Minimum Group Size:

The minimum amount of people that it takes to establish a group health insurance plan is two. Although all carriers will take a group of two, most carriers will put an additional premium of anywhere from 10%-30% due to the small size.

Medical Questionnaire:

Any group with less then 25 eligible employees has to have their employees each fill out a medical questionnaire. As long as the group is based out of Arizona all carriers have agreed to underwrite the group based on the questionnaire. Employees will not be required to fill out medical information again once the company selects a health insurance carrier.

26+ Group Size:

For groups of 26 or more eligible participants the carriers do not require individual employee questionnaires to be filled out. However they do require one medical questionnaire be filled out by the employer and only asks, to the best of their knowledge(employers should never inquire about their employees medical history).

75% Participation:

All groups have to have at least 75% of all eligible employees participate in the plan. Qualified waivers do not count against the 75% ratio. For example if you have 12 employees and 2 have coverage through their spouse, You would have to have 75% participation from the remaining 10 employees or in this example it would be 8.

50% Participation:

A group must have at least 50% of the eligible participants enrolled in the plan regardless of qualified waivers. For example if you have 16 employees and 6 had qualified waivers, you would still have to have 50% of the 16 employees or 8 participate.

Courtesy of:
Rory Stone-Walsh
Vice President
The Hershenberg Group