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.*
¢º
80% report that it helps with recruitment
and retention
¢º
70% report that it increases productivity
by keeping employees healthy
¢º
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.
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* Source: EBRI/CHEC//BCBSA
2000 Small Employer Health Benefits Survey.
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