Is your small group eligible for coverage?
Small Group Eligibility:
To qualify for a small business health plan, the business must have at least 1 Fulltime employee enrolling in the health 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
A group must meet the 75% participation requirement in order for the carrier to approve your group health plan.
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