Group Health Insurance in California For Small Business

About Group Health Plans

Group health plans are purchased when the employer is eligible to purchase such a plan. We’ll be looking at the conditions for eligibility for group health insurance in the next section. For the group health plans to be possible, the members of the group or employee must also qualify to receive such insurance coverage from the group healthcare purchaser. Group healthcare plans are preferred because of the cost advantage it has over individual healthcare coverage plans. These plans can be selected to be convenient for the employer to purchase and still meet the needs of the employees. Group health plans also provide the opportunity for employees to add family members and dependents to their plan. The addition of family members turns the individual employee’s health coverage plan to a family coverage plan. Through the group health insurance plan, it is also much easier for employees to renew their plans. This is because the plans are purchased from the insurance company in trust to the employer. The eligibility of an employee qualifies the individual for the next renewal automatically. This is not the same for an individual health coverage plan where the insurance company may refuse to grant a renewal to an individual.  

California Small Group Health Insurance Eligibility

For a small business to be eligible to purchase a group health insurance plan, the business has to have within the range of 1-100 employees. There are also other requirements attached to this. The Federal and State laws also require that a small business must have had an employee for six months of the preceding year, or six months of the preceding quarter.  The small business also has to submit a recent quarterly wage statement to an insurance provider when the application process for eligibility commences. To also make it easier for new small businesses to enroll, the laws also permit the submission of a four-week payroll record in place of the quarterly wage statement. However, it is possible that insurance companies may reject the payroll record from the new small business in favor of the quarterly wage statement.

How Much Does It Cost to Provide Health Insurance for Employees?

The price for a group health insurance plan depends on the plan selected by the employee. There is an option for the employee in the group plan to add family members and dependants to the plan.

The average premium plan for an individual is within $600-700/month and $1600-$1700/month for the family coverage plan. These plans are subject to inflation and some other parameters. The cost of the premium for the employee is mandated to be shared at least equally between both parties.

The type of group healthcare coverage plan provided to a small business is also determined by the employer. Some employers make use of single plans for their employees. This means that all employees no matter their age or experience will get the same health coverage plan. Others prefer to select plans that suit the needs of their employees. There are companies that may select a range of plans for their employees to choose from. Also, many insurance companies have the option available to employers where they can select up to twenty plans for their employees’ coverage. These plans all have different prices and the premiums for individual/family coverage for the employees also vary. 

Prior to 2014, the rates of small business health plans were designed to depend on the age range of members of the association or employees. This age range used for rating simply meant that if the member/employee desired to include dependents to his/her healthcare coverage plan, all the rates would be the same.

Rules for California Small Business Health Insurance

There are rules in the state of California which govern the eligibility of employers/employees to buy/participate in group health insurance plans. The rules for a small business in the state make it necessary for at least 60 percent of the employees or members of an association should be members of the group plan. This rule makes it compulsory for a majority of the group’s members to be part of the plan.

Also there are provisions in the state guidelines that allow employees to remove some members of its organization from the group insurance plan. There are many reasons a waiver can be granted to an employer. Situations where an individual is already registered on a healthcare coverage plan through being a dependent to a family member. The waiver can also come up if an individual is registered through Medicare, or some other healthcare plan. This waiver is done through the insurance company and the employee is removed from the number of eligible employees.


There are many benefits inherent from getting a group healthcare plan. The law also protects the smaller businesses that wish to get a plan through allowing the purchase of any plan no matter the number of employees in the business.