Small employers that offer health insurance usually must contribute a minimum amount toward the cost of their employees’ health coverage. But this contribution requirement can vary from state to state and carrier to carrier. Meeting the miniumum requirement, though, is not the only consideration. Decisions about how much an employer contributes to premiums and how much is passed on to employees are key considerations in plan affordability and attractiveness. Agents must be adept at guiding small businesses through these financial decisions to balance cost with benefits. Note that contribution requiremetns are waived for small employers that enroll during the annual small group enrollment period (usually Nov. 15 – Dec. 15 for a Jan. 1 effective date).
It varies by state and carrier. Many carriers require the employer to pay at least 50% of the employee-only premium, though some states set no statutory minimum and leave it to the carrier (applied uniformly). The requirement is waived during the year-end open-enrollment window.