If you’re struggling with Group Medical participation rules, the Special Open Enrollment Window is the time to enroll them in coverage.

The Affordable Care Act (ACA) requires health insurers to offer a one-month Special Open Enrollment Period, where eligible small groups can enroll in coverage without having to meet standard employer- employee-participation guidelines.

When you stay within the small business FOE window, you will not be required to meet the normal participation requirements for small groups.

This means you can have a group of 35 employees on payroll with only 1 employee enrolling. This is good news for businesses that would not be eligible because of participation requirements.

The Special Open Enrollment Period allows eligible small groups to enroll for coverage for a 1/1 effective date in every state. Additional effective dates in November and December are available but vary by state and carrier.

A group application must be fully submitted to the carrier between 11/15 and 12/15 or the group will be subject to participation and contribution requirements. There are NO EXCEPTIONS to this rule.