Employment Coverage

Offering group health and dental insurance has lots of benefits for both the employer and the employees.  The premiums contributed by the employer is tax deductible and providing health coverage promotes good health and excellent benefit options for your employees. 

In most cases, all applicants are guaranteed issue regardless of health conditions or pre existing conditions.

Why Purchase Group Health Coverage?

Offering health coverage to your employees can help you recruit and retain the quality workers who can help make your business a success.  In a recent survey, small employers gave these reasons for offering health benefits to their workers.*

• 80% report that it helps with recruitment and retention

• 70% report that it increases productivity by keeping employees healthy

• 68% report that it reduces absenteeism by keeping workers healthy

How many employees do I need to get a group coverage?

Minimum 2 employees including the owner will qualify your company as a group. 

What employees are eligible for group health?

Full Time: Those employed on a permanent basis and have a normal work schedule of at least 30 hours per week and must be compensated for that work by employer (subject to withholding appearing on a W-2 form).  Sole Proprietors/Partners/Corporate Officers.

What is the standard employee participation requirement in a group's health plan?

75% of eligible employees.  The standard participation requirement increases to a minimum of 80% of eligible employees if (a) the employer selects any Defined Contribution Options; (b) the employer selects two PPO or HMO plan options.  If the employer is paying 100% of employees medical and dental premium, 100% of eligible employees must enroll (Except those who are covered under spouse's group health plan).

Can I offer health insurance to certain employees only?

Yes, you can obtain health insurance for certain group of employees, for example the management level employees only, officers only etc.  This is called a "carve out plan" .  With a carve out plan each employees' plan will be subject to health conditions and restrictions from pre existing conditions and will go through individual underwriting.

What if one of the employees who had coverage leave our company?

When a employee leave a employer and was under the company's group plan he/she will have 18 months of COBRA coverage option.  This will extend the same benefits of his/her current group benefit until he/she can join a new employer plan or find individual coverage.

What if I have out of state employees?

The majority of enrolling employees (at least 51%) must be employed within the state of California.  Residents of Hawaii are not eligible.  Out of state employees may not choose HMO plans.

Will I be able to go to a doctor near my home instead of my work?

Yes, you can choose from a list of doctors who can provide you service from your health plan.  Check the updated provider list to find a doctor nearest to you or see if your current doctor is on the list.

* Source: EBRI/CHEC//BCBSA 2000 Small Employer Health Benefits Survey.