Eligibility Guidelines
ELIGIBLE COMPANIES
To be eligible for coverage a company must:
- Be an active business
- Enroll 1-5 eligible employees (owners included)
- Contribute 50% of the Individual and 33% of the Family premium
- Employers can only be located in zip codes starting with 010, 011, 012 or 013.
ELIGIBLE EMPLOYEES
An eligible employee is one who:
- Full Time: Works at least 30 hours per week for the employer
- Part Time: Works at least 20 hours per week for the employer
- Lives within the Health New England service area
NEW EMPLOYEES
- All future eligible employees can be enrolled within a time frame consistent with company new hire probation policy
WAIVER OF COVERAGE
Full Time employees can be excluded who are:
- Covered by a spouse’s or parent’s health plan
- Covered by Masshealth, Medicare or Veteran’s Coverage
- Living outside the Health New England service area
PARTICIPATION REQUIREMENTS
Groups of 1 - 5
- 100% of eligible employees must enroll
PLAN SELECTION
- Employer groups are allowed to select two plan options
If selecting a dual option of HMO & PPO, the plans must match metal tiers.
EFFECTIVE DATES
All coverage will be effective on the 1st day of the month, contingent upon the carrier’s enrollment requirements. Enrollment materials must be signed by employee and employer and received by HSA prior to the effective date of coverage