Group Health Insurance Qualifications

If you have a small business and wish to qualify for group health insurance, there are certain guidelines that you must meet in order to qualify for this benefit. There are many reasons why a small business owner would want to qualify for group health insurance, even if they don’t have any employees. The biggest reason is that group health insurance may provide lower rates than individual health insurance especially if you have a pre-existing health condition. So, how exactly do you quality for group health insurance as a small business owner? This article will go over the qualification criteria with you, so that you can determine if applying for group health insurance is the right step for your small business.

Legitimate Business Entity
This stipulation is to ensure that you are not an individual without a business trying to qualify for group health insurance in order to take advantage of guaranteed acceptability and lower premiums. Anyone can say that they own a business, but to qualify for group health insurance you must have the documentation to back up your claim. Acceptable documentation includes:

• Articles of incorporation/organization
• A business license
• A fictitious name (DBA) filing

These requirements cover documents that are required in order to register most types of businesses, including corporations, limited liability companies, partnerships, and proprietorships. Therefore, if you have one of these legitimate businesses, then you should have the documentation required to prove you are a true business entity for insurance purposes. This helps to weed out those who are just looking for the insurance benefits.

Two or More Full-Time Employees
This requirement ensures that those who could just as easily get an individual health insurance plan aren’t getting a group plan just to take advantage of its benefits. Basically, you need to have one other person, besides just yourself, working for the company full-time. This person also has to be listed on your business tax filings in order to prove that they are a true employee of the business. This person can be an owner, officer, partner, or a regular employee.


Minimum Employer Contribution Percentage
The minimum employer contribution percentage is how much you, as the employer, are required to contribute to your employees’ health care (expressed as a percentage). The actual number will be determined by the insurance company who you choose for coverage. Either you are willing to contribute the minimum employer contribution percentage or you don’t. To keep this expense under control, you can shop around and find out which insurance company requires the smallest minimum employer contribution percentage, especially if you have more than one or two employees.

It is important to note that your business must meet ALL of the above criteria, not just one or two of them. For example, if you are a legitimate business entity and plan to contribute the minimum employer percentage, but only have yourself and one or two part-time employees working for the business, then you will not qualify for coverage. Requiring small business to meet all of these criteria ensures that only true business with at least two full-time employees receive this benefit.