INTEGRITY BENEFITS GROUP, LLC
OUR PROMISE
We make your benefits our business, so you can run yours... It is our goal to help your business reach its short and long term goals while caring for your employees like they are our own. We achieve this by helping employers design, implement and maintain a comprehensive benefits package tailored to their companie's unique needs. Small or large, we believe that your company and its employees deserve our careful attention.
Focusing on the following areas:
Major Medical
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Fully Insured
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Self-Funded
Ancillary Benefits
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Dental
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Vision
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Life, Supplemental Life
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Disability
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Cancer, Accident & Critical Illness
Section 125
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Flexible Spending Account
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Dependent Care Account
COBRA
Wellness Programs
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Carrier sponsored programs
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Third-Wellness Programs
Partners:
FAQ FOR EMPLOYERS
What information is required to Get a Quote
If you have less than 50 full-time employees, we only need your employees dates of birth to obtain a quote. You can provide this information on the Census Template.
If you have more than 50 full-time employees, you may have to complete an additional questionnaire.
Am I required to offer my health insurance to my employees?
To be subject to the Employer Shared Responsibility provisions for a calendar year, an employer must have employed during the previous calendar year at least 50 full-time employees or a combination of full-time and part-time employees that equals at least 50.
I want to offer health insurance to my employees, but can't afford to. Are there any programs out there to help?
With the support of Insure Oklahoma, employers can provide quality health insurance to their employees while saving on health insurance premiums.
To qualify, a business should:
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Have 250 or fewer employees
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Be located in Oklahoma
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Offer a Qualified Health Plan
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Contribute at least 25% of the premium for qualified employees.
To get more information, read the Employer Brochure, or visit the web-site below.
Could I have to pay a penalty even if I do offer health insurance to my employees?
If you are an employer that is subject to the employer shared responsibility provisions, you may choose either to offer affordable minimum essential coverage that provides minimum value to your full-time employees and their dependents, or to potentially owe an employer shared responsibilitypayment to the IRS. Many employers already offer coverage that is sufficient to avoid owing a payment.
Am I required to comply with the Information Reporting Requirements (Forms 1094 & 1095)
"Section 6056" Reporting Entities: Employers with 50 or more full-time employees (including FTEs) are required to report information to the IRS and to their employees about their compliance with "pay or play" under Internal Revenue Code section 6056 - even those that qualfied for 2015 transition relief from the "pay oro play" provisions.
"Section 6055" Reporting Entities: Self-insuring employers (regardless of size) that provides minimum essential coerage are required to report information ont this coverage to the iRs and to covered individuals under section 6055 of the Internal Revenue Code.
For more information go to the IRS Questions and Answers page on Information Reporting by Health Coverage Providers. (Section 6055)
Am I required to offer health insurance to my employees?
To be subject to the Employer Shared Responsibility provisions for a calendar year, an employer must have employed during the previous calendar year at least 50 full-time employees or a combination of full-time and part-time employees that equals at least 50. For example, an employer that employs 40 full-time employees (that is, employees employed 30 or more hours per week on average) and 20 employees employed 15 hours per week on average has the equivalent of 50 full-time employees, and would be an Applicable Large Employer, "ALE".
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If an employer has at least 50 full-time employees, including Full-Time Equivalent Employees, "FTE", on average during the prior year, the employer is an ALE for the current calendar year, and is therefore subject to the employer shared responsibility provisions and the employer information reporting provisions.
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To determine its workforce size for a year an employer adds its total number of full-time employees for each month of the prior calendar year to the total number of full-time equivalent employees for each calendar month of the prior calendar year and divides that total number by 12.
Full-time Employee
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A full-time employee for any calendar month is an employee who has on average at least 30 hours of service per week during the calendar month, or at least 130 hours of service during the calendar month.
Full-Time Equivalent Employees
An employer determines its number of full-time-equivalent employees for a month in the two steps that follow:
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Combine the number of hours of service of all non-full-time employees for the month but do not include more than 120 hours of service per employee, and
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Divide the total by 120.
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An employer’s number of full-time equivalent employees (or part-time employees) is only relevant to determining whether an employer is an ALE. An ALE need not offer minimum essential coverage to its part-time employees to avoid an employer shared responsibility payment. A part-time employee’s receipt of the premium tax credit for purchasing coverage through the Marketplace cannot trigger an employer shared responsibility payment.
Seasonal Workers
When determining if an employer is an ALE, the employer must measure its workforce by counting all its employees. However, there is an exception for seasonal workers. An employer is not considered to have more than 50 full-time employees (including full-time equivalent employees) if both of the following apply:
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The employer's workforce exceeds 50 full-time employees (including full-time equivalent employees) for 120 days or fewer during the calendar year, and
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The employees in excess of 50 employed during such 120-day period are seasonal workers.
WHAT ARE THE BASICS REQUIRED TO PUT A GROUP HEALTH PLAN IN PLACE?
If your company has 2 or more full-time employees, you should be able to put a group health plan in place.
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Who do I have to offer health insurance to?
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All Full-Time Employees: A full-time employees is defined as an employee who works 30 or more hours per wek.
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Eligible dependent of your full-time employee.
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How many employees have to enroll inthe group plan?
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Most insurance carriers require that 75% of all full-time employees, that do not have coverage elsewhere*, enroll in the group health plan.**
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*Other coverage can be: group coverage through another employer or spouse's employer, individual coverage, CIIB card (Indian Healthcare), Medicare.
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How much do I have to pay toward my employee's premiums?
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Employer's are required to pay for 50% of the employee's premium.**
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Employer's are not required to contribute anything toward dependent's premium.
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**Employer's with less than 50 employees can put a group health plan in place for a January 1st effective date without being required to pay 50% or have 75% of employees enroll.
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Can I just help pay for my employee's individual health insurance premiums?
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The law no longer allows employers to pay for individual premiums or reimburse employees for the cost of their individual health insurance.
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How Coverage You Offer (or Don’t Offer) May Mean an Employer Shared Responsibility Payment for Your Organization
IRS Health Care Tax Tip 2015-59, September 24, 2015
Under the Affordable Care Act, certain employers, based on workforce size – called applicable large employers – are subject to the employer shared responsibility provisions. The vast majority of employers fall below the workforce size threshold and, therefore, are not subject to the employer shared responsibility provisions.
If you are an employer that is subject to the employer shared responsibility provisions, you may choose either to offer affordable minimum essential coverage that provides minimum value to your full-time employees and their dependents, or to potentially owe an employer shared responsibilitypayment to the IRS. Many employers already offer coverage that is sufficient to avoid owing a payment.
If your organization is an applicable large employer, and you choose not to offer affordable minimum essential coverage that provides minimum value to your full-time employees and their dependents, you may be subject to one of two potential employer shared responsibility payments.
More specifically, you may need to make an employer shared responsibility payment to the IRS if you are an applicable large employer and either of these circumstances applies for 2015:
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You offered minimum essential coverage to fewer than 70 percent of your full-time employees and their dependents, and at least one full-time employee enrolled in coverage through the Health Insurance Marketplace and received the premium tax credit.
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You offered minimum essential coverage to at least 70 percent of your full-time employees and their dependents, but at least one full-time employee enrolled in coverage through the Health Insurance Marketplace and received the premium tax credit. A full-time employee could receive the premium tax credit because the coverage that was offered was not affordable, did not provide minimum value, or was not offered to the full-time employee.
For both of these circumstances, the 70 percent threshold changes to 95 percent after 2015.
The terms “affordable” and “minimum value” have specific meanings under the Affordable Care Act that are explained in questions 19 and 20 on the employer shared responsibility provision questions and answers page on IRS.gov/aca. Transition relief for offers of coverage to dependents for 2015 is described in question 33 on the same page.
For more information on the information reporting responsibilities that apply to applicable large employers see our Questions and Answers on Reporting of Offers of Health Insurance Coverage by Employers.
Page Last Reviewed or Updated: 23-Sep-2015