What do I need to set up group health insurance?

*This post applies to small businesses only (under 50 employees).

Right now you're looking to set up benefits for your employees. Now, how do you make it happen? Also, are you eligible to get group health insurance? We set up a checklist to get you started.

  1. Do you meet carrier participation requirements?

  2. Do you have your most recent DE9C?

  3. Do you have your most recent payroll?

  4. Do you have details for each employee: name, address, and date of birth?

  5. Do you have a workers' compensation policy?

The list can seem daunting at first, but keep in mind that the beginning set up is always the hardest. Once you're enrolled, you are good to go!

1. Carrier participation requirements

Most carriers require around 75% of eligible full time employees to enroll in the group health plan you set up, unless they have a valid waiver.

A valid waiver is when an employee declines coverage because they have health insurance through one of the following:

  • Spouse's employer plan

  • Another employer (i.e. 2nd job)

  • Parent's employer's plan (up to age 26)

  • Medi-Cal

  • Medicare

Employees who have a valid waiver do not count into the full participation requirement. You can subtract the employees from the full time eligible employee count.

2. DE9C

This document is required to apply for group health insurance. It also helps to calculate full time eligible employees.

3. Payroll

Like this DE9C, this document is required to apply for group health insurance. It also helps to calculate full time eligible employees.

4. Employee information

You'll need to provide each employee's name, date of birth, and home zip code. This information is needed to get a quote (small group is rated based on age and zip code). It's also needed to get employees enrolled in the plan. If you're offering spouse and dependent coverage, we'll need their information as well.

5. Workers' compensation

California law requires that any company with 1 employee must have a workers' compensation insurance policy. This insurance provides compensation and benefits to employees who suffer work-related injuries or illnesses, regardless of who was at fault.

Take some time to collect the necessary documents listed above. Once gathered, we will help start the process with you and make it as seamless as possible. You can sit back and get your employees covered!