| Criteria |
Information |
| Underwriting Guide |
No information yet |
| Small Group Definition |
No information yet |
| Employer Contribution |
No information yet |
| Carve-Outs / Varied Offerings |
No information yet |
| Participation Requirements |
No information yet |
| NPNC Groups |
No information yet |
| Valid Waivers |
- Other Group Coverage
- Individual Coverage
- Enrolling as a dependent in a group health plan through a different employer
- Medicare
- Medi-Cal
- TRICARE
- Indian Health Service (Native American Tribal Coverage)
|
| Residency Requirements |
No information yet |
| W-2 Enrollment Requirements |
Requires W2 common law employee to enroll unless the group is a true Owner Only Group with no W2 common law employees. W2 cannot be owner/officer or spouse/domestic partner of the owner/officer. |
| Owner Only Groups |
UnitedHealthcare will accept Owner Only groups as long as the groups’ business entity is a type of Corporation such as LLC, S-Corp or C-Corp. At least 2 eligible owners are required. |
| Husband & Wife Only Groups |
Spouses Only / Domestic Partner Only Groups are not eligible for coverage. |
| One-Person Groups |
No information yet |
| Slice Business |
No information yet |
| Employers Replacing Coverage |
No information yet |
| Start-Up Group Requirements |
- All groups must be true Start-Up. An existing group that just hired their first W2 is not eligible
- Group must be in business 6 weeks prior to the requested effective date and provide at least 2 weeks of payroll IRS or Secretary of State letter indicating issued tax ID number is required to support evidence of time in business
- Evidence of time in business must also be supported by payroll records. The payroll records must cover the 2 weeks preceding the requested effective date for at least one eligible employee
- The group must have and maintain business licenses and/or appropriate state filings allowing the company to conduct business in the state of California
- Owner Only Start-up Groups are not eligible
|
| Common Ownership Guidelines |
- Copies of the filed/stamped Statement of Information reflecting all officer/owners, or signed/dated Partnership Agreements listing all partners’ names
- A letter from the employer’s CPA stating that all business entities are eligible to file a combined tax return Submission of a completed and signed Common Ownership Certificate form
- All companies in the common ownership group must appear as Active on the California Business Portal Common ownership groups must meet the definition of a small employer when combined
|
| Spin-Off Groups |
No information yet |
| Employers with Union Employees |
No information yet |
| Employers Leaving a PEO |
No information yet |