VSVS Health Benefits
Free eligibility check

Do you have enough employees for group health insurance?

Most small employers are told no by one carrier and assume the answer is no everywhere. Answer three questions and find out where you actually stand — including the one window each year when participation rules don't apply.

60 secondsNo cost, no obligationLicensed in 40+ states
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Let's check your group in 60 seconds

Answer three quick questions and we'll tell you whether you can put a group health plan in place, and which route fits your headcount.

Please enter your business name.
Please enter a valid phone number.
Enter a number between 1 and 500.

No cost, no obligation. We use your number only to send your results and to have a licensed advisor follow up. See our Privacy Policy.

Who is on your payroll?

Carriers count W-2 employees. This is the question that decides whether a group plan is even on the table.

Contractors don't count toward group eligibility, but they can often be covered a different way.

How many would actually enroll?

This is the number that trips up most small employers. Carriers require a minimum percentage to take the plan — but employees with other coverage don't count against you.

Enter how many employees would enroll.
Spouse's plan, a parent's plan, Medicare, VA or TRICARE. These are valid waivers.
Why this matters: participation is calculated on employees without other coverage — not on your total headcount. Employers are told "you don't have enough people" all the time when they actually do.
—Your participation
—Typical carrier minimum

This is an estimate based on the participation and contribution rules carriers most commonly apply to small groups. Final eligibility is determined by the carrier at underwriting. VS Health Benefits sets up group coverage at no cost to the employer.

Where should we send it?

We'll send your eligibility summary and a licensed advisor will confirm it against the specific carriers in your state.

Please enter your first name.
Please enter your last name.
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By submitting you agree to our Privacy Policy and consent to be contacted by a licensed VS Health Benefits advisor. We never sell your information.

You're all set

Your eligibility summary is on its way. A licensed VS Health Benefits advisor will call to confirm which carriers will write your group and what it would cost.

Start a full group quote

Group health eligibility questions

How many employees do you need for group health insurance?

In most states, including Florida, you can set up small group coverage with as few as one enrolled W-2 employee besides the owner - two people total. The owner alone is not enough, because carriers treat a business with nobody else on payroll as an individual rather than a group. Businesses with up to 50 employees are considered a small group.

What is minimum participation for group health insurance?

Carriers typically require about 70% of eligible employees to enroll. The important detail is that employees who waive because they have other coverage - a spouse's plan, a parent's plan, Medicare, VA or TRICARE - are removed from the calculation entirely. A business with 10 employees where 4 have coverage elsewhere only needs about 4 of the remaining 6 to enroll.

Is there a way around minimum participation requirements?

Yes. Under federal guaranteed-availability rules, carriers must offer small group coverage between November 15 and December 15 each year for a January 1 effective date without applying minimum participation or employer contribution requirements. An ICHRA is the other route, because it has no participation requirement at any time of year.

Do 1099 contractors count toward group health insurance eligibility?

No. Only W-2 employees count toward group eligibility and participation. Contractors cannot be enrolled on a group plan, though there are other ways to help them get covered, including reimbursement arrangements and individual coverage.

Can the owner and their spouse get a group plan?

It depends on the carrier. Some carriers treat an owner-plus-spouse business as a group of one and decline it; others will write it if the spouse is a legitimate W-2 employee with payroll records. It is worth checking, because the answer varies by carrier and by state.

Does the employer have to pay for the plan?

Carriers normally require the employer to contribute at least 50% of the employee-only premium. During the November 15 to December 15 window that contribution requirement is waived along with the participation requirement.

Not sure which route fits your business?

A licensed VS Health Benefits advisor will look at your headcount and tell you what will actually get written - at no cost to you.

Get a group quote

Related: Employer cost calculator · Minimum participation explained · Small business health insurance · ICHRA vs group health