KBenefits Insurance Services
Group Health Eligiblity

Small Group Health Eligibility

Is your small group eligible for coverage?

Small Group Eligibility:
To qualify for a small gusiness health plan, the business must have at least 1 Fulltime employee enrolling in the helth plan. The FT employee must not be an owner or related to the owner.  Carriers can no longer enroll groups that have:

 

1)  Owners-only enrolling
2)  Husband/Wife-only enrolling
3)  Family-only enrolling

 

Participation: 
A group must meet the 75% participation requirement in order for the carrier to issue a group health plans.

 

 75% of the Fulltime employees must enroll or have valid health coverage elsewhere (covered under a spouse, another job, Medicare, Medicaid, GCNJ, VA benefits).

  • 8 out of 10 = 80%   Eligible
  • 6 out of 10 = 60%   Not eligible

 

If your group is not eligible, see below.
Special Enrollment Period

Compliance: - Enrollment and Renewal
Upon enrollment and renewal, carrier's will review your group's eligibility and participation levels. This is done by requesting the following documents*:

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

Special Enrollment Period
November 15 - December 15.  

Under the Special Enrollment Period, small business owners are exempt from the contribution and participation requirements.  If approved, plans start January 1st.

Contact us for questions, plan options & free enrollment assistance.

Christopher S. Kudryk
chris@kbenefits.com
732-333-1976


KBenefits Insurance Services
Health - Life - Medicare

Christopher S. Kudryk
Insurance Specialist
chris@kbenefits.com
732-333-1976

KBenefits specializes in health, dental, vision, life and medicare insurance for employers and individuals in NJ & NY.

Thank you for your referrals!
Referrals are the cornerstone of our business.  Let us know if we can be of further assistance to you or someone you know.  Glad to be of service
.

Print | Sitemap
2011 KBenefits LLC

Call

E-mail