Group Health Insurance Basics

This is the “Group Health Insurance Basics” section of the Benefits Compliance FAQ: ACA, COBRA, ERISA, HIPAA & More.

Group health insurance is coverage offered by an employer to employees and often their dependents. Employers typically share the cost of premiums with employees and may offer multiple plan options.

Eligibility depends on the employer’s plan design and carrier requirements. Most plans cover employees working 30 or more hours per week.

Most carriers require at least two eligible employees to establish a group plan, though some states allow different arrangements depending on underwriting guidelines.

Under federal law, employers with 50 or more full-time equivalent employees may be required to offer health insurance or face potential penalties.

Yes. Many carriers offer plans specifically designed for small businesses with 2–50 employees.

Common employer-sponsored benefits include:

  • Medical insurance
  • Dental insurance
  • Vision insurance
  • Life insurance
  • Disability insurance
  • Supplemental benefits (accident, critical illness, hospital indemnity)

Contribution requirements vary by carrier but most require employers to pay at least 50% of the employee premium.

Open enrollment is the annual period when employees can enroll in benefits or make changes for the upcoming plan year.

Disclaimer

This information is provided for general educational purposes and should not be considered legal, tax, or compliance advice. Employers should consult with qualified professionals regarding their specific compliance obligations.