Choice Stories

September 17, 2020

How Many Employees Are Needed for Group Health? – and Other Frequently Asked Employer Questions

When it comes to group health insurance, small business owners have many questions on the subject. For example:

  • How many employees do I need to have to qualify for group health insurance?
  • What type of coverage is best for my employees?
  • What sort of investment am I looking at?

We've provided answers to these frequently asked employer questions and insights related to group health insurance.

Group Size

As we discussed in a prior article, How to Get Group Health Insurance -- and What It Covers, group health insurance is available to groups with as few as two employees. However, some plans and insurers do not offer coverage to husband and wife groups if both are owners of the company. Other business types like an LLC, S-Corp. C-Corp, or Partnership (where the spouse is a W-2 employee) are acceptable.

Smaller groups often think individual health insurance may be less expensive than offering a group health plan to employees; however, since the introduction of the Affordable Care Act (ACA), with the elimination of the pre-existing condition limitation, coverage for smaller groups is sometimes more affordable than individual plans for multiple plans. An employee benefits broker can help you compare plans to find the one that works best for you, your business, and your employees. 

Coverage Options

Regardless of your group size, if you are shopping for a group health plan, you’re likely to see HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), or EPO (Exclusive Provider Organization) plans. You may even be able to select a High Deductible Health Plan that is compatible with an HSA (Health Savings Account). In some areas, Point of Service (POS) plans may also be available.

Each plan offers different out-of-pocket costs and co-pays and may or may not include coverage outside of a specified provider network. Some EPOs and HMOs may serve only a certain geographic region.

If you select the CaliforniaChoice multi-carrier, private health exchange, you can give employees the option to select the plan type that works best for their individual or family health insurance needs, while still controlling costs for your business.

More Than Health Coverage

You can also offer your employees access to other types of insurance, which can be offered on a voluntary-only basis. Of course, you can also contribute to your employees’ cost for coverage, if you choose.

Popular ancillary and supplemental coverages include:

  • Dental
  • Vision
  • Chiropractic and Acupuncture
  • Life Insurance
  • AD&D (Accidental Death & Dismemberment)
  • Hospital, Disability, and More

Value-Added Extras

Depending on your source for coverage, your health plan, carrier, or administrator may offer value-added benefits such as these available through CaliforniaChoice:

  • Discounts on health care-related services like Dental, Vision, and Hearing
  • A Premium Only Plan, which allows employees to pay for some of benefits pre-tax
  • Online human resources support services
  • Employee discounts on travel, entertainment, and other services
  • Cal-COBRA or Federal COBRA billing services

Getting a Quote

An employee benefits agent can provide you with more information on specific plans available in your area and the costs associated with each. If you do not already have an agent, you can search for one here.

Your Beginner's Guide to Choosing a Small Business Employee Benefits Program

Do you need help choosing the right health benefits for your employees?
This guide can help!