The business must be operating to generate a profit. We recognize that for start-up business and because of current economic conditions this may not always but possible, and we may, at our discretion, make an exception in some cases.
The person should have the cash flow to afford our fees. Generally, he or she should have a gross business income of at least $40,000 a year. We recognize that a spouse may be working, and there may be income from investments or other sources.
The self-employed individual or business owner must currently be covered under an ERISA qualified medical plan. This is both an underwriting guideline and, for pre-existing conditions to be covered, the individual must have had medical insurance with another ERISA qualified plan for at least 63 days before joining our UHC plan. Furthermore, because coverage under our medical plan will not take effect until the first day of the month after an individual has been on our payroll, the 63-day period for the waiver of pre-existing illnesses will include both this period plus any additional time (s)he was without coverage prior to joining our program. We recognize that there may be reasons that an individual does not currently have medical insurance, and we may, at our discretion, make exceptions to this requirement depending on the facts of the situation.
Limited indemnity insurance, even if deemed to be an ERISA qualified medical plan, will not qualify for the above required coverage; however, we may, at our discretion, make exceptions to this requirement depending on the facts of the situation.
The self-employed individual or business owner must have the cash flow sufficient to pay two months’ fees plus the set-up fee before he/she receives the first paycheck. In addition, (s)he must have the cash flow sufficient to pay our recurring monthly fee in advance of receiving his/her pay.
We require the family unit to be covered under our medical plan, e.g. Husband and Wife or Family coverage. An exception may be made in certain cases, such as where a spouse is receiving medical insurance under his/her employer’s medical plan.
We are prohibited by law from asking people their health history or making a decision to cover or not cover them based on age, sex or health history.
Call us at 800-272-0512 Mon - Thurs 9 am to 8 pm EST and until 6 pm on Friday or click here to send us an email