How much does an employer have to contribute?

Group health insurance plans typically require the employer to contribute at least 50% of the premium for employee-only coverage. This ensures that employees have affordable access to the plan and helps meet carrier participation requirements. Employers can choose to contribute more than the minimum or offer a fixed dollar amount toward premiums. You’re not required to contribute toward dependent coverage, though you may choose to do so as an added benefit.

What counts as a full-time employee?

Most insurance carriers define a full-time employee as someone who works at least 30 hours per week on a regular basis. This threshold is commonly used to determine eligibility for group health benefits. However, some carriers allow you to set a higher requirement (such as 35 hours) as long as it is applied consistently. It's important to clearly define full-time status in your employee handbook or onboarding materials so there’s no confusion.

Can our group be declined for health insurance coverage?

If you're applying for a small group fully-insured plan (typically 2–50 employees), coverage is guaranteed issue — that means you can’t be declined based on the group’s health history. These plans follow Affordable Care Act rules and don’t require medical underwriting. However, some employers may qualify for level-funded plans , which can offer lower premiums for healthy groups. These plans do consider risk — carriers may ask for prior claims history or require employees to complete individual health questionnaires. Based on that information, the carrier can choose to offer coverage, adjust the rates, or decline the group altogether. We can help you evaluate both options and determine which makes the most sense.

Does my company qualify for group health insurance?

To qualify for a small group health insurance plan, your business usually needs at least one eligible employee who is not an owner or the owner’s spouse. The employee must work full-time or meet your state’s definition of eligibility. Some carriers may require wage documentation to confirm that the business is active and that employees are being paid. Even if you're a small company, there are options available, and we can help you determine your eligibility.

Why do employers offer health insurance?

Health insurance is one of the most valued employee benefits a company can offer, and providing it can help you attract and retain top talent. It demonstrates that you care about your employees’ well-being and helps reduce turnover. In addition, offering a group plan may provide tax benefits to both the employer and employees. For example, premiums paid by the employer are generally tax-deductible, and employees’ contributions can often be made pre-tax through a Section 125 cafeteria plan.

What happens to my HSA when I die?

What happens to your HSA after you die depends on who you name as your beneficiary. If it’s your spouse, they can take over the account and continue using it tax-free for medical expenses. If it’s anyone else, the HSA will be cashed out, and the beneficiary will owe taxes on the balance. Read more →

FAQs – Page 4 – JME Insurance

How much does an employer have to contribute?
April 29, 2025Employer FAQs0 min
What counts as a full-time employee?
April 29, 2025Employer FAQs0 min
Can our group be declined for health insurance coverage?
April 29, 2025Employer FAQs1 min
Does my company qualify for group health insurance?
April 29, 2025Employer FAQs0 min
Why do employers offer health insurance?
April 29, 2025Employer FAQs0 min
What happens to my HSA when I die?
April 23, 2025HSA FAQ Excerpts0 min

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FAQs

How much does an employer have to contribute?

What counts as a full-time employee?

Can our group be declined for health insurance coverage?

Does my company qualify for group health insurance?

Why do employers offer health insurance?

What happens to my HSA when I die?

Have more questions?

JME Insurance Agency
A Division of Patriot Growth Insurance Services, LLC

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Medicare Disclosure

FAQs

How much does an employer have to contribute?

What counts as a full-time employee?

Can our group be declined for health insurance coverage?

Does my company qualify for group health insurance?

Why do employers offer health insurance?

What happens to my HSA when I die?

Have more questions?

JME Insurance Agency A Division of Patriot Growth Insurance Services, LLC

Quick Links

Medicare Disclosure

JME Insurance Agency
A Division of Patriot Growth Insurance Services, LLC