Important Change in Eligibility
Beginning with new business effective May 1, 2017, we will no longer be able to accept business where the sole owner of a business is the only one enrolling in group coverage. Beginning with January 1, 2018, renewals, groups where only the sole owner is enrolled will be moved to the individual market. We will provide details of this process at a later date.
This decision is based on the following guidance: Under ERISA, the sole owner of a business (including a C or S corporation) and his/her spouse, cannot be the only enrollees in a group plan. Under ERISA, an employee welfare benefit plan does not exist if the only enrollees are the owner or owner and spouse (see 29 CFR 2510.3-3). Thus, whether the owner includes himself/herself on the NYS45 is not relevant.
Please contact your account representative with any questions.