Qualifying for a Small Group Health Plan
In order to comply with the Affordable Care Act, an employer must have at least one common-law employee enrolled to qualify as a group health plan. If you do not have any common-law employees enrolled you are no longer eligible for a group health plan and must be transitioned to individual coverage.
Sole owners/partners and their spouse are not considered common law employees regardless of whether they are listed on the quarterly wage report.
Beginning on this week, groups we have identified as no longer qualifying for group coverage will receive a notification by mail.
- If you believe you still qualify for small group coverage, please contact your Broker or dedicated account manager to work with an underwriter on resolution.
- If you do nothing, you will be automatically enrolled in an individual market plan similar to the plan you have now.
- If you want to select another individual plan other than what you are mapped to, you will need to complete an application for the plan you wish to enroll in. You can contact 1-888-576-6593 for assistance with Individual market plans.
- If you are Medicare eligible you will not be automatically enrolled in a plan. For help selecting a plan, you can call 1-800-671-6081 or visit excellusmedicare.com.
Alternate plan options can be found on our website under Individual & Families.