Kaiser Permanente Small groups with effective dates from September 1, 2018, to January 1, 2019, will only need to meet 50% health plan participation rate instead of 70%. This means only 50% of eligible employees will need to be covered by a group health plan to offer Kaiser Permanente.
- Minimum participation rate is 50% of eligible employees are covered in a group-sponsored health plan for new business.
- We’ll continue to write small groups with one enrolling subscriber.
- There’s no change to our counting methodology for valid waivers.
Example: A group of 6 with 2 enrolling with KP, one declining for spouse’s employer plan and 3 waiving. Does this group qualify?
- Yes! This group has 50% in a group-sponsored health plan; 3 in a group sponsored plan, and 3 waiving = 50%.
An employee is considered to have a group health plan and count toward the 50% participation rate requirement when:
- They enroll in a Kaiser Permanente plan offered by the group.
- They decline coverage due to enrollment on another group health plan.