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FAQs - Click on an item below for a specific answer:

How do I know the carrier I select is reputable and the particular plan is good?

How and when do I tell my employees about the new health insurance plan?

What is the best way to save on health insurance premiums?

How do I know which plan to choose?

Why buy health insurance from HealthPlanOne?

What size employers qualify for business coverage?

How long does it take to get coverage?

What documents does the carrier require to apply for insurance?

What documents does a sole proprietor not on a payroll filing need?

What documents are required for a newly formed business?

Who is considered an eligible employee?

Are retirees considered eligible employees?

Are 1099 contractors eligible?

What are the rules on dependent eligibility?

What is a waiting period?

Can an employee enroll in the health insurance plan at any time of the year or only during the open enrollment period which precedes the group’s anniversary date?

What is a qualifying event?

Can employees reside out-of-state?

How much must the employer contribute towards the cost of the health insurance?

Is health status a consideration in determining premium rates?

What about preexisting conditions? How long do I have to wait?


How do I know the carrier I select is reputable and the particular plan is good?

HealthPlanOne has already done this work for you. We only offer carriers that are licensed to do business in your state and are well rated with A.M. Best. Additionally, all of the plans offered on the site are analyzed to determine if they are a good value.
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How and when do I tell my employees about the new health insurance plan?

The ideal time to tell your employees is 30 to 60 days before the open enrollment period begins. That is about the right amount of time for decision making. Also, let your new insurance company provide materials about the new plan. You can also include a letter which outlines why you decided to make the change.
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What is the best way to save on health insurance premiums?

Look at ways to increase your deductible. Many times higher deductibles simply make financial sense.

Pay varying portions of your employees’ premiums based on longevity. It will serve a dual purpose of saving you money and rewarding

Set up a Health Savings Account (HSA). The Health Savings Account is an attractive way to use pre-tax money to pay health related expenses. Read about HSA’s here.
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How do I know which plan to choose?

Health insurance is like any other purchasing decision. It pays to do a bit of research. Here are some basic tips:

Use sites like HealthPlanOne to research various companies and plans.

Understand the health needs of your employees. What are the demographics of your employees?

Define goals of the plan. Is the goal of purchasing health insurance to maintain key employees, attract new ones? Maybe, your goal is simply to provide a very basic low cost plan. In short, be sure to understand your goals for purchasing health insurance.

Analyze the cost of various plans and budget accordingly.
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Why buy health insurance from HealthPlanOne?

Our service comes at no additional cost to you. Our service is paid for by the insurance carrier. Even if you buy directly from the insurance carrier, your cost will be the same as if you bought from us.
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What size employers qualify for business coverage?

In most states, small group medical insurance plans can be offered to groups with 2-50 eligible employees. Some states will go as low as one eligible employee. Insurers generally require that organizations not be formed solely for the purpose of obtaining health coverage.
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How long does it take to get coverage?

It should probably take you less than one hour to fill out the employer application, etc. Once you have completed the application and you submit the other required documentation, we will get your information to the carrier within 72 hours. Once the carrier receives your paperwork, it usually takes two to three weeks to receive your ID cards.

Please note, most carriers only have effective dates on the 1st and 15th of the month. If you want your ID cards in hand before you are effective, you do not want to wait until the last minute to submit your paperwork.
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What documents does the carrier require to apply for insurance?

Submission of the most recent quarterly payroll form which must contain the names, salaries, etc. of all employees of the employer group. Employees who have terminated or are part-time (less than 20 hours) should be noted and employees not listed on the payroll filling should have a W-4 and payroll stub.
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What documents does a sole proprietor not on a payroll filing need?

Sole proprietors not listed on a payroll filing need to show a state business license with SIC, an assumed name certificate and a certificate of organization (for LLC and LLP).
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What documents are required for a newly formed business?

A newly formed business is typically required to show a tax identification number and payroll records or a letter from an attorney or certified public accountant listing the names of all employees, number of hours worked on a regular basis and indication of salary rate.
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Who is considered an eligible employee?

Most carriers consider eligible employees to be those who are permanent and work on a full-time basis with a normal workweek of at least 20 hours (the employer is free to establish its own eligibility rule as regards the number of hours worked per week to qualify for coverage as long as the number is 20 or above). Coverage must be extended to all such employees unless they belong to a union class excluded as the result of a collective bargaining agreement.

Employees who do not meet the definition of a permanent full-time employee will often not be eligible. Such employees might be leased, part-time, temporary/seasonal or substitute employees. In addition stockholders, partners or other outside consultants who are not active, permanent full-time employees are usually not eligible.
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Are retirees considered eligible employees?

No, and retiree coverage is typically not available through small group insurance carriers.
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Are 1099 contractors eligible?

Most insurers do not consider 1099 contractors eligible.
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What are the rules on dependent eligibility?

Eligible dependents include an employee’s spouse and unmarried children up to the limiting age of the plan, typically through age 18 or 23 if a full-time student.

Most carriers do not consider domestic partners to be eligible dependents.
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What is a waiting period?

An employer may decide to impose a probationary period during which new employees are not eligible for benefits. The rule must be applied consistently and only be changed at the group’s coverage anniversary.
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Can an employee enroll in the health insurance plan at any time of the year or only during the open enrollment period, which precedes the group’s anniversary date?

An employee can only join the plan or add dependents during the open enrollment period unless there is a qualifying event.
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What is a qualifying event?

A qualifying event is marriage, divorce, newborn child, adoption or loss of spousal coverage. In addition new employees, or employees that have worked through the waiting period can enroll at any time of the year.
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Can employees reside out-of-state?

Most insurance carriers require a minimum percentage of employees to live in the health plan’s service area. Each carrier will have specific requirements.
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How much must the employer contribute towards the cost of the health insurance?

Many carriers require that the employer contribute at least 50% of the single rate for health coverage.
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Is health status a consideration in determining premium rates?

Many states allow insurers to consider a group or member’s health status in determining small group premium rates. However, in New York, Connecticut, New Jersey, Massachusetts, Vermont, Maine, Maryland, Oregon and Washington insurers cannot use health status (or medically underwrite) in the calculation of small group rates. This is also considered “community rating.”
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What about preexisting conditions? How long do I have to wait?

If you have had insurance coverage for the previous 12 months, as evidence by a “continuation of coverage“ document from your existing carrier, you cannot be subject to a preexisting condition exclusion.

If you have had a gap of greater than 63 days in health insurance coverage prior to enrolling, you may be subject to a waiting period for preexisting conditions. Under HIPAA, a "preexisting condition," is defined as a condition for which medical advice, diagnosis, care, or treatment, including use of prescription drugs, was recommended or received during the six months immediately preceding the enrollment date in a new plan or effective date of coverage.
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