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Group Health Insurance

     I specialize in helping employers who have less than 25 employees in Oregon. Health insurance premiums keep risings, and it can be a challenge to continue to offer coverage. I primarily work with Providence, Kaiser, Regence for small group plans.

 Some basics for offering a Group Medical Plan:

      You need at least 75% of 'eligible' full-time employees to participate in your group plan.  They don't count employees 'waiving' coverage to a spouse, who have VA or OHP, or other group coverage.  An employer is considered an employee for the count.   You can define how many hours an employee must work on average to be eligible for benefits, and how long they have to wait for the coverage to begin.  

     Let's say you have the employer, and 3 employees working full-time, you need at least 3 of the 4 to participate in the coverage, unless they are 'waiving' coverage to a spouse's group plan, Oregon Health Plan, or another coverage. 

As the employer you must pay at least 50% of the employee-only premium.  You do not need to offer benefits to dependents.  This would be called an employee-only contract.  Sometimes this is in their best interest so that your employees dependents can buy coverage through the Marketplace.

    Let's say your employee John is married with a wife and 2 kids.   You pay 75% of his health benefits, but do not offer coverage to dependents.  In this case John's wife and kids can purchase coverage through Healthcare.gov and maybe qualify for a tax credit.  However, if you offer coverage to the dependents, even if it's not affordable for him, it disqualifies them from a tax credit to help pay premiums.  This is a  bad glitch in the Affordable Care Act law.  

     Group Health insurance is largely calculated based on the  ages of the employees enrolling on the plan.   For example, if you start the coverage with a 31 and 42 year old employee, the rates will be locked in for that year based on the quote generated.  If you had a 22 year old join the group mid-year the rates would not change until the annual renewal.  Prior to renewal, a questionaire is sent out to you.  Based on who on the plan at renewal, the rates could go down, but normally increase each year.  At renewal you can keep things the same or change to a new plan should you want to.




Give Dan a call at 503-650-4325 and let's talk about your situation.  I will email you a 'Group Insurance Request Form' so you can provide the info on your business and employees so that I can generate accurate quotes for you.





 page updated 11/15/2022












































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