Health insurance for small businesses is among the most flexible health insurance products for employers. Large employer’s rates are determined by the claims experience of their particular employees. Small employers are generally pooled with other small employers within a given industry or in a general pool of businesses of many industries.

The best news is that health insurers cannot decline coverage for qualified employers with between two and fifty employees. In accordance with the Health Insurance Portability and Accountability Act (HIPAA), small employers who provide a reasonable contribution towards the cost of health insurance for their employees (typically at least 50% of the single cost) cannot be declined coverage so long as 50% of the eligible employees participate in the health plan.

As a small employer the ability to get coverage is viable and can be affordable. Health insurers must comply with the 50 departments of insurance within the 50 United States and there are differences within each states insurance regulation. Your states department of insurance probably has an employers buyers guide for health insurance that is likely available online.

Now the bad news about health insurance for small businesses: In many states, health insurers have the ability to charge based upon the risk within a given employer. For example, a small employer with 20 employees that has a healthy group of employees with no health risk will be less expensive than a comparable group of 20 employees with a serious medical risk such as cancer or other serious health condition. In fact, in many states the range of rates from low to high can be as much as 107.8% rate increase from the lowest point to the highest point.

Health insurance for small businesses will allow for much flexibility in plan design. Remember that the lower the deductible and out of pocket liability, the higher the pricing. Going with a higher deductible plan and using a health savings account or setting up a health reimbursement arrangement may enable lower employer costs than a low deductible plan such as a $250 or $500 deductible plan.

So the choices are many and the price will be reflective of the choice you make and the risk within your company depending upon the state in which your business is domiciled. Be sure to evaluate on your plan choices and understand how the plan works so that your employees will be able to gain a full understanding of the plan’s core attributes. And remember to reassess your plan at least every other year if not each year.

Finding the right group health plan for your business can be downright intimidating: sorting through lists of insurance companies and plans; checking and re-checking the dollars and totals for deductibles and co-pays; making sense of plan limitations and exclusions; deciphering a dictionary’s worth of insurance-speak. It’s enough to make anyone feel like a high-school freshman again.

Texas insurance law allows a wide array of health care coverage plans and packages. All group health insurance has its limitations and finding the right employee health plan at the right price can be challenging.

In Texas, the term “small employer” is a special insurance designation reserved for businesses with two to 50 eligible employees. The law provides some added protections to these businesses, including a 15 percent annual cap on rate increases due to health factors, a state-enforced guarantee that carriers cannot arbitrarily discontinue coverage, and a cooperative purchasing provision that lets small employers pool their purchasing clout to negotiate lower rates.

For employees of small businesses in Dallas, Houston and throughout Texas, the law provides several ways to maintain benefits after leaving a job and limits the waiting period before pre-existing conditions are covered.

Beyond these requirements, small-employer carriers may offer a wide variety of plans, with virtually any combination of features and benefits.

Small-Business Coverage Eligibility

Texas businesses with two to 50 eligible employees may obtain small-employer coverage from either a traditional insurance company or a health maintenance organization (HMO). Eligible employees are defined as those who usually work at least 30 hours per week; are not classified as temporary, part-time, or seasonal; and are not already covered by another group health plan. A business’ owners count toward the employee total.

The number of eligible employees — not total employees — determines whether a business is considered a small employer under Texas insurance law. For example, if your business has 60 total employees, it could still qualify if six of the workers are part-time and four have coverage through some other source, such as a spouse’s plan.

If you decide to offer a group health plan to your employees, you must make it equally available to all of your eligible employees and their dependents.

Coverage is available under a small employer health benefit plan if at least 75 percent of a small employer’s eligible employees elect to be covered. Carriers must always “round up” when calculating the percentage. For example, a five-person business with only three employees wanting to participate satisfies a 75 percent requirement by rounding up.

However, in the case of a business with only two eligible employees, the law requires 100 percent participation. A husband and wife working in a business must be counted as two separate employees. Neither of the employees is eligible for coverage as a dependent of the other.

If you provide a health plan, state regulations and a federal law called COBRA (Consolidated Omnibus Budget Reconciliation Act) allow employees to maintain benefits for a period of time after separation from the job. It is your legal responsibility to inform employees of their rights to continue coverage. Former employees who choose to continue their coverage through COBRA or state continuation must pay the full cost of the plan. You are not obligated to contribute toward their premiums, even if you previously paid a share. Ask your carrier for details about your responsibility toward former employees.

Types of Plans Offered

Health plans are classified as either “state-mandated plans” or “consumer choice plans.” A state-mandated plan provides certain required minimum features and coverages. A consumer choice plan is any plan developed by a carrier that excludes some state-mandated benefits. Generally, consumer choice plans that do not include all the state-mandated coverages will save you money on your monthly premium.

Although consumer choice plans are sometimes called “standard plans,” be careful not to interpret the term to mean that the coverages provided are “standardized.” Each carrier’s consumer choice plan may be different, and a carrier may offer several different consumer choice plans.

Some state-mandated benefits continue to be required for consumer choice plans, including coverages for:

* Phenylketonuria treatment, if prescription drugs are covered.

* Complications of pregnancy.

* Minimum hospital stay after childbirth (federally mandated).

* Reconstruction surgery following a mastectomy (federally mandated).

Consumer choice plans may vary depending on the type of carrier offering the plan. For example, HMO consumer choice plans must pay for 20 outpatient mental health visits per enrollee per year, but that’s not a requirement in indemnity plans. In addition, unlike insurance companies, HMO consumer choice plans must include basic health care services, such as inpatient, outpatient, and preventative services. Carriers may offer optional benefits that vary widely from plan to plan.

You don’t have the time for all this research and number crunching. But can you really afford to leave it on your “maybe someday” list? As the cost of medical care rises, the risks of not having health insurance are more apparent than ever. Today a single injury or illness –if uninsured– can leave a family in financial ruin. Moreover, health coverage is a key benefit of employment. You may not be able to hire and keep the best employees without offering it.

Another alternative to group health insurance plans, which can be unaffordable for many small businesses, is to offer individual health insurance options to your employees. By law, an employer is not allowed to contribute to these plans, or that would be treated as group insurance under Texas state law. But you can still help your employees become insured in a good plan and improve their health and well-being and also improve employee retention in the process.

Because premiums, deductibles, copayments, and coinsurance levels for small business group health insurance policies in Texas can vary widely from plan to plan, it pays to shop around.

Have a good understanding of your employees’ healthcare needs before you start shopping. Do they require frequent medical care or do they rarely see the doctor? Are they more concerned about preventive checkups or coverage in case of emergency? Are prescription or maternity benefits important to them? This is an essential first step. You want to purchase a plan that offers the medical benefits your employees need, without a bunch of “extras” your employees won’t take advantage of. You’ll pay for these “extras” in the form of higher premiums.

When shopping for coverage, the Texas Department of Insurance recommends keeping these guidelines in mind:

- Be sure you understand the full extent of each plan’s coverage when comparing plans and rates. If you decide to go with a consumer choice health benefit plan over one with all the state-mandated benefits, the carrier or agent is required to explain in writing which coverages you don’t have.

- Plans with higher deductibles, copayments, and employee share of coinsurance generally will have lower premiums. Keep in mind, however, that your employees will also have to pay more out of pocket when they access services or benefits.

- Consider factors other than cost, such as a company’s financial strength and complaint record. These are indicators of the service you can expect. You can learn a company’s financial rating, as determined by an independent rating organization, by calling the Texas Department of Insurance (TDI) Consumer Help Line. You can also learn information about the frequency of consumer complaints filed against specific companies by calling the Consumer Help Line: 1-800-252-3439/463-5515 in Austin.

- Look into purchasing cooperatives. These are groups of small employers with similar health care needs who join together to negotiate discounted rates for shared plans. For a list of registered purchasing cooperatives in Texas, call the Consumer Help Line.

- Buy only from licensed insurance companies. Selling unlicensed coverage is illegal in Texas. If you buy from an unlicensed carrier, your employees’ claims could go unpaid and you could be held liable for the full amount of your employees’ claims and losses. Guaranty associations pay the claims of licensed carriers that become insolvent. You can learn whether a company is licensed by calling the Consumer Help Line.

- Understand that employee health coverage is different from workers’ compensation insurance, which covers only job-related injuries and illnesses. Although workers’ compensation insurance is not required in Texas, it protects you from high damage awards in the case of workplace accidents. Providing regular health coverage to your employees is not a legal alternative to providing workers’ compensation insurance.

Who Pays and How Much?

The law doesn’t require employers to contribute toward health benefit plan premiums. However, many carriers require employers to pay at least 50 percent of the plan’s premiums. Employers may choose to pay a higher percentage than the carrier requires.

The carrier must offer dependent coverage to all eligible employees. Generally, employers are not required to contribute toward the cost of dependent coverage. If the employer doesn’t contribute, employees may have to pay all of these costs themselves.

Premiums may increase at each renewal term, largely due to rising health care costs and possibly as a result of employee claims experience. Texas law caps small-employer rate increases due to health factors at 15 percent per year.

Insurers cannot require businesses to purchase additional lines of insurance, such as life insurance or disability insurance, as a condition of the sale of a health plan.

Employee Signup and Waiting Period

New employees must be given at least 31 days from their start date to enroll in a plan. After this time, they may be required to wait up to one year for the next “open enrollment period” to join. Carriers must offer a 31-day open enrollment period annually.

You can choose to require your employees who enroll in a plan to wait up to 90 days before being eligible for benefits. During this period, the carrier may not charge you or the employee a premium.

Carriers may require participants to wait a certain amount of time before covering pre-existing medical conditions. In general, plans have different rules for pre-existing conditions. Plans using the open-enrollment requirement cannot make new members wait more than one year before covering their pre-existing conditions.

New enrollees who were covered in the year prior to joining a plan also receive credit toward the waiting period on a month-for-month basis. For example, an employee who was covered under creditable coverage for the entire year before joining a new plan would receive 12 months credit toward a one-year pre-existing condition wait — and would therefore experience no wait at all. For previous coverage to be considered creditable, there may not have been more than a 63-day break between the end of the previous coverage and the start of the new coverage.

A small business employer carrier cannot refuse to provide health coverage for employees on the grounds of employee illnesses or pre-existing conditions. Nor may carriers use health-related factors — such as employees’ prior claims experience or information on conditions arising from violent family situations — to decide whether to provide coverage.

How Small Employer Plan Premiums are Calculated

The rates for any given small employer plan are not solely determined by the benefits and deductibles of the plan itself. Certain objective “case characteristics,” along with any health status-related factors of employees, may also be components in determining the premium rate for the small employer group. Case characteristics consist of age, gender, group size, industry, and geography. Carriers can use some or all of these five objective criteria:

- Age of employees: Older people can reasonably be expected to have more expensive and more frequent health-related claims. Generally, the older your workforce, the more your plan will cost.

- Gender: Females generally incur higher medical costs than males at younger ages, particularly during childbearing years. The variance diminishes with age until medical costs for males begin to exceed those for females as they near ages 50 and 60. If you have a younger, proportionately more female workforce, or one that is older and proportionately more male, expect to pay higher premiums.

- Number of plan participants: Carriers often base rates on group size for two reasons. As size increases, administrative costs per insured decrease. Also, smaller groups tend to buy health coverage based on the targeted needs of participants, increasing the likelihood of claims for the benefits provided. As group size increases, this “custom-tailoring” becomes more difficult and premiums tend to decrease. However, the highest group size factor may not exceed the lowest group size factor by more than 20 percent.

- Industry: Some industries have higher medical claims costs than others because of working conditions and the prevalence of accidents. High employee turnover in some industries can also result in higher administrative costs for the carrier. However, the highest industry factor a carrier charges may not exceed the lowest factor by more than 15 percent.

- Geographic area: Health care costs vary by region due to differences in cost of living and medical practices, as well as the amount of medical competition in the area. Most plans vary rates by either county or ZIP code, using the employer’s business address to set rates.

The rating process for a small-employer group can be described as a two-step process. First, a carrier determines a premium rate based on case characteristics and plan design, without regard to health status-related factors. This produces the baseline price of the policy. Second, the carrier may adjust the rate to reflect health status-related factors of the group. This adjustment must apply uniformly to all members of the group and may not exceed 67 percent of the baseline price of the policy.

Group health insurance can be not affordable for many small businesses, not to mention an administrative headache. Another alternative to group health insurance plans is to offer individual health insurance options to your employees. By law, an employer is not allowed to contribute to these plans, or that would be treated as group insurance under Texas state law. But you can still help your employees become insured in a good plan and improve their health and well-being and also improve employee retention in the process. If you’re a small business owner who would like to offer affordable health insurance plans to your employees, but can’t afford group health insurance, you should consider offering your employees the revolutionary, comprehensive individual health insurance solutions created by companies specifically for young, healthy individuals.

Is there an approach through which someone will bring down their health insurance prices? Yes, there are. We’ll deliberate regarding a few here…

You will lessen your health insurance premium quickly and rather easily by acquiring quotes from highly regarded insurance quotes sites. You will not realize savings if you utilize no more than one quotes website. However, you will get cheaper health insurance quotes by using at least three. This is often because deals not covered by one site would be covered by another.

Quit smoking if you wish a reasonable individual health insurance quote. Smokers are more susceptible to die young and are more likely to contract several deadly diseases. This increases their risk to an insurer and thus raises their premiums significantly. When you stop smoking for up to twelve months tell your health insurance agent or reapply to another insurer and you may observe a remarkable decrease in your health insurance rates.

You could conjointly prefer to hire an independent agent to get you the most reliable quotes. Some freelance agents get discounts from some companies thus you will get better health quotes from them. Simply make sure that although you’re presented with the quotes that are light on your budget, they need to cover your wants well too. Independent agents can be a very big facilitate especially if you do not have time for the telephone calls or you are doing not really grasp how to match and distinction health insurance quotes.

You can get the foremost reasonable individual health insurance quote for your profile and needs by getting and comparing quotes from reputable quotes sites. And, it will take only about fifteen minutes on the whole. Some individuals fill in details that aren’t quite true concerning themselves. That is NOT wise as what they get are misleading quotes. For those that take their time to try and do this well all they have left to do is simply choose the most cheap individual health insurance quote from the quotes returned.

Begin the method by obtaining as many cheap health insurance quotes as you’ll be able to now.

For now, most small businesses are not required to offer health insurance, but there are insurance regulations in certain states. However, offering health care benefits will do more than keep up with regulations; it will attract new employees and help reduce turnover. Besides, many small businesses can seem like a second family to owners and employees alike. A caring business owner wants to provide for his or her employees as well as possible without going bankrupt. The key to providing health insurance is choosing the best type of policy possible.

States regulate health insurance providers, but there are federal laws protecting small businesses from discrimination. A provider, for example, may not deny coverage to a small business because of a health condition or illness of any employees or their dependents. The Employees Retirement Income Security Act of 1974 (ERISA) established federal regulations for self-insured health plans, should small business owners choose to insure themselves. However, most small businesses do not opt to self-insure.

Types of Health Insurance Plans for Small Businesses:

The National Association of Insurance Commissioners (NAIC) has compiled information on different types of insurance plans to help small business owners choose the best plans for their employees. Major medical plans include Indemnity plans, Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, and Point of Service (POS) plans.

Indemnity plans are major medical plans that allow patients more freedom to choose their physicians than some others. This plan usually has a deductable the insured is responsible for paying before the insurance company begins making payments. Once the deductible is paid the insurance covers a predetermined percentage of the medical expenses, typically 80 percent.

HMO insurance plans do not offer the same flexibility that Indemnity plans do. HMOs require the insured to choose a preferred care provider (PCP) from a list of approved providers or network. The PCP chosen by the insured is responsible for all of the patient’s care. Seeing a doctor outside of the network is not covered under an HMO, or it is covered at a rate much lower than physicians in the network. If a patient needs to visit a specialist, the preferred healthcare provider will need to issue a referral in order for the insurer to honor any claim made by the specialist.

PPO plans offer more flexibility than HMO plans in choosing a physician. Preferred Provider Organizations establish contracts with doctors and hospitals. People who have PPO insurance plans are allowed to visit the doctors and hospitals that they choose, but they will pay more for using someone outside of their preferred provider network.

POS plans are a mixture of PPOs and HMOs. Point of Service plans require the insured to choose a PCP much like an HMO. However, they are allowed to pay more and see a doctor outside of the network. The singular difference is that the insurance company will pay for an out of network visit if it is the result of a referral from the primary care physician.

Choosing a Health Insurance Provider for Your Small Business:

Part of choosing a health insurance plan is choosing a provider. Only negotiate with licensed professionals and look for agents who have experience working with small businesses. Make certain to speak with several agents to ensure that the best possible rate is negotiated. Always ask the agent to explain the insurance rates for the past five years as well as the differences between the types of plans the agent has to offer. An agent who is unwilling to answer questions should not be trusted to handle your accounts.

When choosing an insurance agent and plan, ask other businesses about the experiences they have had with their agents and insurance companies. It is also important to discover what the employees need from their health insurance policies. Have a meeting and allow employees to address their concerns. Take into account the demographic of your employees and what their medical needs may be.

Health Insurance Requirements for Small Business:

State governments regulate insurance plans for small businesses. Different states require different levels of coverage, so it is important to be aware of state regulations. States also regulate premiums an insurer is allowed to charge by determining the methods used to calculate premiums. This may be done by with a community rating or by employee characteristics such as health, number of smokers, etc. There is little that a small business can do to control insurance premiums, but there are some choices that employers do have to reduce costs.

The type of plan a small business uses is the best way to control costs. For example, HMOs are usually cheaper than other major healthcare insurance plans. PPO insurance plans are more expensive than HMOs, but they are less expensive than Indemnity plans. Employers also have control over certain aspects of insurance policies like deductibles, copayments, lifetime medical coverage, maximum out-of-pocket limit, and other health coverage that may have an impact on premiums.

Deductibles are the best way for employers to lower insurance premiums. Normally deductibles range from $50 to $250. However, there are some larger deductibles available such as $1000. These are used for “catastrophic coverage”, but the higher a deductible is the lower the insurance premium will be. The same is true of copayments for PPO or POS insurance policies. Higher copayments will lower the insurance premium. It is up to the employer to determine the best deductible and copayment for employees and the business.

Lifetime medical coverage is the amount used to cover an employee over the course of his or her life with an insurance policy. The typical recommended amount is 1 million dollars to cover serious health issues. The maximum out-of-pocket limit is the maximum amount that a person is supposed to pay in a year for healthcare expenses.

Many companies offer other forms of healthcare coverage to their employees such as dental or prescription drug benefits. These benefits greatly increase employee morale and welfare, but every additional health benefit will increase the cost of the premium. If employees need added benefits it may be wise to increase the amount of insurance cost that is transferred to employees. The practice of transferring some of the cost of insurance to employees is a typical business practice that usually ends up saving money for both the business and the insured employees.

Small businesses can do more than provide health insurance to their employees. Educating employees about healthy lifestyle choices and encouraging healthy diets and activities will greatly enhance the health of workers. Healthy workers may do more than help lower premiums; their attitudes and productivity could increase as well.

For more information on how Bridge Capital can provide accelerated cash flow solutions for your business in the Suffolk and Nassau area of Long Island, NY; Please visit us at http://www.bridgecapitalsolutionscorp.com

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Most insurance companies will provide some sort of group plan for your company even if you have as few as two employees. Many will have special plans set up for just such businesses, and while they offer fewer options than something purchased by a large corporation they will still give you options as to what coverage you take and various levels of coverage to suit your budget. It is important that you find the right kind of coverage in all way so that there are no problems later in any way. It is very important that you find the right kind of information so that there are no problems later in any way.

You will need to determine whether or not you are to include only your employees or if you will also be covering the families as well. It should be noted that in different states, the burden of responsibility is different for the cost of the plan and there are minimum limits in place as far as what the employer will have to pay.

The information that is required from your employees is needed for you to set up a plan and get quotes from different insurers. Usually the information is generally the same from insurer to insurer but you can often start with the forms provided by one to use for others as well. You will need the ages of the people to be insured, often the nature of the work that they are doing and the number of dependents that will be covered in the event that you are covering families as well. Look to one of the larger insurers to offer these to you, and they will often be able to give you the best rates due to economies of scale and large pools of companies that are insured through them. You can find lots of good information on the internet without too much of a problem.

It is vitally important that you know the rules and the options available, and therefore it is advisable to take a look at your state’s guide to group health insurance. Any large insurer can offer guides to the different types of insurance, like Health Maintenance Organizations, Preferred Provider Organizations and fee-for-service plans. A basic knowledge of what is available to you will go a long way in protecting you and your business in the long run.

As the economy continues to tank so do the number of Americans without health insurance-and the number small business owners who can afford to insure their employees.

A recent survey by the NFIB Research Foundation, a small business advocacy group, showed that only 47 percent of small business owners offer employee health benefits. Those employing 20 or more people are more than twice as likely to offer employee health benefits as those with fewer than 10.

The survey found that the low numbers are primarily the result of new small businesses opting not to cover employees. Most small businesses who offer benefits have offered them for a while and are reluctant to drop them for fear of losing good employees.

”It’s much better for employee morale if a small-business owner never offers health benefits, than it is to offer them and then be forced to take it away because it is too expensive to continue,” said William J. Dennis, NFIB’s senior research fellow. “Small-business owners experience considerable turmoil in their early years. They often experience cash flow problems and are reluctant to incur additional expenses such as health insurance. What’s new to this picture is that it appears that new small-business owners are waiting longer or choosing not to offer health insurance benefits to their employees at all.”

The fact that new small businesses are choosing not to offer benefits is a disturbing trend because of the swift turnover of the small business population. If the trend continues, the number of employers who never offer benefits will increase. And that will hurt small businesses because it will limit thet talent pool from which they draw.

What Can Be Done?

Small businesses aren’t alone in struggling with the cost of health care (and premiums) in the current economic climate. The U.S. Census Bureau reports 47 million people, or 15.8 percent of the U.S. population, were without health insurance during 2006

Unfortunately for the small business owner, new legislative approaches to help the uninsured may actually hurt them. One popular option is the “pay-or-play” mandate, in which employers are required to either provide health insurance for their employees or pay a penalty to offset costs the government incurs to provide health care for the uninsured. The rules likely would only apply to full-time employees.

Proponents say such mandates could significantly reduce the ranks of the uninsured, since the vast majority of the uninsured are in families with at least one full-time worker. Many of these are low-income families, suggesting that such measures could benefit the working poor.

Opponents argue that many low-wage workers will just be paid less, reduced to part-time or laid off to offset the insurance costs.

In their paper, “Employer Health Insurance Mandates and the Risk of Unemployment,” researchers Katherine Baicker and Helen Levy found several factors affect the extent to which such mandates cost more jobs:

? Cost of the insurance.
? How much of the cost of coverage will be passed on to workers via lower wages.
? How many uninsured workers have earnings so close to the minimum wage that their wages cannot be reduced enough to offset the cost of the new coverage.

The authors found that the mandate would still leave 54 percent of American workers without coverage.

”The vast majority of those who benefit from pay or play mandate live in families with incomes twice the poverty line or more and, depending on how coverage is determined, the mandate will leave a significant share of the working poor ineligible for such benefits either because their hourly wage rate is too high or they work for smaller exempt firms,” the authors wrote.

Most experts agree that such mandates are bad for small businesses. Employers are faced with hard choices. In the NFIB poll, only 20 percent of small employers said they would simply provide the insurance as required. Many more said they would either cut jobs or move more employees to part-time status.

Moving people to part-time work is a particularly attractive option to small business owners. In fact, how part-time employees are treated is a key influencing factor on whether small businesses support pay or play legislation.

According to NFIB, “The treatment of these employees will alter relative costs in one direction or the other, providing small employers’ strong relative incentive to change.”

Small business experts agree that if part-time employees are covered by a mandate, most employers will respond by simply eliminating jobs, adding to the jobless rate and doing nothing for the rate of uninsured.

Small business owners have always faced an uncertain future but the current economy and the health care crisis make this an extremely tough time to take the startup step.

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Finding the right group health plan for your business can be downright intimidating: sorting through lists of insurance companies and plans for ongoing monitoring and re-verification of money and totals for deductibles and co-pays, meaning the plan limitations and exclusions; deciphering a dictionary’s worth of insurance-speak. Just to feel like a person of high school freshman again.

Texas insurance law allows a wide range of plans and health care packages. All group health insurance has its limits and find the right plan for the health of employees at the right price can be difficult.

In Texas, the term “small employer” is an insurance designation reserved for the two companies with 50 employees. The law provides some added protections to these businesses, including an annual ceiling of 15 per cent rate increases because of health factors, a guarantee of performance that carriers cannot arbitrarily stop coverage, a cooperative purchasing and provision for giving their small employers to purchase weight negotiate lower rates.

For employees of small businesses in Dallas, Houston and Texas, the law provides several ways to maintain benefits after leaving a job and the limits of the waiting period before pre-existing conditions are covered.

Small Business Coverage

Eligible employees are defined as those who usually work at least 30 hours per week are not classified as temporary, part-time or seasonal, and are not already covered by another group of health. A business’ owners count total for the employee.

If your Company has 60 total employees, it may still qualify if six of part-time workers and four have coverage through another source, such as a spouse.

If you decide to offer a health plan to your employees, you must also make available to all your eligible employees and their dependents.

Coverage is available under a small employer health insurance plan if at least 75 percent of a small employer, eligible employees chooses to be covered. Carriers must always “round up” when calculating the percentage. For example, a company of five people with only three employees wanting to participate satisfies a requirement of 75 percent by district.

However, in the case of a company with only two eligible employees, the law requires a stake to 100 percent. The husband and wife working in a company should be considered as two employees. None of the employees eligible to cover as depend on another.

If you provide a health plan, a regulation and a federal law called COBRA (Consolidated Omnibus Budget Reconciliation Act) allow employees to maintain benefits for a period of time after termination of employment. It is your legal responsibility to inform employees of their rights to continue coverage. Former employees who choose to continue their coverage under COBRA or continuation of the state must pay the full cost of the plan. You are not obliged to contribute to their premiums, even if you have already paid a part. Ask your operator for more details about your liability for former employees.