Group Eligibility

Small Group Eligibility

Determining Small Group Eligibility

Eligible Employee:: 
To qualify for a small business health plan, the business must have at least 1 fulltime employee other than the owner..  An eligible employee is an employee who works over 25 hours per week.


Carriers require that a non-family, FT employee enroll on the policy.  Owners can't be the only one enrolling.

A group must meet the 75% participation requirement.  75% of the fulltime employees must enroll or have valid coverage elsewhere (ie. covered under a spouse, another job, Medicare, Medicaid, Obamacare, VA benefits). 


  • 8 out of 10 is 80%  (compliance) 
  • 6 out of 10 (not eligible).


If the 75% participation is not met, the policy can not be approved or renewed.

Upon Enrollment and Renewal:
Upon enrollment and renewal, employers are required to provide eligibility and participation paperwork for compliance  review:


  • Employer Certification
  • WR-30 payroll form
  • Owners Tax forms
  • Waivers

KBenefits, LLC
Christopher S. Kudryk
Call:  732-333-1976
Fax:   732-444-5971




Chris Kudryk


KBenefits provides insurance solutions for small business owners and individuals in NJ & NY.  Contact KBenefits today and see how we can benefit you.

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