We are often asked about:
Under 50 employees no, over 50 employees yes
No penalty for groups under 50 employees. Over 50 — $2,000 per employee penalty, minus the first 30 employees. Then an additional $3,000 per employee penalty if the employee obtained insurance at Healthcare.gov and qualified for a federal subsidy.
Yes. Federal tax credit for groups under 25. Insure Oklahoma for groups with less than 100 employees.
Yes. Many marketing studies have shown that it is a major factor in retaining employees.
It is a qualifying event. They can purchase through us directly. If the group has more than 20 employees, the employee would qualify for COBRA to keep the group insurance for up to 18 months.
50 percent for the employee. None for dependents.
Contact us to discuss your situation.
No. They are both important.
The “usual and customary” fee is what an average of providers in a region charge for any visit, treatment, surgery, etc. The insurance carrier will pay contracted health care providers a percentage of a bill with the patient being responsible for the remainder. But, not responsible for any charges over “usual and customary.” Therefore, it is important to have an insurance carrier that is contracted with your specific doctors, hospitals, etc.
Only during the open enrollment period for the group.
Coinsurance is what you pay after the deductible. Deductible is what you pay first. The out of pocket limit is the combination of the deductible and your coinsurance. Once you reach that maximum out of pocket, the insurance pays 100 percent for the rest of the year. Most out of pocket limits for individuals are $6,600
It does not exist. Oklahoma uses the Federal exchange at Healthcare.gov. We can help you navigate this system and enroll you on Healthcare.gov, either in person or over the phone.
All plans have to meet the guidelines of the Affordable Care Act.
Pre-existing conditions are no longer an issue on individual or group health insurance.