IR Health Benefits Renewal Season is Coming

Learn More About the IR Health Insurance Plan before the December 15th enrollment’s deadline

Benefits renewal time allows you to assess your family’s needs and find coverage options that work for you. With the Idaho REALTORS ® Benefits Center, you have access to affordable medical benefits and other services exclusively for Idaho REALTORS®.

We can help you keep your family healthy with high-quality, cost-effective health plans. The process is simple, but if you need help, our service teams are ready to answer any questions you may have.

Coming soon! Enrollment for January 1, 2025 coverage opens 11/16.

• Your Friends at Idaho REALTORS ® Benefits Center

What are the Basics I Need to Know?

Eligibility: To establish your plan, you must be an independent, self-employed business owner with NO employees. The business must have its own federal Tax ID.; Complete a short health questionnaire and be accepted. A federal tax ID can be from an LLC, S-corp, or other business structure.

Structure: Vault Health Captive, a captive insurance company domiciled and regulated by the North Carolina Department of Insurance. You will establish a self-funded plan for your ‘business of one’, which means you are an owner of the captive and are represented by its Advisory Board.

Plan Design Options: There are three model plan designs for the business. Those plan levels offer deductibles of $2,500, $5,000, and $10,000 – and, unlike the ACA, the deductibles are also the out-of- pocket maximums, with the exception of co-pays for tier 2 and above pharmacy benefits (once the annual deductible is satisfied). As the owner of your self-funded plan, you have the right to request changes to your selected plan design; however, Vault, as administrator, must approve. Plan design change will result in re-rating and change to monthly payment.

Network and Claims: You also have access to a nationwide PPO, PHCS Physician. Check their doctor list here. Be sure to compare your explanation of benefits to the provider bill and contact Vault Admin Services, our claims administrator, if they do not match.

Benefits of the Plan Designs: The structure, plan designs and application of a health questionnaire are all components designed to allow the captive to remain healthy now and in the long run. As the cost of healthcare continues to increase, the captive will choose how to control costs by adjusting participation requirements or plan benefits. Other benefits may include:

• Potential savings vs. the ACA Exchange
• Access to a national physician PPO network or go to any doctor of your choice
• Two HSA eligible plan design options with business tax deductible premiums (always confirm with tax professional)
• Three major medical plan design options

Are dental and vision offered?: Dental/vision are offered separately. Check your specific website and your plan design options for details.

Plan Establishment: Creating your plan is simple and secure via an online portal. Review the plan design options and monthly fees, complete and pass a medical questionnaire and select your plan design, sign final contracts, enter bank information, and you’re done.

Participation Requirements: You must meet the following requirements to establish your health plan:

• Individual business owners / independent contractors with a federal Tax ID (the policy is issued to the business).
• Complete a health questionnaire on behalf of primary and dependents and be accepted based on the answers.
• Join and/or maintain your annual group membership if it is required by the sponsoring organization.
• Your federal tax ID can represent an LLC, S-corp, or other legal business structure.

If you do not pass the medical questionnaire, your business will not be allowed to establish your plan within the captive (information on the next page). You may not be admitted based on the results of your health questionnaire or if you do not meet other eligibility requirements.

Information on Monthly Fees: Regardless of when you establish your plan and participate in the captive, any changes to monthly fees, details or plan designs will occur January 1 each year. In early November, each plan will have the opportunity to renew for the next calendar year and all plans must be renewed.

Monthly fees are guaranteed through the end of the calendar year. The 2024 plan year begins on January 1, 2024 through December 31, 2024.

Enrollment for 2025 begins November 16th. For a detailed breakdown of the plans, rates, and enrollment you can visit IRHealthbenefits.com.