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A group is defined as at least 2 people, at least one of whom is paid on a W-2 basis and who is not related by marriage to any owner of the business. Partner-only businesses are no longer eligible for group plans under the Affordable Care Act.

Generally you need to provide documentation of the legitimacy of your business and sufficient payroll history to show you've been around at least a short while. The types of documents usually include a business license, proof that you are registered with the California Secretary of State's office, a Statement of Information listing business owners and address, and any DBA (Doing Business As) paperwork if applicable.

For payroll purposes, most insurance carriers will insist on a copy of the latest DE-9C Quarterly Contribution Return and Report of Wages form showing that at least one full time employee has been active for at least half of the prior calendar quarter. However, some carriers will accept less payroll, especially if you are a newly incorporated startup. If you have questions as to whether a group plan is a viable option, please contact us.

In some instances, a group plan will not consider an individual or family plan a qualifying reason to waive coverage. We can help you sort out the factors in play and find the right solution.

Except in one particular circumstance, you cannot. This is specifically prohibited under the ACA and carries stiff tax penalties of up to $36,500 per year per employee if you are shown to be reimbursing for open market plans.

There is a particular type of Health Reimbursement Arrangement (HRA) that small businesses can set up to allow partial reimbursement for purchase of plans on the individual market. This <strong>Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) must be done instead of a standard group plan and has far fewer protections for employers and employees. These arrangements do not have access to group plan networks, have no provisions for enrolling employees in coverage if they have missed the standard open enrollment period.

If you are a small group between 1-50 employees, you are not required to put a plan in place. However, the plan options available for groups are substantially more comprehensive than those available on the individual and family market.

You are eligible as soon as you turn 65. However, if you are still working and your company provides benefits, you can delay signing up until you are ready to leave the company. If your company has under 20 employees, let us explain.

4 months prior to the month of your birth, you can go to Medicare.gov and apply online for Medicare. If you are already receiving Social Security, a Medicare card will be sent to you automatically. If the card shows Part A and Part B and you don't want Part B yet, you'll need to fix this with the Social Security Department.

Part A is free. Part B for 2015 has a base cost of $104.90 per month. This is based on an adjusted gross income of $85,000 for an individual and $170,000 for a family. If your income is higher, the cost will be higher. Here's the link for higher incomes. Part D is a separate product for prescription drug coverage, and the government cost for Part D is free but it can cost if you are a higher earner.

Medicare definitely does not pay for everything, and it is a good idea to buy a Medicare Supplement (Medigap) or a Medicare Advantage plan to augment Medicare.

Advantage plans are typically HMO-type programs where you select a primary care physician and are referred to specialists and hospitals by that physician. Kaiser Senior Advantage is the primary example of this that most people know about.

A Supplement plan allows you to any provider nationwide as long as they accept Medicare patients. A Plan F is the most comprehensive Supplemental plan and covers 100% of what Medicare Part A and Part B do not cover for any claims that are a Medicare-permitted expense. There are other options to reduce costs.