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Medical Insurance
Rules of the Game
“Small” Employer Based Medical InsuranceOregon law stipulates that every employer with 2 or more employees working 17.5 hours per week or more be guaranteed group medical insurance.
In exchange for this guarantee, there are some rules that must be followed:
- You must do a head-count of all employees you paid in the last 12 months. This determines which “category” of small employer you fall into. This count includes all employees, part-timers, seasonal employees and 1099 employees;
- Next, you count how many of those employees are permanent and who work, on average, 17.5 hours per week or more;
- Employees who have other group coverage (through a spouse/partner or parent for example) need to be counted, but do not have to be covered on the group health plan.
- The employer can set eligibility requirements for participation in the medical insurance plan, by class of employee or by number of hours worked weekly.
- The employer must pay at least 50% of the employee’s medical insurance premium.
Other rules also apply. However -- these are the most significant rules.
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Pacific Benefit Consultants, Inc. 450 Country Club Rd. Suite 330 Eugene, Oregon 97401 (541) 484-6624 (541) 484-4245 (Fax) (800) 588-8688 (Toll Free) |