Florida Group Health Insurance
Self-Employed Persons or Business with 1 to 3 Enrolled Employees

On July 1, 2000 legislation went into effect that dramatically changed small group health insurance and particularly group health insurance for self employed persons and businesses with one employee.  Briefly, the legislation allows insurance carriers to rate a business based on the health conditions of the companies employees.  This is a change from the community rating system in effect since 1994.  Self employed persons and businesses of one employee will only have one open enrollment period a year.  That period is August 1.  The first open enrollment period will be August 1, 2001.  Underwriting can be much stricter and if approved insurance for self employed persons and businesses of one would begin October 1. 2001.  The business would not be able to apply at any other time of the year and strict underwriting guidelines would be adhered to.  You will probably find it extremely difficult to find any insurance agent willing to work on these cases.

When the US Congress passed HIPAA, they addressed businesses with 2 to 50 employees. They did not address self-employed persons or businesses having one employee. Federal law sets most of the guidelines the states must follow for businesses having 2 to 50 employees. There is room for the individual states to set standards for rates, but in all states health insurance must be guaranteed issue for 2 to 50 employee businesses.

In most things, we believe that if something is being offered for sale, then the seller wants a buyer. In the case of guaranteed issue health insurance for very small businesses, the insurance companies and HMO's do not want a buyer, they are required by law to offer it. 

Health insurance in Florida is guaranteed issue for self-employed persons and 1 employee businesses. The open enrollment application period is August of each year for October 1 effective dates. 

Florida does allow the insurance carriers to set underwriting standards for these businesses. Some of the companies have begun requiring the premium be paid by a check from a business account. Most self-employed persons don't have or need a business account. This means the those particular companies will reject the application as not meeting the underwriting requirements. It has become increasingly difficult to get self-employed persons and very small businesses approved for health insurance. A great deal of time, effort and aggravation is involved. The companies pay the agent almost nothing even if the case is approved.  It becomes a financial loss to an agent to provide group health insurance.  

There are very few small group insurance carriers in Florida.  Insurance companies and HMO's do not like that business health insurance is guaranteed issue. They would prefer to be able to select who they could insure and under what conditions. They have said that small groups are a financial loss to them.   The companies would prefer not to do it. 

There have been 5 HMO's in bankruptcy since March 1998.  Other insurance companies have ceased to offer small group health insurance.  Many companies will not give quotes for groups with less than 4 enrolled employees and others also require 2 years of complete business tax returns as well.

Beginning in 2003, due to the losses on the self employed businesses, the legislature has allowed the carriers to rate up self employed persons another 50%.  This means that the rates for being insured will be higher than the rates a person would have on individual health insurance, if the person can qualify for individual health insurance.

Please note that HSA plans, Health Savings Accounts, are also offered as Individual Health Insurance.  Further information on these and other individual health insurance plans can be found at Individual Health Insurance. 

All insurance companies require tax forms to qualify as a business. Two proofs are required one being taxes.  The following is required:

Individual health insurance plans are medically underwritten and do not fall under the business guidelines. Individual PPO plans have the most freedom in determining who they will take and under what conditions. Rates are often less for these plans than as a business. For more information see