What Does the "Group" in California Group Health Insurance Mean?
California health insurance is available for both groups and Families / Individuals. California group health insurance coverage refers to a single policy issued to a group (typically, a business with employees, though there are other kinds of groups that can get coverage) that covers all eligible employees and, sometimes, their dependents. Individual health insurance coverage, on the other hand, is a single policy issued to a single person or family. Individuals and Families applying for california health insurance are required to go through an underwriting process. More explanation on this later.
The rules are quite different for California group health insurance coverage versus individual health insurance coverage, in large part because the insurer's risk is calculated differently. With California individual health insurance coverage, the insurer will base its premium rates (or deny coverage) based on the detailed medical history of the person or family. A health / medical exam is often required.
Small employers applying for california health insurance, on the other hand, the insurer determines a premium price based on risk factors balanced over the entire group, using general information on members of the group such as age or gender. Perhaps most importantly, insurers are required by law to offer California health insurance to small groups. In contrast, there is no such guarantee of individual health insurance coverage in California.
We explain this guarantee in more detail below in "Is Your Business Eligible for California Group Health Insurance Coverage?"
Is Health Insurance Required in California?
There is no law requiring employers in California to offer employees or their dependents health insurance.
Is Your Business Eligible for Group Health Insurance Coverage?
Under California law AB1672, small employers are guaranteed group health insurance coverage should they choose to purchase it, regardless of the employees' health status. A "small employer" is defined as a business with 2 to 50 full-time employees. Owners are generally counted as employees, so sole proprietorships with one employee fall into this category, as do partnerships without any employees (by definition partnerships have two or more partners).
Please contact us directly or via email to address any specific questions you may have about california health insurance for your small business. We're here to help with no hassle pressure free information.
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