Most employers are eligible to participate. A list of ineligible businesses is shown below. Firms in business less than two years, firms not participating in Social Security, and firms with employees residing on employer’s premises are also ineligible.
Eligible employees are those actively working full time for a minimum of 30 hours per week year round (non-seasonal) who have satisfied the employer’s minimum service requirement.
All future eligible employees can be enrolled within 30 days of hire or within a time frame consistent with company new hire probation policy
- 2 to 5 eligible employees – all must be insured
- 6 to 9 eligible employees – all but one must be insured
- 10 to 19 eligible employees – 75% must be insured
All coverage will be effective on the 1st day of the month, contingent upon the HMO’s enrollment requirements. Enrollment materials should be received by the 25th of the preceding month.
Employers must contribute at least 25% of premium. If the employer
pays 100% of the premium, all eligible employees must be insured.
The following types of groups are ineligible for the SmartChoice LTD Plan:
SIC Code Industry Classification
0111-0971 Agriculture, Forestry, Fishing, Hunting & Trapping
1011-1241 Metal & Coal Mining
1311-1499 Oil/Gas Extraction, Mining & Quarrying
1611-1629 Heavy Construction
1761-1799 Special Trade Contractors
2111-2141 Tobacco Products
2411-2431 Logging, Sawmills & Millwork
2611-2631 Pulp/Paper Mills
3482-3489 Ordinance & Accessories
4311 U.S. Postal Service
5541 Gasoline Service Stations
5812-5813 Eating & Drinking Places
5921 Liquor Stores
5983-5989 Fuel Oil Dealers
7381 Detective, Guard or Armored Services
7911-7999 Amusement & Recreation Services
8082 Home Health Care Services
8811 Private Households
8999 Services, Nec
9221-9229 Public Safety
9711-9999 National Security/International Affairs
NOTE: For SIC Code range of 8011-8099, Health Services, Doctors (including Anesthesiologists) and Dentists are ineligible for SmartChoice LTD coverage. The other employees of the Health Services offices are eligible for coverage.