Tips for Individuals and Employer Groups:

  • To lower your premium, consider a plan with a smaller network or higher deductible and out-of-pocket maximum.
  • If you have children in college, check to see what student plans are available to them.
  • Consider a High Deductible Health Plan and Health Savings Account option.  Click here for more information on HSAs.

Tips for Individuals:

  • Check to see if you qualify for a subsidy to help pay part of your individual insurance premium http://kff.org/interactive/subsidy-calculator/. If you qualify, contact our Life and Health Department to set up an appointment to enroll in an on-exchange plan.
  • Consider joining your or your spouse’s employer-sponsored plan. Compare the premium and coverage offered to your current plan, to see if it makes sense to change.
  • Consider an employer-group plan. As long as there are two people in your entity, you might qualify for a group plan. These two people can both be owners, or one owner and one employee (part-time employees may meet this requirement). Even if only one of you needs coverage, the group will meet participation requirements if the other waives coverage due to having coverage elsewhere.
    • The typical requirements for starting a group plan are:
      • Proof of entity and ownership, such as articles of organization
      • Proof of employees on payroll, such as OESC quarterly wage and tax reports or payroll stubs
      • 75% participation of eligible employees
      • 50% employer contribution to employee portion of premium
    • The benefits of a group plan are:
      • More enrollment flexibility: You can start a new group plan at any time of year.
      • Premiums are tax deductible as an employee benefit.
      • In Oklahoma, there are more carriers, networks and plan options available to employer groups.
      • In most cases, the premiums are lower for employer group coverage than individual coverage.
    • Most group plans are subject to a minimum 50% employer contribution and 75% participation requirement.  However, we can help you set up a group plan with these requirements waived during a special enrollment period between November 1 and December 15. Contact us for more information and to see if your company is eligible.
    • Please be aware that offering affordable coverage to employees receiving a subsidy may disqualify them for future subsidies.
  • The Insure Oklahoma Individual Plan might be an affordable option for self-employed individuals, part-time workers, individuals receiving unemployment benefits, and students age 19-22 attending an accredited college in Oklahoma, who meet IO’s Income Guidelines

Tips for Employer Groups:

  • Group: Employers with fewer than 250 employees, some of whom likely meet the Employer-Sponsored Income Guidelines, may want to consider applying for a qualified plan through Insure Oklahoma. When the employer contributes at least 25% of the employee premium for a qualified plan, and the employee is responsible for no more than 15% of the premium, Insure Oklahoma subsidizes the remaining amount. Contact us for more information about this program.
  • Offer multiple plans, and base your contribution on the lowest cost option. Employees can pay the premium difference if they want to buy up to higher level plans.
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