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The Health Insurance Challenges that Small Businesses in Western Washington Face in 2018
Thursday, July 27 2017

For small businesses with less than 5 employees in western Washington state, buying health insurance inside the more stable group insurance marketplace will be a challenge, but one which needs facing.  Why? Because of proposed large rate increases to Washington's 2018 individual health insurance rates plus the desire by various individual insurance companies to pull out of entire counties in Western Washington altogether.  

It is scary to watch the deterioration in individual health plan options and increases in costs, coupled with what's happening in the healthcare debate in Washington D.C. Now is simply not the time to keep the status quo. Small businesses do have options, however not all businesses will qualify to purchase coverage in the small group market. 

Generally speaking, there are three hurdles to overcome if you are what's called a "micro group" with less than 5 full-time employees. They include:

  1. Group Participation Requirements (which has various "common law" employee rules for owner and spouse employees)
  2. Group Premium Contribution Requirements (which include various rules for how much employers have to pay towards their employee's premium)
  3. Tax Documentation Requirements (which can include Quarterly Wage Detail Reports 5208 A&B

In Washington state, there are 6 carriers who will write eligible groups with 1-4 employees that meet these three requirements. Generally speaking, the carriers fall into three different requirement categories for a small group of this size to qualify:

  • At least two W-2 employees:  HealthNet
  • At least one W-2 employee:  Premera & Regence
  • At least one W-2 employee who is NOT an owner or an owner's spouse: Aetna, Kaiser & United Healthcare

Purchasing coverage in the group health insurance market may be challenging, but can be overcome with the help of a competent health insurance broker's guidance.  Let us know how we can help.

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