Business Eligibility Criteria
For a business to participate in HealthShare, it must meet the following criteria both at the time of application and, except as specified otherwise below, throughout the entire period of its participation:
- qualify as a business according to IRS definition
- be located in one of the following counties:
- St. Louis
- Must have one or more W-2 employees.
- Must employ at least one but no more than 50 employees at the time of initial enrollment in the program. Employee count is based on weekly payroll hours. 2,000 hours or less per week qualifies as 50 of less employees.
- The median wage of all employees within a specific Designated Employee Group at the date of application must meet the current wage qualifier established by HealthShare, currently $18.22 per hour.
- The business does not offer health coverage to one or more of its Designated Employee Group(s) at the time of application and did not offer it to that Designated Employee Group during the 12 months preceding the date of application. Full-time and part-time employees are considered separate Designated Employee Groups for this test. Or, the business does offer health coverage to one of more of its Designated Employee Groups, but contributes less than 50% to the employees'' monthly premium.
- The business can have a traditional health insurance plan and still offer HealthShare. The uninsured employees that don''t qualify for an existing plan could be eligible for HealthShare. However, and employee cannot drop existing health insurance in order to enroll in HealthShare unless the plan is a COBRA policy or Major Medical/Catastrophic policy.
Once enrolled, businesses are required to:
HealthShare may formally review a business''s eligibility for continued program participation at least annually.
- Offer coverage to all uninsured Employees who work and are paid for an average of 15.5 hours or more per week.
- Offer dependent coverage to all uninsured dependents of all Employees of the Designated Employee Group.
- Pay a minimum of $60 towards the monthly cost for each Employee; business is not required to contribute to the dependents'' monthly cost
- Execute the HealthShare Employer Contract and comply with its terms
- Notify HealthShare immediately upon discovering it fails to meet any of the employer eligibility criteria or that any employee fails to meet any of the employee eligibility criteria