Who is Eligible for Group Health Insurance?

one person away from group

First, a congratulations: that you are even asking questions about group health insurance shows a commitment to your employees, support for their healthcare, and a financially savvy decision to save when individual plans can be astronomically more expensive. And now, as another year begins, you have the opportunity to evaluate your insurance plans and needs to take proactive steps to secure group coverage.

But who is eligible for group health insurance? The easiest answer is full-time employees, but that term can be malleable depending on the company at hand. If you have a smaller company (one to 50 employees), full-time is defined as staff who work an average of 25 hours a week. For larger companies (51 or more employees), it is defined as an average of 30 hours a week.

This minimum number of hours might not be hard to reach: generally, full-time staff work 40-hour weeks. However you might ask what happens if an employee falls below this minimum number of hours. While that employee might not be offered your group health insurance, they must be offered an extension through COBRA, which benefits employees falling under this margin and, importantly, their dependents.

Are Freelancers and Independent Contractors Eligible?

Increasingly, more and more companies work with freelancers or independent contractors. A perk of working with groups such as these, like an outside marketing agency or press team, is that you needn’t offer them coverage. What is noteworthy, though, is that if an independent contractor receives 100% of their compensation from one source, they can be allowed to be added in to your group plan.

How Does Part-Time Staff Turning into Full Time Affect Group Eligibility?

It is also possible that your part-time staff will be promoted or take on more hours. If this is the case, such employees can be added into your company plan but need to satisfy the new-hire wait period first, which may vary business to business.

What this does illuminate are the many ways to offer coverage to entice diligent employees who want to work with and for your company. If you are seeking ways to offer coverage and thus legitimize your company, or are seeking a new plan that works best for your employees, Dawson Benefits is the skilled insurance concierge for you. We build plans around your health, life, dental, vision, and disability insurance needs.

Call 201 258 4669 to set up a free consultation today!