Group Health

If you are a small or medium-sized business owner, you’ve probably conducted a search for insurance coverages for yourself, your business and your employees. Purchasing commercial insurance like workers’ compensation or professional liability coverage for your business, though, is different than buying group health insurance, and there are different rules with which you need to comply. And although providing group health insurance to your employees can come at a cost, it can be an effective way to boost your attraction and retention efforts and improve morale.  

What Is Group Health Insurance? 

Group health insurance is an employer-sponsored medical insurance policy for employees. This coverage provides health insurance to members at a lower cost than if obtained individually due to the risk spread across multiple members of a group health plan. 

How Does Group Health Insurance Work? 

A business can buy a group health plan to provide medical coverage to its employees. Enrolling in group health insurance requires at least one full-time employee in addition to yourself, the business owner. Only groups can enroll in this plan, not individuals. While all group plans vary in cost, health insurance company, group plan type and policy specifics, they generally share the following characteristics: 

• Participation rate—Group health plans typically require a 70% participation rate.
• Member choice—Group members can decide whether to enroll in or decline coverage.
• Dependent additions—Group members can add family members and dependents to their plan.

Who Is Eligible for Coverage? 

If an employer offers coverage to any full-time employees, it generally must be offered to all full-time employees. The employer has the option to provide plans for part-time employees as well, but if coverage is offered to any part-time employee, then all of them must be offered coverage. Any eligible employee can’t be denied coverage based on preexisting conditions.

In addition, any dependents of eligible employees are generally qualified for insurance under a group plan. Dependents typically include spouses and children but cannot get coverage unless the employee has enrolled. Under the Affordable Care Act (ACA), group insurance plans must extend insurance protection to adult dependents through age 26.

Is Group Health Insurance Required?  

Group health insurance is not required for small businesses. If you’re a small business (fewer than 50 employees) and choose not to offer group health insurance, you will not be punished under the ACA. Regardless, you may want to consider this coverage for the following reasons: 

• Lower premiums than individual plans
• Potential tax incentives
• Hiring and recruiting improvements
• Loyalty and retention of employees
• Job satisfaction amongst employees
• Healthier and more productive employees due to fewer sick days and absences
• Healthy company culture
• Pre-tax benefit for employees 
• Accessible and affordable health coverage for employees

Contact Us Today!

At Insurance for Wholeness & Health we know that deciding on the right coverage option can be difficult. Contact us today—we’re here to help!