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Small Business Health Insurance Plans & Benefits – Washington

Group health insurance plans from major Washington health insurance companies provide varying choices depending on which geographic area of Washington you live in. Group health insurance is available for groups of 2-50 employees considered small groups and larger employer groups over 50 employees. Small businesses under five employees and self-employed business owners may find individual policies a better and less costly option.

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Small Businesses Under 5 Employees and Self-employed Owners May Want:

A small group in Washington health insurance regulations is defined as a business having an employer-employee relationship actively engaged in business that employed an average of at least two, but not more than fifty employees, during the previous calendar year. Over 50% of the employees have to reside within the state of Washington. You are not required to offer health insurance to employees of your business. If you do offer health insurance, both Washington State and federal rules and regulations apply, as well as requirements imposed by the individual health insurance companies. The insurance companies, in most cases, are required to offer you group health insurance on a guaranteed issue basis without regard to the health status of the group.

The rules allow you to determine who is an eligible employee for health insurance purposes.

You are given flexibility in determining the number of hours worked per week for an employee to be considered full time and eligible for health insurance. The minimum requirement is 20 hours per week; therefore, you can choose an hourly requirement between 20 and 40 hours. The 30-hour figure used to count employees in the above definition is to determine which regulations apply to you and has no bearing on your hourly work requirement for health care plan eligibility. You are also given some flexibility in determining a probationary period or waiting period for newly hired employees.

Groups of two or three employees are required to provide IRS documentation as proof of business in addition to standard application and enrollment forms.

Additional forms and requirements may apply depending on individual insurance company requirements and circumstances relating to the group itself. Insurance companies usually require that 100% of the eligible employees, without other valid group coverage, enroll in the group plan for groups of this size.

For groups of from four to 50 employees, insurance company rules specify the minimum contribution you have to make toward an employee's health insurance premium and the minimum participation level for employees in a group health insurance plan. Employers are generally required to contribute 75% of the employee's portion of the premium, but are not required to contribute to the cost of covering the employee's dependent coverage. You also must meet labor laws that specify equal treatment for all similar employees. Generally a minimum of 75% of the eligible employees must enroll and 25% of the eligible dependents must enroll.

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