Qualifications for Small Group Insurance
To qualify for small group insurance, your company must have from 2 to 50 employees.  Owners and officers count as employees for small group insurance.  In most cases, you must include all eligible employees in your company.

• Do I qualify for small group insurance?
  
• Do you have 2 to 50 employees?
  
• Do you report employee wages on the Wage and Tax Form?
  
• Do you have your most recent tax forms?  (tax extensions are not acceptable)
  

Qualifications will vary by state and by carrier.  CBC can assist you with determining if your company will qualify for small group insurance.

Eligibility:
The group must be able to show that all eligible employees are being included in the enrollment and that all enrolling are eligible employees.  In order to accomplish this, the carrier will require the most recent Wage and Tax Statement.  Using this document, the group must account for each person listed as to whether they are enrolling, waiving, terminated, seasonal, union or part-time.  Depending on the age of the company, payroll documents may be acceptable.

Owners and officers are eligible to enroll as part of the group.  If they are not included on the Wage and Tax Statement, they must provide the most recent year’s tax forms, as appropriate for the group’s status.  Tax forms such as Schedule K-1’s, Form 1120’s or Form 1040 would be required as appropriate.  If a group has been in business less than one year, business documents will be required.  Such documents include Articles of Incorporation, (showing all owners/officers), filed Statement of Information (showing all owners/officers), Partnership Agreements signed by all partners and LLC Agreements signed by all managers/members/parties.
Tax extensions are not accepted.

Participation:
The group must enroll at least 75% of the eligible full-time employees.  Employees working 20-29 hours per week may be enrolled at the group’s discretion, as long as all employees in the category are included.  Employees working less than 20 hours a week are not eligible.  Employees with eligible waivers are not included in the participation calculation.  Eligible waivers include other group coverage and Medicare/Medi-Cal coverage.  Individual coverage is not considered an eligible waiver.

If the employer contributes 100%, the group is required to have 100% participation.

Employer Contribution:
The employer is responsible for contributing towards the premium for each employee.  This will vary by state, but in most cases the minimum contribution is 50%.  The maximum is 100%.  However, if any employees are waiving, the maximum contribution is 99%. 

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