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Greetings fellow pros,
I only do group health in my domiciled state of CT. However, I wanted to familiarize myself with group health rules in other states and was wondering what is HIPAA based and what is state-specific. For example, in CT, working 30 hours per week is considered a full-time employee. Is that specific to my state or is that HIPAA?
Other questions:
*In other states, is a 75% participation factor in the absence of spousal waivers pretty much standard practice or do some group carriers allow a lower participation percentage.
*Is there a minimum participation percentage established by HIPAA?
*In CT, the minimum premium an employer must contribute to an employee's plan is 25%. There is no participation minimum on dependents. Is that state specific or HIPAA?
*In a nutshell, what exactly is ERISA? Since I mainly do groups of 1 to 3, ERISA is never a factor according to my carriers when I ask them what to answer on the applications when ERISA is asked about.
*In CT, we have group of 1 options that are underwritten to a degree. Approvals can have their choice of the carrier's plan. Declines are reverted to a statutory plan that all group carriers must offer a legitimate group of 1. The statutory plan is actually a decent plan but with a capped pharmacy benefit. In NH, groups of 1 are guaranteed issue but have only two open enrollment periods throughout the year. How do the rest of the states work for groups of 1? All states seem to be different in this regard.
Newmindfashion (NMF)
I only do group health in my domiciled state of CT. However, I wanted to familiarize myself with group health rules in other states and was wondering what is HIPAA based and what is state-specific. For example, in CT, working 30 hours per week is considered a full-time employee. Is that specific to my state or is that HIPAA?
Other questions:
*In other states, is a 75% participation factor in the absence of spousal waivers pretty much standard practice or do some group carriers allow a lower participation percentage.
*Is there a minimum participation percentage established by HIPAA?
*In CT, the minimum premium an employer must contribute to an employee's plan is 25%. There is no participation minimum on dependents. Is that state specific or HIPAA?
*In a nutshell, what exactly is ERISA? Since I mainly do groups of 1 to 3, ERISA is never a factor according to my carriers when I ask them what to answer on the applications when ERISA is asked about.
*In CT, we have group of 1 options that are underwritten to a degree. Approvals can have their choice of the carrier's plan. Declines are reverted to a statutory plan that all group carriers must offer a legitimate group of 1. The statutory plan is actually a decent plan but with a capped pharmacy benefit. In NH, groups of 1 are guaranteed issue but have only two open enrollment periods throughout the year. How do the rest of the states work for groups of 1? All states seem to be different in this regard.
Newmindfashion (NMF)
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