Sole Proprietor Plans
Finding self-employed health insurance nowadays is not an easy task. Not too long ago, if you were self employed or a sole proprietor, you could qualify for a very robust sole proprietor plan from any major insurance company.
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Sole Proprietor Plans
New York Sole Proprietor Health Insurance Options
Finding health insurance as a self-employed individual isn’t as simple as it used to be. Not long ago, sole proprietors had access to comprehensive plans from major insurance carriers—no fuss, no hurdles.
But times have changed.
While the landscape has shifted, there are still a few solid options out there for those seeking sole proprietor health coverage.
Sole proprietors can now access affordable health insurance by joining a network of thousands of small businesses owners and self-employed (1099) workers.
If you have been searching for an affordable health plan for you or your family, we have some very creative options available for you.
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Option # 1: Employer Association Health Plans
Association plans are group health plans provided by an organization of like minded people who want access to quality health insurance coverage.
Our sole proprietor plans are your solution to comprehensive health coverage that fits your budget without sacrificing quality. PPO health plans feature in-network and out-of-network coverage. National coverage protects you anywhere in the United States.
We have more than 15 quality health plans designed specifically for the Sole Proprietor, 1099 employee and independent contractors. The plans are offered by insurance companies you know and trust. Such as, Cigna Open Access, Anthem Blue Cross, and HIP/Emblem.
The Association uses the power of its group buying (over 80,000 members) to offer benefits that previously were not available to the self-employed and at rates that are substantially lower than those plans purchased on an individual basis.
Open enrollment all year! You do not need a qualifying event to access our health plans.
Please note: The association reserves the right to set their own underwriting guidelines – which means you could be denied coverage if you are being treated for a serious health condition. For example: cancer, heart disease or diabetes.
Patriot National PPO Health Plans
Affordable National PPO Health Plans are available with the Cigna Open Access Plus, PHCS/Multiplan, Anthem Blue Cross, and the HIP/Emblem Prime HMO and POS network. Open Enrollment Available All Year!
To get your FREE Sole Proprietor Health Insurance Kit and access to our private benefits website, email bill@healthplansny.com
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Cigna PPO National Plans - Open Access Network
Normally, if you wanted to qualify for a Cigna PPO plan, your business would need to employ more than 100 employees. But because of the power of group buying by the Employer Association, a sole proprietor can now enjoy the benefits of one of the largest insurance networks in the Country, Cigna Open Access.
Key plan details:
Renewal: Plans renew 12 months after enrollment.
Enrollment: Available year-round, with start dates on the 1st of any month.
Enrollment Deadline: Applications must be submitted by the 18th of the month prior to the desired effective date.
Pricing: Plans start at $753.50 per month.
Underwriting: Initial acceptance is subject to underwriting approval.
Association Dues: $10 per month
There are 6 Cigna PPO plans to choose from:
- 1500 Classic
- 2500 Classic
- 3500 Classic
- 5000 Classic
- 5000 HSA
- 7350 Value
Complete the form at the top of this page to request your free Sole -Proprietor enrollment kit.
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Patriot Anthem Blue Cross PPO Health Plans
Patriot Blue Cross plans utilize the national Anthem BlueCard network, offering robust, nationwide coverage for individuals and self-employed professionals.
Plan Highlights:
Renewal: Automatically renews 12 months after your enrollment date.
Enrollment: Open year-round, with coverage beginning on the 1st of any month.
Deadline: Submit your application by the 18th of the month prior to your desired start date.
Cost: Monthly premiums start as low as: $763.00
Underwriting: Initial acceptance is subject to underwriting approval.
Association Dues: $10 per month
There are 5 Anthem Blue Cross plans to choose from:
- Ultra 8000 HSA
- Ultra 7350 HSA
- Ultra 6000
- Ultra 3000
- Ultra 1000
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PHCS - MultiPlan Health Insurance
Private Healthcare Systems (PHCS) uses that national MultiPlan network to provide medical care. The network is available in 49 states and provides out-of-network benefits.
PHCS is our low cost provider with plans starting at $607.00 p/month. However, the network is not as robust as other companies and uses Reference Based Pricing which is a cost-saving approach that uses Medicare rates for reimbursement instead of negotiating prices directly with providers.
Check with your doctor first before you sign up.
There are 4 PHCS plans to choose from:
- 8000 HSA
- 6000
- 3000
- 1000
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Union Membership Health Plans
If you’re currently managing a serious health condition and prefer a private alternative to an ACA (Obamacare) plan, you may qualify for a EmblemHealth Prime HMO or POS (Point of Service) plan through our trusted union partnership.
Thanks to our relationship with a local union that supports self-employed professionals, you can now enroll in the exclusive EmblemHealth Prime Network, plus enjoy added union benefits, such as Dental and Vision insurance.
Plan Highlights:
Eligibility: Open to self-employed residents of New York, New Jersey, and Connecticut.
3 Top Health Care Networks:
- New York: EmblemHealth HIP Prime Network
- New Jersey: QualCare
- Connecticut: ConnectiCare
Coverage Level: Platinum Plan benefits with $0 deductibles.
Enrollment: Open Enrollment all year.
Underwriting: No medical underwriting. Plans are guaranteed issue.
Association Dues: An annual membership fee is required to join the employer association.
Complete the form at the top of this page to request your free sole-proprietor enrollment kit.
Association Health Plan Highlights:
- Brand Name Insurance Companies
- National Health insurance Networks
- In and Out of Network Coverage
- Annual Rate Lock
- Benefits include doctor visits, prescriptions, hospitalizations, and more
- 100% Coverage for Mandated Preventative Services
- Cancel Anytime
- Plans are Designed for self-employed individuals
Complete the form at the top of this page to request your free Sole -Proprietor enrollment kit.
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Option # 2: Qualify for Small Group Health Insurance –
Hire a Friend or Family Member – But not your spouse!
You can hire a family member (son, daughter, nephew or etc.) or a friend and pay them part-time minimum wage (must be 20 hours per week) to help you qualify for group health insurance plans. You can go here to view pricing for group health plans.
Pros:
* You will have several choices of health insurance coverage
* You can easily add new employees to your group plan as your company grows
Cons:
* You will have more paperwork
* You will have to file payroll tax and and quarterly wage reports
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Option # 3: Qualify For a Group Health Plan by Giving a Share Away
Not long ago, a small business owner could put their spouse on payroll, pay them part-time minimum wage, and qualify for a group health plan.
Simple.
Then the Affordable Care Act stepped in — and everything changed.
Now, to qualify for a small business health plan, you must have at least one eligible w-2 employee in addition to yourself – this employee can not be your spouse.
Just like that, thousands of small family-run businesses were shut out of the small group market and forced into individual plans.
But don’t lose hope…
There is some good news.
A new way for the Sole Proprietor to qualify for a group health plan – The “Give a Share” Program.
Here is how the “Give a Share” Program works:
The “give a share” program is a “loophole” in the insurance industry’s small business certification process. But don’t worry, it’s perfectly legal.
Here’s the twist…
If you give just one share of your LLC or S-Corp to a friend or family member — (not your spouse) — you now have two shareholders.
And two shareholders can unlock access to a group health plan.
One shareholder enrolls in the health plan and the other shareholder waives coverage. This gives you access to health plan options to one of the top insurance companies in the marketplace.
Please Note: For new LLC’s or S-corporations, you must wait one full year before qualifying for the “Give a Share program.”
Pros of “The Give a Share” Program:
1. Gives you access to a group health plan with United Healthcare and Anthem Blue Cross.
2. No payroll tax to pay. No quarterly wage reports
Cons:
1. Must file a schedule K-1 with tax return
2. Your friend or family member owns a percentage of your business
3. The friend or family member is now your business partner
We do not offer tax or legal advice regarding this program. Please check with your CPA or attorney if the “Give a Share” Program is right for your business.
For more information on this perfectly legal method and how it can work for your small business, call our office at: 914-633-1717. But you better hurry, the insurance companies might close this loophole too.
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Option # 4: Buy an Individual Insurance Policy
You can purchase a Individual Health Plan for yourself and or your family. To learn more about your individual health plan options go to this blog post: How to buy individual health insurance in NY
For more information about any of these options or if you have any questions, send an email to bill@healthplansny.com
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