Insurance for Small Business Employers

Through 2015, the Access Health CT Small Business marketplace is open to employers with 50 or fewer full-time-equivalent employees. They provide quotes year-round on a wide variety of plans. For information on their products and services, visit their site.

Under federal law, small employers (a business with 2 to 50 full-time employees) are guaranteed group coverage if they decide to purchase it, regardless of the employees’ health status. An employer has the option to offer coverage to part-time employees (those working fewer than 30 hours per week), however if an employer offers coverage to one part-time employee, all part time employees must be offered coverage. Dependents of eligible employees are generally eligible for coverage under a group plan.

Small Business Health Options Program (SHOP)

Access Health CT, Connecticut’s health insurance exchange, has a separate exchange, known as SHOP, which is designed specifically for small businesses. Employers who offer insurance through the SHOP can start coverage at any time.  If an employee enrolls by the 15th of any month, coverage will begin on the 1st of the following month.

The small business health care tax credit benefits employers that:

• have fewer than 25 full-time equivalent employees
• pay an average wage of less than $50,000 a year
• pay at least half of employee health insurance premiums

To be eligible for this credit, you must have purchased coverage through the small business health options program, also known as the SHOP marketplace. For more information on the program and specific tax benefits, visit IRS.gov.

For information about insurance plans offered through the SHOP Marketplace, visit Healthcare.gov.

Essential Benefits

All insurance plans must cover a set of essential benefits.  These benefits include:

• Ambulatory care (outpatient) services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance abuse services
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services, including annual physicals and mammograms
• Chronic disease management
• Pediatric services, including dental and vision