Group Health Insurance

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)

Only Available in NY, NJ or CT

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 New York, New Jersey and Connecticut only.

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 MultiPlan PPO network. This is a national PPO network.

Basic Medical Plan Features	Gold Plan	HSA Plan
Provider network	Multiplan	Multiplan
Maximum age for a dependent child	25	25
In-Network Services
Annual deductible
Individual	$1,000	$2,500
Family	$3,000	$5,000
Annual out-of-pocket max.
Individual	$1,500	$2,500
Family	$3,000	$5,000
Coinsurance	90%	100%
Routine Adult or Well Child Care to Age 19	No Charge	No Charge
Office Visit Copay	$30	No charge after deductible
Specialist Copay	$30	No charge after deductible
Hospital Admission Copay	Subject to Deductible and Coinsurance	No charge after deductible
Hospital Outpatient Copay	Subject to Deductible and Coinsurance	No charge after deductible
Emergency Room Copay	$100	No charge after deductible
Lab Fees at Participating Lab	$30	No charge after deductible
Lab Fees at Provider’s Office	No charge	No charge after deductible
Lifetime Max. Benefit	Unlimited	Unlimited
Out-of-Network Services
Annual Deductible
Individual	$2,000	$7,000
Family	$6,000	$14,000
Annual Out-of-Pocket Maximum
Individual	$3,500	$7,000
Family	$10,500	$14,000
Coinsurance	70% after deductible	80% after deductible
Prescription Drug Features
Generic Copay	$0	No charge after deductible
Preferred Copay	$25	No charge after deductible
Non-preferred Copay	$50	No charge after deductible
Prescription Drug Deductible	None	No charge after 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.

	Gold Plan	HSA Plan
Single	$650	$410
Single + Spouse	$1,400	$850
Single + Child(ren)	$1,250	$750
Family	$1,800	$1,100

Rates For Groups of One or Two Employees

These rates are for all employess regardless of age, gender or location.

These are "cash flow rates". When you talk to our rep they will be explained. But, you can use them for comparison purposes.

	Gold Plan	HSA Plan
Single	$785	$586
Single + Spouse	$1,321	$838
Single + Child(ren)	$1,158	$787
Family	$1,684	$1,015

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)