Qualification Requirements & Tax Documentation

Qualification Requirements

Group Medical Insurance Qualifications

• You must have at least 2 Full-Time Employees on the Payroll working a minimum of 20 hours for at least state required minimum wage.
• You must have your corporation papers listed below available.
• Most Group cases must be submitted 15 days prior to the requested effective date for efficient processing time.

Self-Employed Medical Insurance Qualifications

• You must be the only ONE on the payroll.
• You must have your corporation papers listed below available.
• Most Self-Employed cases must be submitted 15 days prior to the requested effective date for efficient processing time.

Group and Self-Employed Medical Insurance Effective and Deadline Dates

Individual Medical Insurance Qualifications

We do not write Individual Medical Insurance. Please use the phone
numbers below.

New York Individual Phone Numbers

New Jersey Individual Phone Numbers

Tax Documentation

For Groups of 2 - 50+ (on the payroll)

• NYS-45 - Quarterly Combined Withholding, Wage Reporting and Unemployment
  Insurance Return including Attachment ( 2 pages - must list all employees
  employed ). ( New York )
• WR-30 - Quarterly Combined Withholding, Wage Reporting and Unemployment
  Insurance Return including Attachment ( 2 pages - must list all employees
  employed ). ( New Jersey )
• UC2-5A - Quarterly Combined Withholding, Wage Reporting and Unemployment
  Insurance Return including Attachment ( 2 pages - must list all employees
  employed ). ( Connecticut )
• W4 - Employee’s Withholding Allowance Certificate - for New Hires
  who do not appear on the NYS-45 yet.

For a Limited Liability Partnership or Limited Liability Corporation

• 1065 - U.S. Return of Partnership Income.
• Schedule ‘K-1′ - Partner’s Share of Income, Credits, Deductions, etc.
  ( Most medical insurance companies require all Schedule K-1’s to equal
  100% Partnership - even if all partners are not accepting the medical
  coverage offered by the group ).
• Schedule ‘E’ - Supplemental Income and Loss From Rental, Real Estate,
  Royalties, Partnerships, S. Corporations, Estates, Trusts, REMIC’s,
  Etc.
• Partnership Agreement - For New Partnership.

For a New Corporation / Incorporation

• Articles of Incorporation / Organization - New Corporation, Existing
  Corporation or LLC.
• W4 - Employee’s Withholding Allowance Certificate - For all employees
  accepting medical coverage.
• Paystubs / Payroll Run from Paychex ( or equivalent ) - For all employees.

For an S. Corporation

• 1120S - S. Corporation
• CT-6 - Election by a Federal S. Corporation to be Treated as a New
  York S. Corporation.
• NYS-45 - Quarterly Combined Withholding, Wage Reporting and Unemployment
  Insurance Return including Attachment ( 2 pages ).
• Schedule ‘E’ - Supplemental Income and Loss From Rental, Real Estate,
  Royalties, Partnerships, S. Corporations, Estates, Trusts, REMIC’s,
  Etc.
• W4 - Employee’s Withholding Allowance Certificate - for New Hires
  who do not appear on the NYS-45 yet.

Self-Employed / Sole Proprietor ( Only One Employee )

• Schedule ‘C’ - Profit and Loss From Business ( of the 1040 Individual
  Income Tax Return ).
• 1040 - Individual Income Tax Return.
• Schedule ‘SE’ - Self-Employed Tax.

If the Business is new as there is no Tax documentation set up yet *

• Your Business Name.
• Employer Identification Number (EIN).
• Partner Names.
• Partner Social Security Numbers.
• Percentage Amount for Each Partner.
• Employees Names.
• Employees Social Security Numbers.
• Expected Tax Documentation the Business will file going forward.
• SS-4 - Application for Employer Identification Number ( EIN )
• Articles of Incorporation / Organization - New Corporation, Existing
  Corporation or LLC.
• Business Certificate - This form must be Notarized by the County your
  business is located in.
• CPA letter – The letter MUST be on CPA or Attorney Company Letterhead,
  MUST contain the following and be accompanied by W4’s for all:
• Your Business Name.
• Employer Identification Number (EIN).
• Partner Names.
• Partner Social Security Numbers.
• Percentage Amount for Each Partner.
• Employees Names.
• Employees Social Security Numbers.
• Expected Tax Documentation the Business will file going forward.

* Tax Documentation is required by each of the medical insurance carriers with the submission of group cases within New York State. The major medical carriers might deny your group submission if they do not receive proper state documentation to reinforce that your company is a valid candidate for group insurance. For state other than New York, please speak to your group insurance salesperson.

Percentage Requirements