Many business owners assume their small business is too small to start a group health plan. However, this might not be the case. In many cases, a small group can be set up with as little as two eliglbles, even if only one of those eligibles enrolls!

As long as there are two people in your entity, you might qualify for a group plan. These two people can both be owners, or one owner and one employee (part-time employees may meet this requirement). Even if only one of you needs coverage, the group may meet participation requirements if the other waives coverage due to having coverage elsewhere.

The benefits of a group plan are:

  • More enrollment flexibility: You can start a new group plan at any time of year.
  • Employer paid premiums are tax deductible as an employee benefit.
  • More options: In Oklahoma, there are more carriers, networks and plan options available to employer groups.
  • Lower premiums: In most cases, the premiums are lower for employer group coverage than individual coverage.

The typical requirements for starting a group health plan are:

  • Proof of entity and ownership, such as articles of organization
  • For husband-and-wife-only groups, the only way to be covered on a small group plan is if they are owners in a partnership entity. A copy of the partnership agreement or K-1 1065s must be submitted as proof of entity and ownership.
  • Proof of employees on payroll, such as OESC quarterly wage and tax reports or payroll stubs
  • 75% participation of eligible employees*
  • 50% employer contribution to employee portion of premium*

*Most group plans are subject to a minimum 50% employer contribution and 75% participation requirement.  However, we can help you set up a group plan with these requirements waived during a special enrollment period between November 1 and December 15.

Please be aware that offering affordable coverage to employees receiving a subsidy may disqualify them for future subsidies.

Contact us for more information and to see if your company is eligible.

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