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Open Market Health Insurance - Carrier Install Document Requirements

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The Affordable Care Act (ACA) established the Small Business Health Options Program (SHOP) for small employers who want to provide health and dental coverage to their U.S.-based employees.

In order to enroll in small group health insurance on the open market, carriers will request certain documents to verify a business’s ability to participate in these offerings through the ACA. 

 

Open Market Health Insurance - Document Upload

During your plan selection and setup process, you will have the ability to upload the required documents directly into the Justworks Open Market Benefits Center. This will be Step 4 of the enrollment process: 

 

Once on Step 4, you will be prompted to upload the required carrier install documents based on your company and location. You will have the ability to upload multiple documents by simply dragging and dropping them into the flow:

These documents are required in order to offer medical insurance through the small group open market. Carriers may request documents outside of what is outlined in this flow as well. If this is the case, our Justworks Support team will reach out to you directly to facilitate the collection of these. Additional documents can be uploaded directly in-app through the “Other Documents” portion of this flow: 

 

Open Market Health Insurance - Carrier Install Documents 

These document requests can vary by state, health insurance carrier, business type, and how long a business has been operating. Carriers may request documents outside of this list. With that said, we have outlined below many examples of documents a carrier may request, along with where you can locate these if you do not have them on hand. 

 

Articles of Incorporation

  • What is this document?  
    • Articles of incorporation, sometimes called a certification of formation or a charter, are a set of documents filed with a government body to legally document a corporation’s creation. These legal documents contain general information about the corporation, including the business name and business location.
  • Where can I find this document? 
    • Each state's secretary of state has a website you can typically use to get documents for corporations registered to do business in that state. 

Articles of Organization

  • What is this document?  
    • Articles of organization, sometimes known as a certificate of organization or certificate of formation, is an official document that outlines basic details about your company. You must file this document with your state in order to officially establish a business as an LLC. 
  • Where can I find this document? 
    • Each state's secretary of state has a website you can typically use to get documents for corporations registered to do business in that state. 

Business License

  • What is this document?  
    • Business licenses are permits issued by government agencies that allow individuals or companies to conduct business within the government's geographical jurisdiction. It is the authorization to start a business issued by the local government.
  • Where can I find this document? 
    • A copy of your business license can be requested from the issuing agency. Each agency will have its own process for ordering a new copy of your business license, professional license or permit.

Certificate of Filing

  • What is this document?  
    • Certificate of filing means the document issued by the executive officer that confirms an application for a change of organization or reorganization has met submission requirements and is accepted for filing.
  • Where can I find this document? 
    • A Certificate of Filing in Texas can be ordered by fax, mail, email, phone, in person, or online from the Texas Secretary of State. 

Certificate of Formation

  • What is this document?  
    • A document filed with state authorities (usually the Secretary of State or Division of Corporations, depending on the state) to form a limited liability company (LLC). As required by the general LLC law of the state, the certificate normally includes the purpose of the LLC, its principal place of business, and the names of its initial members or managers. Most states refer to this document as the articles of organization.
  • Where can I find this document? 
    • In most cases, you can go to the website of your state's secretary of state. Each state's secretary of state has a website you can typically use to get corporate documents for corporations registered to do business in that state. 

Certificate of Limited Partnership

  • What is this document?  
    • A limited partnership is formed by filing a certificate of limited partnership with the state signed by all general partners. Some states only require that the certificate contains the name of the limited partnership, the name and address of the registered agent and registered office, and the names and addresses of all of the general partners.
  • Where can I find this document? 

Current 2-Week Payroll

  • What is this document?  
    • A report displaying the breakdown of your most current 2 weeks of payroll. 
  • Where can I find this document? 
    • This can be requested from your current payroll provider. Depending on your provider, these requests can take between 2 weeks and 90 days. This document must be provided in a non-editable format. For customers currently on Justworks, this information can be pulled from the “Reports” tab in Justworks. Steps for downloading this report can be found here.

Current CA Business License

  • What is this document?  
    • A business license in California is the permit that allows you to do business within the state and, more specifically, the county that you are located in.
  • Where can I find this document? 
    • Copies and certificates can be obtained by submitting a request to the California Secretary of State's Sacramento office either in person (drop off) or by mail. Please refer to the Information Requests webpage for detailed information about copy and certificate requests.

Current Schedule K1

  • What is this document?  
    • The Schedule K-1 is the form that reports the amounts that are passed through to each party that has an interest in an entity, such as a business partnership or an S corporation. 
  • Where can I find this document? 
    • Individuals can download a sample copy of Schedule K-1 (Form 1065) for reference from the IRS. But you'll probably receive a copy of your filed Schedule K-1 around tax time from your accountant or whoever is responsible for filing your partnership's Form 1065.

Fictitious Business License

  • What is this document?  
    •  In California, an individual or a business entity must file a fictitious business name (FBN) statement with the Registrar-Recorder/County Clerk's office in the county where the business will be located when the name of the business does not include the owner's last name.
  • Where can I find this document? 

Form 1040

  • What is this document?  
    • Form 1040 is an IRS tax form used for personal federal income tax returns filed by United States residents. 
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Form 1120

  • What is this document?  
    • A 1120 tax form is an Internal Revenue Service (IRS) form that corporations use to find out their tax liability, or how much business tax they owe.It is also called the U.S. Corporation Income Tax Return. American corporations use this form to report to the IRS their income, gains, losses, deductions, and credits.
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Form 1120 S with K1

  • What is this document?
    • An S corporation need to fill out the Form 1120S to file annual tax returns just like partnerships. Every shareholder in the corporation receives a Schedule K-1 after the Form 1120S is filed. The shareholders report all of the information on the K-1 to report the allocated income on their separate tax returns.  
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Form 1120 with Schedule G

  • What is this document?  
    • Schedule G (Form 1120) is used to provide information applicable to certain entities, individuals, and estates that own, directly, 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of the corporation’s stock entitled to vote.
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Form 1125 E

  • What is this document?  
    •  Certain entities with total receipts of $500,000 or more use Form 1125-E to provide a detailed report of the deduction for compensation of officers.
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Form W-4

  • What is this document?  
    • Form W-4 is an Internal Revenue Service tax form completed by an employee in the United States to indicate his or her tax situation to the employer. The W-4 form tells the employer the correct amount of federal tax to withhold from an employee's paycheck.
  • Where can I find this document? 

Operating Agreement

  • What is this document?  
    • An operating agreement is a key document used by limited liability companies to outline the business' financial and functional decisions, including rules, regulations, and provisions. 
  • Where can I find this document? 
    • This information is available through the Secretary of State's office in the state where your business is registered. The same office may also have a copy of your LLC operating agreement, although filing such agreements is generally not required.

Partnership Agreement

  • What is this document?  
    • A partnership agreement is a legal document that dictates how a small for-profit business will operate under two or more people. The agreement lays out the responsibilities of each partner in the business, how much of the business each partner owns, and how much profit and loss each partner is responsible for. This document must identify the partners of the business. 
  • Where can I find this document? 
    • Business partnership agreements are usually drafted and reviewed with legal counsel. In most cases, you can reach out to your legal counsel for a copy of this document. 

Proof of Business

Quarterly Payroll Report/Journal

  • What is this document? 
    • The Quarterly Payroll Report/Journal document is used by employers to report wage and payroll tax withholding information each quarter.
  • Where can I find this document? 
    • This can be requested from your current payroll provider. Depending on your provider, these requests can take between 2 weeks and 90 days. This document must be provided in a non-editable format. For customers currently on Justworks, this information can be pulled from the “Reports” tab in Justworks. Steps for downloading this report can be found here.

Quarterly Wage and Tax Report

  • What is this document?  
    • The Quarterly Wage and Tax Report document is used by employers to report wage and payroll tax withholding information each quarter. 
  • Where can I find this document? 
    • This can be requested from your current payroll provider. Depending on your provider, these requests can take between 2 weeks and 90 days. This document must be provided in a non-editable format. For customers currently on Justworks, this information can be pulled from the “Reports” tab in Justworks and presented with a PEO letter. Steps for downloading this report can be found here.

Schedule C

  • What is this document?  
    • Schedule C is used to report income and expenses from a business you own as a sole proprietor or single-member LLC.
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Schedule E

  • What is this document?  
    • Use Schedule E (Form 1040) to report income or loss from rental real estate, royalties, partnerships, S corporations, estates, trusts, and residual interests in real estate mortgage investment conduits (REMICs).
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Schedule G

  • What is this document?  
    • Schedule G (Form 1120) is used to provide information applicable to certain entities, individuals, and estates that own, directly, 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of the corporation's stock entitled to vote.
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Schedule K1

  • What is this document?  
    • The Schedule K-1 is the form that reports the amounts that are passed through to each party that has an interest in an entity, such as a business partnership or an S corporation. The parties use the information on the K-1 to prepare their separate tax returns.
  • Where can I find this document? 
    • You can quickly request transcripts by using the automated self-help service tools at IRS.gov and click on "Order a Return or Account Transcript" or call 1-800-908-9946. If you need a copy of your return, use Form 4506, Request for Copy of Tax Return.

Signed LLC Agreement

  • What is this document?  
    • An LLC operating agreement is a document that customizes the terms of a limited liability company according to the specific needs of its members. It also outlines the financial and functional decision-making in a structured manner. It is similar to articles of incorporation that govern the operations of a corporation.
  • Where can I find this document? 
    • If you're not sure who is serving as the LLC's registered business agent, the information is available through the Secretary of State's office in the state where your business is registered. The same office may also have a copy of your LLC operating agreement, although filing such agreements is generally not required.

SS4/EIN Letter

  • What is this document?  
    • Form SS-4 is used to request an Employer Identification Number (EIN) from the IRS. An EIN is assigned to a business for business activities such as tax filing and reporting purposes. Carriers require an SS-4 letter that confirms your business's EIN assignment. 
  • Where can I find this document?
    • You can obtain a copy of your verified SS-4 by returning to the IRS online portal where you applied for an EIN. From here, you can re-download the form as a PDF. You can also contact the IRS at its Business and Specialty Tax Line and EIN Assignment Line. The number is: (800) 829-4933.

Statement of Information

 

Disclaimer

This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.

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