“Skyscraper Insurance proudly partners with Kathy L. Casale and her team of trusted advisors in the health, life and wellness space. Kathy is passionate about serving others and helping businesses and individuals find unique solutions to the ever-rising health insurance costs. Reach out to Kathy to receive quality coverage and to have all your questions answered!!!”Choice Health Options serves individuals, families and business owners both large and small.
Choice Health Options is an Independent Agency which allows us to discuss many design options versus representing one plan or carrier.
We search nationally for insurance carriers and programs with exceptional ratings, stability in rates and solid customer service. In forming relationships with these partners, our goal is to provide you with a seamless experience in the time you need it most. Our options vary from affordable, user friendly products with low copays, traditional private health insurance options, on exchange and SHOP plans and plans that provide wellness benefits to capitalize on retention and MERP tax advantages for employees and employers.
Our focus is YOU and we work with you to explore your needs today and potential needs in the future.
Individuals:
Nationally, states vary with what carriers and products within are offered and this highly depends on the state’s rules and regulations. Private insurance is typically medically underwritten although “guarantee issue” products are available as well, typically in limited numbers. After conducting a quick needs analysis, we are able to offer options that suit you and your particular situation be it budget concerns, health concerns, networks, prescriptions or simply if you are looking to cover yourself or your family “just in case.”
Open enrollment for individuals occurs once per year and it’s important for you to understand when these dates are, particularly if moving from a private plan or if you qualify for a tax subsidy to help pay for your insurance. The Federal Government provides a Marketplace for most states and Open Enrollment runs from November 1, 2021 to January 15, 2022. Consumers who enroll by midnight December 15 can get full year coverage that starts January 1.
More information about your states open enrollment can be found here.
States providing their own Marketplace outside of the Federal Market can have different open enrollment periods. These states include NY and NJ. Please consult this chart for information if your state hosts its own Marketplace.
At Choice Health we specialize in health care options and provide our consultation, quotes and service at no charge to you. Simply fill out the contact form below?? (would love to collect some info including Skyscraper representative so we can consult with that rep before reaching out to your customer in order to provide optimal service. Ad to each category if possible) and get on your way to finding peace of mind in an educated health insurance decision.
Small to Midsize Groups:
Your business is growing and you’d like to explore benefits for your employees, but where to start? We have a team of experts that can work with your demographics and budget to determine the best fit. Additionally, we can provide strategies to give the feel of providing benefits to employees by incorporating WIMPER’s. These wellness plans boast immense benefits ensuring a healthier workforce while freeing up funds via payroll/tax strategies allowing employees to purchase voluntary products they feel best suit their family needs with no change in their take home pay. In this, employers also save an average of $500 per employee.
When offering traditional coverage to employees, certain participation requirements are enforced. Often at minimum, at least one W2 employee is required to participate in a group plan outside of the owner’s family. Other W2 employees are required to sign a waiver indicating they have coverage from another source. Some exceptions may apply to LLC, C and S Corporations with no W2 employees and more than 2% shareholder ownership.
You can find your state’s minimum participation requirements here.
Please note: participation requirements are much more liberal during the limited enrollment period of November 15 – December 15th. Business owners hoping not to satisfy MPR’s should consult our team of specialists October 15th to review options.
From traditional insurance product to ancillary benefits which provide critical illness, accident, dental, vision and more, our team works hard to ensure employees champion their employers and everyone wins.
Large Employer Groups 50+
It is extremely important for large employers – or soon to be large employer groups to educate themselves on the IRS enforced penalties for not providing coverage.
Large groups are required to provide Minimum Essential Coverage when employing 50 Full Time or Full Time Equivalent employees (FTE) and report proof of coverage to the IRS or may be subject to substantive fines and penalties. ALEs are employers who employed (in the preceding tax year) an average of at least 50 full-time or full- time equivalent employees on business days during the preceding calendar year. A full-time employee averages at least 30 hours of service per week. To calculate full time equivalent employees, monthly service hours for all non-full-time employees are totaled then divided by 120. When full time and full- time equivalent subtotals are added together and total more than 50 the employer is deemed an ALE.
Penalty A
The ACA employer mandate’s large §4980H (a) penalty (frequently referred to as the “A Penalty” or the “Sledgehammer Penalty”) applies where the ALE fails to offer minimum essential coverage to at least 95% of its full-time employees in any given calendar month.
The Section 4980H (a) penalty, issued to ALEs that fail to offer minimal essential coverage to at least 95 percent of their full-time employees and their dependents, are $2,750 per employee, or $229.17 a month, for the 2022 tax year. The assessed amount will be applied to all full-time employees, the employer can deduct 30 full-time employees from the total number of full-time employees when determining the penalty amount.
Penalty B
An Applicable Large Employer must offer a health plan that meets minimum value requirements, the plan must cover at least 60% of the allowed cost of benefits provided under the plan and be deemed affordable. To be deemed affordable the employee only rate cannot exceed 9.61% of the employee’s earnings. This penalty is also triggered when an employee receives a premium tax credit on a plan through the marketplace. The penalty associated with this legislation is $4,120/ per employee per year or $343.33/month. This penalty is assessed per occurrence and a penalty on one employee does not mean a penalty for all as is the case for penalty A. The penalty for noncompliance in penalty B cannot exceed penalty A.
Minimum Participation Requirements hold true to ALE’s as Small to Midsize Employer groups.
Exploring to offer traditional coverage to your employees?
We work with the top carriers and self-insured options to find the best fit based on your wants, needs and budget. In addition, we partner with the top mental and health wellness plans and incorporate transparency strategies to help keep claims, therefore your premium, as low as possible.
At Choice Health Options, we can help make sure your company is in compliance, your employees happy and healthy and your bottom line is where it needs to be.
We aim to be your go to health care specialists, in partnership with Skyscraper Insurance, “WE SHARE YOUR VISION FOR A BETTER TOMORROW.”