How can we help?

Employee classification & benefits eligibility

Health insurance eligibility refers to which types of employees are given the option to enroll in your company's insurance offerings.

Your company determines eligibility when you set up your insurance package and you can only make changes at renewal. If you offer benefits to one group of employees, you must offer benefits to everyone in that group. That is, if you choose to make part-time employees eligible, you can't just choose a couple part-timers — all employees who work the minimum hours will be eligible.

The way you classify your employees determines their health insurance eligibility, so pay attention to their coverage implications if you change an employee's status

Full-Time (30+ hours per week)

Employees who work 30 hours or more in a week on average are always eligible for health benefits.

Part-Time (20-29 hours per week)

Employees who work between 20 and 29 hours in a week on average may be eligible for health benefits, depending on the carriers' rules in your state and whether your company included part-time employees when you set up your insurance package. 

Part-Time (0-19 hours per week)

Employees who work less than 20 hours in a week on average are never eligible for health benefits (carriers’ rules, not ours!).

Variable (hours vary every week)

Employees who have unpredictable working hours and the employer can’t determine if the employee will work an average of 30 hours per week based on the initial measurement period. Learn more from our Help Center article on variable hour employees.

Seasonal employee

Employees who are hired into a position that will last 6 months of the year or less. 

Dependents

If an eligible employee enrolls in medical, dental, or vision coverage, their dependents are eligible to enroll in those plans as well. 

Note: Some states have minimum hour requirements that differ from the numbers above. Your specific state’s requirements may vary. We recommend reaching out and talking with a licensed advisor to discuss your needs.

Payroll, benefits, HR and more.