- Employee must be covered by a Health Benefit Plan*
- Minimum size requirement for eligible groups is 10 eligible employees
- Eligibility is restricted to W-2 employees and their dependents participating in the Health Benefit Plan. (1099 contract persons are not eligible, unless the "employer" is sponsoring the medical plan);
- The Health Benefit Plan must have a common deductible for all conditions.
*A Health Benefit Plan is any self-funded or fully insured major medical or comprehensive medical plan. Health Benefit Plan does not include any limited medical program, Medicare or Medicaid. Plan limits will apply according to policy;
- When employer contributes 100% of the employee premium, 100% participation will be required
- Minimum employer contribution is 50% of the employee premium. When employer contribution is less than 100%, there is a 75% participation requirement of those employees taking part in their current health plan.
- Coverage is Guaranteed Issue
- Initial Rates Guaranteed for 12 months;
- Age based rates in following bands: Under Age-40, Ages 40 - 49 and age 50+.
- A composite rate is available upon receipt of a census. Composite rates are subject to revision upon review of the final enrollment census.