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Merritt Personal Lines Manual: The Mechanics of Group Health Insurance Plans

Group policies offered through the employer can either be contributory or non-contributory. Contributory plans require the employee to pay a portion of the premium and usually 75 percent of eligible employees must take the health insurance coverage. Non-contributory plans are paid for fully by the employer and 100 percent of the eligible employees must be covered under the plan.

Anyone employed full or part time can be eligible for health coverage under an employers plan. However, the employer can also make rules about what part time employees are eligible for coverage, such as only part time employees working 25 or more hours per week.

Employees newly hired are usually eligible for health insurance benefits the first of the month following month of hire, but employers can delay that entrance into the plan as long as they have the same rules for all employees.

For employees who did not elect coverage when they were hired, employers have an open enrollment period, usually for 30 days once a year, when employees can change coverage or enter or leave a plan if they were not insured for the prior year.

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