Plan Administration Guidelines
 
 

Employers

Are You Eligible For WINhealth Partners?

WINhealth Partners makes it easy for your business to join our HMO. If you meet the following criteria, you may be eligible for WINhealth Partners’ coverage:

A business must have a minimum of two employees under a formal employment arrangements .
Employees must work at least 30 hours per week, 48 weeks per year to be eligible and must be compensated on a salaried or hourly basis with deductions for Federal Income Taxes and Social Security by the employer.
The employer must pay at least 50% of the employee premium or 25% of the total employee and dependent premium.
Contributory Plan: In groups of 2 to 50, the participation of at least 75% of eligible employees is required. Employees who have other coverage or are otherwise considered ineligible, are not included in this percentage.
Noncontributory Plans: 100% of eligible applicants must apply for coverage if the employer pays the full premium.
Seasonal industries or those businesses not continuously in operation for 12 months per year are not eligible. Business must have been in operation for at least six months prior to application for coverage.
Partners and owners are eligible for coverage. Directors are eligible if they meet the above requirements as employees.