Small Business (2-50 Employees) Frequently Asked Questions (Page 1)

Q.How many employees does it take to make a group? Can a husband and wife owned company qualify for a group medical plan?

A. Yes. In Texas, the minimum is two. A husband and wife who own and work for the company can each enroll at the Employee Only tier, thus making two individual employees enrolling in the group plan.

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Q.If a family owned company wants to have a group plan, do we have to offer the plan to all of our employees or just the family members who work for the company?

A.If you have 5 employees, for example, and all 5 employees (including say 2 family members) are full time employees (i.e., they work 30 or more hours per week) and none of the 5 are 1099 (contract) employees, then you must offer the plan to all. You may elect to cover only employees on the payroll and not 1099 employees, or you may elect to include both payroll and 1099 employees. It’s your choice, but once you decide, you must treat all employees the same relative to benefits.

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Q.Can we pay 100% of the premium for our executives/owners and 80% for all other employees?

A.No. In small and mid-market size groups, all employees must be treated the same relative to: 1) their ability to elect employer-sponsored benefit plans; and 2) the employee cost for participating in such benefits.  

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