A group is required to be based in, or have a clearly defined division in Washington.
The group must have at least one, but no more than 50 employees, working 20 or more hours per week
An eligible employee must meet the following requirements:
An eligible dependent must meet the following requirements:
All groups with four or fewer employees enrolled are required to provide copies of their Washington State Employment Security Quarterly Wage Detail Report (form #EMS 5208 B), or most recently filed IRS forms. Sole proprietors may submit IRS form 1040, along with a Schedule C, Schedule C-EZ or Schedule F, and any associated W-2's if married filed jointly. Partnerships may submit IRS form 1065. Corporations may submit Form 1120/1120A.
Groups of 1 to 3 Employees
Groups of 4 to 50 Employees
In all group sizes, employees with other verifiable group medical coverage are considered eligible participation exclusions, and do not count against the employee participation requirement. Employees with Individual medical coverage are not considered eligible participation exclusions and will count against a Group's employee participation requirement.
Groups with 10-50 enrolled employees may include dual choice when combining two different Premera medical plans. Minimum of 4 enrolled on each plan. A maximum of $1,000 difference between deductibles. Multiple networks are allowed when the deductibles are identical. Cannot mix employee only plans with non-employee only plans. PersonalCare Gold and Silver plans can be sold with a Balance plan when the deductibles are identical, the PersonalCare Bronze plan can be sold with any other Balance Bronze plan.