The basic things you can do are:

• Share more of the insurance premium cost with employees.
• Choose medical plan designs that neutralize cost increase components by providing incentives for more cost effective plan usage, while channeling patients to the appropriate provider and treatment options. HSA-compatible plans are an example. Other examples are encouraging use of centers of excellence, disease/case management programs and eliminating fixed dollar co-pays.
• Aggressively seek out more competitively-priced insurance companies.
• Individual Health Management — Offer incentives to use preventive care and wellness services.

At least two employees have to enroll, but a business still has to meet the insurance company's employee participation requirement.

As a general rule, at least 75% of eligible full-time employees must either enroll in the plan or have other group coverage through their spouse. In addition, at least 50% of all eligible employees must actually enroll. No participation requirements apply to dependents.

New employees can enroll upon completion of the initial probationary period. Employees who don't enroll at that time must wait for open enrollment (usually the policy anniversary date) or a for a qualifying event.

An employee's dependents can enroll upon completion of the new hire probationary period. If dependents are not enrolled at that time, they must wait for open enrollment (usually the policy anniversary date) or a for a qualifying event.

A newborn baby can be added as of the birth date, but it's critically important that the insurance company be notified within 30 days. Otherwise, the employee may be stuck with the nursery bills and the baby's health insurance will have to wait until open enrollment or a qualifying event.

A qualifying event is an occurrence (such as death, termination of employment, divorce, etc.) that changes an employee's eligibility status under a group health plan. The term is frequently used in reference to COBRA eligibility, but it can also refer to an event enabling an active employee to make a coverage change at some time other than open enrollment.

As a general rule, the employer must fund at least 50% of the employee health insurance premium. The employer is not required to fund any portion of the dependent health insurance cost.

Persons who have satisfied the prior plan's pre-existing condition exclusion should be credited likewise under the new plan. Persons who have partially satisfied the prior plan's pre-existing condition exclusion should have the same status under the replacement group plan.

The law states a group of 2-50 employees cannot be denied group health coverage for medical reasons. However, a small group application can be rejected if the organization does not meet the insurer's participation and employer contribution requirements.

Though its provisions may be adjusted from year to year, COBRA basically applies to employer groups that averaged 20 or more full-time employees during the previous calendar year.

Though group health rates are set for twelve-month periods, the group can terminate coverage anytime during the policy year. If you want to switch to another group insurance company, you don't have to wait until your policy anniversary.

No. Many group health insurers have "combo" plans, providing employees a choice of traditional PPO or HSA-compatible coverage. These plans are available for groups with as few as two employees.