FAQ

Coverage for Individuals & Businesses
FAQ2022-01-18T12:12:47-05:00
What is the difference between a co pay and a deductible and co insurance?2022-01-13T20:54:57-05:00

A co-pay is for things like an urgent care sick visit (most of our plans it is $30 out of your pocket) is all you pay for admission. A deductible is the amount you will need to pay on your own, once you meet that number the co-insurance kicks in meaning that on a 80/20 plan you are only responsible for every 20 cents of every the dollar. Once your co-insurance max is met then the insurance pays the rest.

Do you only have health insurance?2022-01-13T20:53:58-05:00

Not even close! We use our outstanding relationships with hundreds companies to find the best plan options for you, which include deductible/gap plans, catastrophic cash fund, mortgage insurance, dental, vision, critical illness, legal, auto, home, even pet insurance.

Do your plans meet the Affordable Care Act (ACA) requirements?2022-01-13T20:53:23-05:00

Yes! All group major medical plans are fully ACA compliant. As of 2019 the individual mandate of requiring a 1095 is currently not being enforced, however the individual and year round open enrollment Super Preferred Medical <https://affordacareinsurance.com/medical-coverage> plans have the option of adding a rider to meet the Affordable Care Act requirements for MEC or Minimum Essential Coverage (also known as qualifying health coverage). All individuals with this rider and all company employees will receive a 1095 at the end of the year with the number of months paid they had coverage for. All eligible plans cover everything on healthcare.gov/preventive-care-benefits <https://healthcare.gov/preventive-care-benefits> with $0 out of pocket.

Why are your plans so affordable?2022-01-13T20:46:49-05:00

Traditional medical plans are required to accept anyone no matter what health they are in. Think how expensive your car insurance would be if you could crash your car and then get insurance the next day and it was paid for completely? Instead we reward people who are healthy at the time they enroll. Less risk to us means you get exceptional coverage at an unbeatable price. The result is you get a better insurance plan for up to 70% less with the same or lower deductible with a vastly improved network!

Who is Suncoast Advisors Group?2022-01-13T20:56:54-05:00

Suncoast Advisors Group is a privately owned company, with headquarters in Pinellas Park, FL. The Suncoast Benefit team brings with them over 100 years of combined experience in operational management of insurance sales, marketing, employee benefits, and individual or group health insurance. Suncoast Advisors Group, by partnering with high quality strategic partners, provides proven industry leading no risk cost reduction programs which will save your company many thousands of dollars by reducing your Payroll tax costs, increasing efficiencies, and effectively working with the current tax laws here in the US. We are experts in helping your company’s bottom line to be more profitable!

What has changed with the IRS Tax Laws to provide employers these tax breaks?2022-01-13T20:59:29-05:00

For almost 50 years, employers have utilized health and wellness insurance programs through Section 125/Cafeteria plans to reduce payroll taxes and can now free up hundreds of dollars for employees. This program combines those principles with the latest developments in wellness tax benefits to give savings back to companies and increase benefits to their employees. This is accomplished without affecting the employee’s net take-home pay or adding any costs to the company’s bottom-line.

On January 1, 2014, a new tax incentive was created by congress which now provides incentives to both employers and employees that participate in a participatory and compliant wellness program. It is the position of Congress, that education and participation in an approved compliant wellness program will lead to a reduction in the nation’s overall healthcare costs benefitting both the employer and the employee.

What is a Participatory Wellness Program?2022-01-13T21:00:18-05:00

“Participatory” Wellness Programs are programs that either do not provide a reward to employees or do not include any conditions for obtaining a reward that are based on an individual satisfying a standard that is related to a health. In addition, participatory wellness programs must be made available to everyone in the company that have similar situated individuals, regardless of their health status. Participatory Wellness Programs are not Health Insurance plans that require the individual to satisfy a standard related to a health factor to obtain a reward.

Why haven’t I heard about this program up until now?2022-01-13T21:00:40-05:00

It is estimated that over 90% of today’s employers have not been informed of these tax breaks as it has only been implemented by a select few companies with the task of educating the business owners at large.

Is this Participatory Wellness Program considered a “Health Insurance Plan”?2022-01-13T21:01:11-05:00

There are 2 types of Wellness plans available:  Our current Participatory “Compliant” Wellness Program does include services that qualify as “medical” care and is considered a “health plan.” The Essential program is the perfect fit for business owners looking to provide a benefits plan for their employees while satisfying penalties imposed on them and their employees by the ACA mandates.  The standard Participatory Wellness Plan is not considered Health Insurance and does not satisfy the ACA mandate.

What are the single and married Pre-Tax Wellness Contributions for this program?2022-01-13T21:01:49-05:00

The Single Pre-Tax Wellness Contribution is $700 per month, per qualified employee and the Married Pre-Tax Wellness Contribution is $1,100 per month, per qualified employee.  These amounts are deducted through a Section 125 pre tax and then put back into the employee’s pay post tax keeping the employee’s pay the same.

What will this new Tax Savings Program do for my company?2022-01-13T21:02:05-05:00

Suncoast Advisors Group has now partnered with industry leaders in participatory compliant wellness healthcare programs, to save employers an average of $525 up to $700 per year per employee on their Payroll/FICA taxes. This reduction takes effect on the first payroll run after plan implementation and is NOT an end of year tax deduction.  In addition, the plan provides additional benefits to employees with no reduction in the employee’s take home pay.

What are the qualifications to participate in this program?2022-01-13T21:02:20-05:00
  • Employees must average 30 hours per week or average 130 hours per month, consistently, to qualify for this program.
  • Employees that are receiving a subsidy through a State or Federal exchange are not eligible because it would mean double-dipping.
  • Owners of the company, including their spouse also do not qualify for this program unless their share is 5% or less.
  • Tipped employees without a salary base, do not qualify for this program.
  • Employees who are 1099 independent contractors do not qualify for this program.
How does this program affect my Social Security for retirement?2022-01-13T21:04:26-05:00

Any pre-tax reduction in employee’s adjusted gross income will lower the amount of payments to Social Security. We recommend purchasing whole life insurance that builds cash value which can be withdrawn down the road tax-free to offset the reduction in Social Security.  The Flex Credits can be used that in almost all cases will provide greater retirement income and a higher level of security for the employee and for their family.

What is the benefit to the Employer and to the Employee?2022-01-13T21:04:46-05:00

The employee’s income subject to payroll taxes is reduced by participation in the wellness plan through a Section 125 or Cafeteria Plan which also reduces the matching FICA tax obligations of the employer. Participating employees then purchase a post tax, self-funded, limited benefit indemnity medical plan. You save money and there is no reduction in the employee’s take-home pay. In addition your employees are provided with additional insurance benefits which can include: accident, critical illness, cancer, hospital indemnity, and cash value life insurance at no net cost to the employee.

Go to Top