Can you have a 1 person "group" plan?

[Belgarath]

I probably don't even have enough information to properly ask this question, but I thought I'd give it a shot.

I don't know whether this relates specifically to a section 125 Cafeteria plan, or some other form of welfare benefit plan. I THINK the question revolved around whether the 1-person employer could be considered as having a "group" health insurance plan, in order to be eligible for some sort of welfare plan with dependent care benefits, etc...

Does anyone know, offhand, what the governing authority is for defining a "group" plan for such purposes? Or any other pertinent items? Thanks.

[Peter Gulia]

Which definition of group health plan applies or is relevant turns on which law, rule, or insurance regime one seeks to apply or non-apply.

Not all definitions are the same.

Also, regarding a "micro" business, some of the definitions can be confusing or ambiguous concerning who counts (or doesn't) as an employee.

[Belgarath]

Ok - I asked the individual, and here's the actual question:

"Section 125/Cafeteria Plan and Health Reimbursement Arrangement eligibility is tied to eligibility for group health insurance; what constitutes group health insurance? Could a C Corporation owner and spouse’s coverage be considered “group” insurance or would that same owner/employee need one or more people (non-family member) to be considered group insurance?"

Thanks.

[Peter Gulia]

Would the spouse be covered because he or she is an employee's spouse?

Or would the spouse be covered because he or she is an employee?

[Belgarath]

I'm assuming the former. But it could be either... - however, I think if the latter, then it could indeed be considered a "group" - so I guess my question really is about if there is only 1 employee.

[Peter Gulia]

If the only worker is the one shareholder, it seems unlikely that there is a group.

But is having a group a condition for the health-insurance income tax treatment your client seeks?

[Belgarath]

Thanks. Apparently (and I'm getting this second-hand) the cafeteria plan specifies that eligibility is such that the employee must be eligible for the employer's group health insurance - or something like that. I don't know if this is a regulatory/legal requirement, or a document eligibility provision (or both). So the question is apparently whether a 1-employee plan can be considered "group" health insurance.

Does this perhaps vary by State?

[lvena]

You should investigate a Section 105 option, I do not keep up with this anymore, but it might be a better fit. Suggest you use an administrator that does this, such as Core or some other.

[Belgarath]

Thanks.