Who Can Qualify for My Employee Benefits?

Posted February 24 2021


Happy multiethnic family having fun while using laptop together, video chat conceptReceiving benefits from your employer is something that all employees appreciate. The question is who is eligible to receive benefits, and when is it required for an employer to offer them.

Who Can Qualify for My Employee Benefits?

There is a short answer and a long answer. The short answer is “eligible employees”. However, there are many different scenarios where more people may qualify.

Eligible Employees

“Eligible employees” which is sometimes defined by the health plan and the group’s employee handbook. Generally speaking, it is full-time employees working at least 30 hours per week. Businesses have no obligation to offer health insurance to part-time employees. However, not every company is required to offer benefits to their full-time employees, but if there are more than 50 full-time workers on the books, then that company is required to offer healthcare benefits, covering 50% of the employee premium of the lowest cost health plan. Some businesses elect to cover even more of the premiums as an additional form of compensation.

Dependents

Per certain rules and laws, eligible dependents are defined as a “qualifying child” or “qualifying spouse or domestic partner”, but premium responsibility is based on the defined employer contribution. To claim a child as a dependent, they must meet the qualifying criteria, which means they must be a certain age, which is based on the selected policy and the home state of the group. An employer is not required to cover the premium of any dependents, and it is typically deducted from the employee’s paycheck. However, some businesses also elect to cover a portion or all of the premium as another additional form of compensation.

Spouse or Partner

In some places, the only way to get health insurance for your partner is if they are your spouse. Depending on the company and the health insurance, you may be able to add someone to your plan if they are your domestic partner. If that scenario applies to you, it’s important to clarify the requirements ahead of time, and ask questions!

Selecting the right health insurance plan for you or your employees can be a difficult task, but the experienced insurance brokers at MHG are glad to help you sort through the terminology and key features to determine the best health insurance plan for your situation. Our Insurance Specialists will help you assemble a complete insurance offering that includes health insurance, gap insurance coverage, life insurance, disability, and more. Call us today at 954-828-1819 or visit us online at mhginsurance.com for help in selecting the ideal health insurance plan for you and/or your employees.