Business
Insurance |
Individual/Family
Insurance |
| Definition: One or more employees in the business can be insured on one policy. Pros:
Cons : Premiums normally higher than individual insurance. |
Definition: One person and/or his or her dependents can be insured on one policy. Pros:
Cons :
|
Considerations When Purchasing Business Health Insurance
- The employer is required to pay a minimum of 50% of the employee-only cost ; they do not have to contribute anything for dependent coverage.
- In the small group market (less than 50 employees) , the employer also makes the determination about:
- The classes of employees eligible for insurance.
- The number of hours an employee must work to be eligible (24-40 hrs.)
- The length of time between the hire date and when the employee can join the plan (i.e., 30 days, 60 days, one year) .
- You must be able to prove you are a viable business. Insurance companies will require tax documentation. Cick here to see what documents will be required for your business.
Business Group of One
If you are a sole proprietor or have no employees besides yourself and don't plan to hire any employees in the near future, you can make the choice between group and individual plans. If you have no health issues, individual coverage is probably the best way to go. If you do have some health issues, then there are certain times you are guaranteed coverage on group plans. The following qualifiers apply if you want to apply for business group of one plan.
- You must be in business for one year and make a profit.
- You are guaranteed coverage if you apply within 31 days of the one-year anniversary of your business.
- You may apply for insurance within 31 days of your birthday.
- If you lose other coverage (through a spouse's employer, for example), you are guaranteed coverage if you apply within 31 days of the notice of that loss of coverage. ( Note , all windows for application require that you have been in business for at least one year; the birthday rule and loss of coverage rule do not apply if you have been in business less than one year.)
Glossary:
Premium: Monthly cost employer/applicant pays to the insurance company.
Policy : A written contract or certificate of insurance.
Underwriting : The process that begins once the insurance company receives a complete application including the first month's premium from the applicant. During this process the insurance company determines whether or not they will insure the applicants and/or determine the rate for a group.
Dependent : Immediate family members.
Classes : Hourly vs salaried, management, owners , etc.
Employee-Only Cost : The cost of insuring an employee if they applied as an individual with no dependent coverage.
Guaranteed Coverage : The insurance company will issue a policy; however, the rates may be higher than standard rates.