Please read this page BEFORE you call us
800-272-0512 (Mon - Thurs 9AM - 8 PM EST)
(Fridays until 6 PM and Saturday 10 AM - 1 PM)
Using a Professional Employer Organization (PEO) to Obtain Health Group Health Insurance Benefits (group size 1 to 1000).
If you are self-employed or have a small group (any size) we can help you obtain a complete, major medical, PPO health insurance plan with no medical underwriting.
The plans described on this page are offered in the following states only:
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Arizona |
Nebraska |
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California |
Nevada |
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Colorado |
New Jersey |
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Connecticut |
New York |
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Florida |
Pennsylvania |
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Georgia |
Texas |
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Maryland |
Virginia |
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Mississippi |
West Virginia |
There are many reasons to use a PEO to obtain your health insurance benefits.
Guaranteed issue health insurance plans with no medical declines - These are true group health insurance plans. You cannot be declined due to a medical condition.
Groups as small as one person - We can write one person groups. There is no special time of year to apply.
Low Premiums - The premiums for one and two person groups are generally lower than COBRA or other guaranteed issue alternatives. The rates for groups of three or more are truly outstanding. The rates do not increase with age or gender. All employees pay the same.
Multi-state coverage - Your employees can be located in any of the states we service. If you have employees in other states, let us know.
Additional Benefits - You have the option of adding disability insurance, 401K, Flexible Spending Accounts or even use an HSA (Health Savings Account) plan.
What is a PEO?
A PEO is not a staffing company or a payroll service. They are a more like a partner who has taken over many of the duties of a human resource department.
For One or Two Person Groups
If you are a group of one or two employees, you are entering into a service agreement that makes the PEO a co-employer. You continue to work for your own company as usual and pay yourself as you always have. But, the PEO will also send you a paycheck each month. This permits them to offer you health insurance and other benefits.
I know this can be confusing at first, but it is really not as complicated as it sounds.
Imagine that you have a part-time job with a company that offers benefits. You work at least 20 hours a week which permits them to put you on their group health insurance plan.
Each month you send them a check and they use the money you send them to pay you. They deduct for the health insurance, taxes, etc. and send you what is left as your paycheck. When you dig down below the surface, that is all there is to this.
If you are self-employed and must have a guaranteed issue group health insurance plan, then this might be the answer.
For Groups of Three or More Employees
If you are a group of three or more employees, the rates for these group health insurance plans are truly outstanding. In most instances you will not be able to purchase insurance this good at such a low premium.
We make this very simple. Just look at your renewal notice for your group plan and compare it to our rates and plans. If we are cheaper, and in most instances we will be, you should call us.
We do not need an upfront census to get an initial quote. Just scroll down this page and look at the fixed rates.
Available Plans
We currently offer three different plan designs. All use the United HealthCare Choice Plus network.
This is a national PPO network. You can use out-of-network providers for the Gold and the HSA plans, but not the Silver plan.
Basic Medical Plan Features |
Gold Plan |
Silver Plan |
HSA Plan |
Provider network |
UHC Choice Plus |
UHC Choice Plus |
UHC Choice Plus |
Maximum age for a dependent child |
25 |
25 |
25 |
In-Network Services |
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Annual deductible |
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Individual |
None |
$1,000 |
$2,000 |
Family |
None |
$2,000 |
$4,000 |
Annual out-of-pocket max. |
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Individual |
Not applicable |
$3,000 |
$2,000 |
Family |
Not applicable |
$6,000 |
$4,000 |
Coinsurance |
None |
80% |
100% |
Routine Adult or Well Child Care to Age 19 |
No Charge |
No Charge |
No Charge |
Office Visit Copay |
$30 |
$30 |
No charge after deductible |
Specialist Copay |
$50 |
$50 |
No charge after deductible |
Hospital Admission Copay |
$500 |
Deductible and coinsurance |
No charge after deductible |
Hospital Outpatient Copay |
Not applicable |
Deductible and coinsurance |
No charge after deductible |
Emergency Room Copay |
$100 |
$250 |
No charge after deductible |
Lab Fees at Participating Lab |
No charge |
Deductible and coinsurance |
No charge after deductible |
Lab Fees at Provider’s Office |
No charge |
No charge |
No charge after deductible |
Lifetime Max. Benefit |
Unlimited |
Unlimited |
$5,000,000 |
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Out-of-Network Services |
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Annual Deductible |
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Individual |
$2,000 |
Not applicable |
$4,000 |
Family |
$4,000 |
Not applicable |
$8,000 |
Annual Out-of-Pocket Maximum |
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Individual |
$7,000 |
Not applicable |
$5,000 |
Family |
$14,000 |
Not applicable |
$10,000 |
Coinsurance |
70% after deductible |
Not applicable |
80% after deductible |
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Prescription Drug Features |
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Generic Copay |
$10 |
$10 |
$10 |
Preferred Copay |
$30 |
$35 |
$30 |
Non-preferred Copay |
$50 |
$70 |
$50 |
Prescription Drug Deductible |
None |
$250/$750 |
Subject to in-network deductible |
Rates
I am going to give you the rate for the health insurance only.
For one or two person groups their are special tax considerations that will give you a lower net cost.
For groups of three or larger the rate is lower but you must have the PEO run your payroll. This is a nominal cost and the rates for these plans are still unbelievably low.
Rates For Groups of Three or More Employees
These rates are for all employess regardless of age, gender or location.
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Gold Plan |
Silver Plan |
HSA Plan |
| Single |
$490 |
$380 |
$410 |
| Single + Spouse |
$895 |
$650 |
$700 |
| Single + Child(ren) |
$800 |
$600 |
$650 |
| Family |
$1400 |
$850 |
$900 |
Rates For Groups of One or Two Employees
These rates are for all employess regardless of age, gender or location.
They are gross rates. The actual net rate is much lower and takes into account the tax savings of deducting the PEO fee and the reduction in self-employment tax. If you are not considering the tax savings (as compared with the deductions for a traditional group or individual plan) you are not fully appreciating how competitive these rates are.
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Gold Plan |
Silver Plan |
HSA Plan |
| Single |
$686 |
$523 |
$537 |
| Single + Spouse |
$1098 |
$788 |
$791 |
| Single + Child(ren) |
$949 |
$690 |
$698 |
| Family |
$1350 |
$980 |
$976 |
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Group of One or Two Illustration
To illustrate how a co-employer arrangement works, we will use the example of a self-employed individual who is organized as a Subchapter S corporation. This could have just as well been a sole proprietor or partnership. The principles are the same.
Please be advised that while we reference the tax savings in this illustration, we cannot offer you tax advice. You should talk to your accountant or tax advisor about the deductibility of PEO fees. We will share with you the tax advice letter we received from a respectable tax firm that discusses the tax implications of a PEO and your business. You are free to share this document with your advisor.
Harry Smith is a self-employed marketing consultant and operates as Smith Consulting Inc. He wants to obtain health insurance for himself, his wife and two children.
Step 1: Mr. Smith signs a service agreement and pays a nominal setup fee. He has selected the Gold health insurance plan with no deductible.
Discussion: In addition to the health insurance, Mr. Smith could sign up for disability insurance, life insurance, a 401K plan and/or a Flexible Spending Account (FSA).
Step 2: In addition to remaining as an employee of Smith Consulting, Mr. Smith has now become an employee of the PEO. So, Smith Consulting and the PEO are Mr. Smith’s co-employers.
Step 3: Mr. Smith sends the PEO a check each month. The check is the PEO fee and will cover the following items – health insurance premiums, the salary for Mr. Smith (this is a minimum wage salary for the minimum number of monthly hours), taxes, unemployment insurance and workman’s compensation insurance.
Step 4: Each month, Mr. Smith will receive a paycheck for his net salary. He and his family will have a full, PPO, major medical health insurance plan. At the end of the year, he will receive a W2 for his salary from the PEO in addition to the W2 he is issued from the business.
Summing Up One and Two Person Groups
I do not want to make this overly complicated. You can condense everything that has been said into a simple statement:
“You send in a check, a portion is deducted to pay for the insurance, taxes and any fees and the rest is sent to you as a paycheck. That makes the PEO your co-employer and allows them to give you health insurance. You get an unbelievable plan for a great price and they make money on service fees. Everybody wins.”
I guess I could have said that in the first place. |
Next Steps
Give me a call and I will help you determine if this is the right way for you to obtain health insurance benefits.
Call
us at 800-272-0512 (9 AM to 8 PM EST)
While we are licensed insurance agents, all contracts and fee arrangements are between you or your company and Benefit & Compensation Consultants, a licensed Professional Employer Organization. You are obtaining health insurance through their group plan arrangement with United HealthCare.