Health insurance requirements—and opportunities—differ depending on your business size. If you have between 1 and 99 employees, you may qualify as a small group under California law, giving you access to exclusive health insurance plans and potentially lower premiums.
What Is a Small Group?
In California, a small group health plan is available to businesses with:
- 1 to 100 full-time equivalent (FTE) employees
(Note: While the federal Affordable Care Act (ACA) defines small groups as 1–50, California extended this to 100.)
Even if you only have one employee besides the owner, you may qualify.
What Determines Group Size?
To determine your status, count:
- Full-time employees working at least 30 hours per week
- Part-time employees (converted to full-time equivalents)
Seasonal and temporary workers may be excluded, and owners may not always count, depending on business structure.
Why It Matters
If you qualify as a small group:
- You can access guaranteed-issue coverage—no employee health questionnaires required.
- You’re eligible for small group-only rates and networks.
- You may qualify for tax credits through Covered California for Small Business.
Special Note for Sole Proprietors
If you’re a sole proprietor with no W-2 employees, you’re not eligible for small group coverage. But with one W-2 employee, you may qualify.
At Rice Insurance Benefits, we walk you through these rules, verify your eligibility, and help you find the most cost-effective plan for your team.
Not sure if your business qualifies as a small group?
Contact Rice Insurance Benefits. I’m happy to answer any questions you may have.
