In 2014, the health insurance market changed forever with the implementation of the Affordable Care Act. Ever since then, the only consistent thing in the health insurance market has been change. One of the biggest health insurance changes happened in 2019. Through new legislation, health insurance companies started offering Association Health Plans to consumers in Nevada. Insurance Companies like Hometown Health, Prominence, Anthem and United all found ways to reduce rates for consumers through Association Health Plans. For the first time, sole proprietors and family run businesses also qualified for Association Health Plans.

Group Health Plan Eligibility Changes

Unfortunately, there have been more health insurance changes in the market which affected these Association Health Plans. In New York, there is an ongoing federal court case which changed the rules nationwide. Sole proprietors and small businesses comprised of a single married couple no longer qualify for group health plans. The Nevada Division of Insurance is enforcing these newly revised rules. They published a public bulletin discussing these health insurance changes. To read the public bulletin, please click here.

Moving forward, the eligibility requirements for all small group plans will be the following:

  • There needs to be a minimum of two W-2 employees enrolled on the plan (if there are only 2 employees enrolling, the 2 employees cannot be married.)
  • The group health plan must be offered to all full time eligible employees. Nevada Revised Statutes define full time as a minimum of 30 hours per week.
  • As an employer, you must contribute at least 50% of the premium for every employee enrolled on the plan.
  • Most insurance carriers require a minimum of 50% – 75% of the eligible full time employees to enroll in coverage.
  • When you enroll, you will need to prove that you are a legitimate business with full time employees on payroll. Insurance carriers will request a Quarterly Wage Report confirming all your employees.

These requirements may seem daunting, especially since eligibility requirements keep changing. Fortunately, our licensed brokers are always staying up to date with legislative changes. We will help assess your eligibility and we will help with these requirements, at no extra cost to you.

Your Options

If you are a business owner or sole proprietor affected by these changes, don’t worry. There are plenty of options available in the market and we will help you enroll in a new plan. Most insurance companies are allowing their members to remain enrolled through the end of the 2019 calendar year before they are deemed ineligible for group coverage under the new rules. With only a few months left in 2019, now is the time to start researching options. Give us a call today to get a free quote for new coverage.