Employer Group Health Insurance Benefits
Many companies choose to offer health insurance to workers as a benefit of employment. If you own a business and are considering the installation of medical coverage, it's essential that you understand the factors affecting employer group health insurance policies. Every state regulates insurance internally, and minor variations of rules and laws exist from one location to another.
Other People Are Reading
-
Eligible Employees
-
If you choose to offer group health insurance to your workers, you must offer it to all eligible employees; you cannot selectively exclude some workers from the plan. Most state regulations indicate that an eligible employee is anyone working an average of at least 25 hours per week. You must make coverage available for every employee in your company who fits this description.
Participation Requirements
-
If too few employees decline to participate in the group health insurance plan you offer, and do not already have coverage elsewhere, your application for a policy may be declined. Most states require that at least 75 percent of all eligible employees participate in your plan.
-
Contribution Requirements
-
Employers must contribute toward the cost of employee health insurance plans. Most states require only a minimal mandatory contribution, typically around 10 percent. However, the required employer contribution typically pertains only to the cost of coverage for the single employee. Even if an employee chooses spousal or family coverage, the employer is only required to contribute a percentage of what the individual plan costs.
Dependents, Spouses and Domestic Partners
-
The law varies from state to state regarding an employer's obligation to offer plans that provide benefits to a worker's spouse, children or domestic partner. These laws also mandate whether insurance companies must make coverage available for these same people. In some states, carriers are required to make coverage available to children, spouses and domestic partners, yet employers retain the ability to restrict coverage to employees only. Additionally, many states do not recognize same-sex domestic partnerships, leaving those people uninsured even when heterosexual unmarried couples can obtain benefits.
-
References
- National Association of Health Underwriters: Consumer Guide to Group Health Insurance
- Texas Department of Insurance: Small Employer Health Insurance
- Insure.com: Health Insurance Benefits for Domestic Partners
- New Jersey Department of Banking and Insurance: Eligible Employees
- Florida Office of Insurance Regulation: FAQs
