Welcome to Dimensions Incorporated

FAQ -- Small Employer Health

Does NJ State Law require that businesses provide health benefits for their employees?

No. If the employer chooses to offer health benefits, they must comply with the requirements of the law. For more information, contact us.

Is a small employer required to offer a health benefit plan to all of its employees?

No. However, if a small employer does not offer coverage to all employees, the factors determining which employees will be offered coverage must be based on classes of employees. The classes of employees must be based on factors that relate to employment (for example: hourly, salary, job title, length of service, etc). Other kinds of distinctions may not be legal. For more information, contact us.

How many eligible employees must participate in the group plan?

75% of eligible employees must participate in the group plan.

Is group coverage in NJ Small Employer Health Benefits Program available to a self-employed husband and wife?

The husband and wife must be eligible employees of the business. For more information, contact us.

How many employees must an employer have to be considered a Small Employer in NJ?

Businesses with a minimum of 2 eligible employees or maximum of 50 eligible employees, for the preceding 12 months, are considered a Small Employer in the State of New Jersey. For more information, contact us.

Can an employer institute a waiting period before employees can enroll in a NJ Small Employer Health Benefit plan?

The employer has the option of electing a waiting period of up to six months.

In a NJ Small Employer Health Benefits Plan, what are the minimum number of hours an employee must work to be eligible for health benefits?

NJ State requires that an employer use the 25-hour standard for determining eligibility for health benefits plan.

When can a carrier impose Pre-Existing Condition Limitations on a NJ Small Employer Health Benefits Plan?

In groups of two to five employees, a carrier may decline to pay (for six months following the member's eligibility date for coverage) the treatment of a medical condition which was diagnosed and/or treated in the six months prior. In groups of six or more employees, the carrier may not impose pre-existing limitations, except in the case of late enrollees.

What factors do the carriers use to calculate insurance premiums?

Carriers may use demographic information (the location of the group), age of employees, gender, and family status.

Are small employers permitted to offer more than one health benefit plan to their employees?

Yes. For more information, contact us.

Are eligible employees on Medicare permitted to participate in the employer's group plan?