HEALTH
INSURANCE

To qualify for group coverage as a small business, your company needs between two and 50 full-time employees (including the owner). All full-time, permanent employees of an employer are eligible for insurance under a group policy. And 70% of eligible employees must select health plan coverage.

A full-time employee for group insurance purposes is one who works at least 30 hours in the employer’s normal work week.

For guidance on other qualifiers, call 833-923-1784.

Employers must provide UI 3/40 quarterly wage and tax statement for all employees and indicate full time, part time, seasonal, temporary, or terminated status for each employee on the document.

If your company is a new business, you may not have this document. This will require a state filed proof of business, and W-4’s for all W-2 employees. Partnerships with no other employees require UI 3/40 and state filed proof of business. If they do not claim wages, K-1 documents for all partners of the group are required. If they are listed as stockholders, they do not qualify for coverage.

Your company can cover 1099 contractors if you have at least one full-time employee.

Partners, proprietors, and members of the firm must meet all requirements applicable to full-time or part-time employees to be eligible.

Only individuals who are insured under a group policy prior to retirement may be insured after retirement. When a Blue Cross and Blue Shield of Illinois group policy replaces that of another carrier, under which retired persons were insured, proof that the employees have satisfied the minimum years of service and achieved the limiting age must be submitted for review.

This is the most employees have to pay out of their own pocket for expenses under the insurance plan during the year. Learn more about how insurance works.

Doctors, hospitals, or other providers who accept your employees’ health insurance plans are “in-network,” also known as participating providers. Doctors who do not take these plans are “out-of-network.” In-network provider services are paid at a higher benefit level. Learn more about how insurance works.Learn more about how insurance works.

Our network plan offerings are built to create health insurance coverage options that fit any budget across different metallic coverage tiers. For more detail on the networks available to you, visit our Plan Options Page

A Smart network is a group of providers that encompass a specific geographical area and is less broad than a standard PPO network. Plans with a smaller network typically have lower premiums. Learn more about how insurance works.

Essential health benefits are included in every health plan, no matter which plan you choose. The Affordable Care Act requires these benefits to be included in all individual, family, and employer-sponsored plans. Visit our Plan Options Page to see all essential health benefits included in our plans.

BCBSIL plans provide comprehensive benefits with options to fit your employees’ needs and your organization’s budget. For more detail on the plans available to you, visit our Plan Options Page.

Employers offering group coverage are required to pay at least 25% of their employees’ premiums. You may pay a higher percentage if you choose; making insurance more affordable for your employees can increase participation. If you purchase group coverage between November 1 and December 15 for a January 1 or January 15 effective date, the minimum contribution requirement is waived. Learn more about the benefits of offering health insurance.

You can apply for health coverage at any time throughout the year. If you purchase group coverage between November 1 and December 15 for a January 1 or January 15 effective date, the minimum amount you are required to contribute towards your employees’ premium, as well as the number of employees required to participate - are waived.

Each policy has a 12-month contract term. We will reach out to you before the contract term expires to discuss your options for renewing your policy.

You can buy coverage any time during the year and indicate a desired coverage start date. Once your business is approved for coverage, you will receive a notice confirming the date on which your coverage will begin. It will be effective for all enrolled employees starting on that date.

Yes, you may be eligible to take a deduction on the amount you contribute towards the premium cost on your employee’s behalf. Please contact your tax professional for more details on the tax advantages you may qualify for by offering your employees health insurance.

It is possible. You can take a pre-tax deduction from employees’ paychecks to cover the portion of the total premium that they are required to pay. This deduction reduces their taxable income and the amount of income taxes owed.

Through the Affordable Care Act, individuals may be eligible for subsidies for purchasing coverage through the individual marketplace if they meet income requirements. If you have additional questions, please contact your tax professional for more information.

Group insurance policies allow employers to offer their employees and their dependents a wider choice of options, with access to more robust plans and larger networks. Monthly premium costs are shared between the employer and the employee.

In the individual marketplace, there may be fewer options to choose from, plans typically have a higher deductible and smaller networks, and employees are responsible for 100% of the monthly premium.

Yes, coverage can be extended to spouses and/or children of any employees who enroll in coverage. You can decide if you want to contribute to the cost of their coverage.

We offer plans that include out-of-state coverage. If you have employees that reside out of state, you should consider including one of these plans. To find out which plans offer out-of-state coverage, review our 2024 Small Group Plans .