Small Group Health Insurance: Enrollment Waivers for January 1st

If you've been thinking about offering health insurance to your employees, now is the perfect time. For January 1st effective dates, insurance carriers are waiving their typical enrollment percentage requirements—making it easier than ever to get coverage in place.

Normally, to qualify for small group health insurance, at least 70% of your eligible employees need to enroll in the plan. This participation requirement ensures the risk pool is balanced and premiums stay reasonable.

But during annual open enrollment periods—specifically for January 1st effective dates—most carriers waive this requirement. That means you can start a group plan with as few as two enrolled members, even if you have more eligible employees who choose not to participate.

This waiver opens the door for businesses that previously couldn't meet the 70% participation threshold. Maybe you have employees with coverage through a spouse, or some who prefer individual marketplace plans. During the waiver period, that's not a problem.

Key benefits:

• Start coverage with just two enrolled employees
• No 70% participation requirement for January 1st effective dates
• Available in both West Virginia and Ohio
• Same comprehensive coverage as traditional group plans

Here's the important part: applications must be fully completed by December 15th to secure a January 1st effective date with the waived enrollment requirement.

That might sound like plenty of time, but the application process involves:

• Gathering employee information and eligibility details
• Completing enrollment forms
• Choosing plan options and contribution levels
• Processing underwriting (which can take a few days)

Don't wait until the last minute. The closer we get to the deadline, the tighter the timeline becomes.

Here's something many small business owners don't realize: group health insurance can actually be more affordable than individual marketplace plans—especially if your employees don't qualify for premium tax credits on healthcare.gov.

When group plans make financial sense:

• Employees earn too much to qualify for healthcare.gov subsidies
• You want to offer better, more comprehensive coverage
• You can deduct premium contributions as a business expense

That last point is huge. As a business owner, your premium contributions are tax-deductible business expenses. This can significantly reduce your actual out-of-pocket cost compared to paying for individual coverage with after-tax dollars.

Small group health insurance is available to businesses with 2-50 full-time equivalent employees in West Virginia and Ohio.

You'll need:

• At least two employees willing to enroll
• To contribute at least 50% of employee premium costs (typical requirement)
• A legitimate business formed for purposes other than obtaining insurance

If you want coverage starting January 1st, reach out to us as soon as possible. We'll:

1. Review your business structure and employee situation

2. Compare plan options from multiple carriers

3. Calculate employer and employee costs

4. Complete all applications before the December 15th deadline

The process typically takes 1-2 weeks from start to finish, so starting now gives you plenty of buffer time.

Not every business needs to offer group health insurance. But if you're trying to attract quality employees, reduce turnover, or provide better benefits while managing costs, it's worth exploring—especially with the enrollment waiver making it easier to qualify.

Ready to explore your options? Give us a call. We'll run the numbers, show you what's available, and help you decide if this is the right move for your business. No pressure, no obligation—just honest guidance.