California Self Employed Health Insurance

Florist Businesswoman

Self-employed business owners often have two options when it comes to getting a healthcare plan. You can apply for individual or group health insurance coverage. It is worthwhile to consider comparing both types to find the right fit for your family and business. As you go through the benefit and price comparison, consider the following advantages of the two types:

  • Medical Underwriting

    Group health insurance in California is not subject to medical underwriting. It is a guaranteed issue so long as you qualify as a business. There are no medical questions and no denials for pre-existing conditions. On the other hand, you can be denied when applying for an individual health plan.

  • Affordability

    Private coverage tends to have slightly more affordable prices. However, if you are looking for California self-employed health insurance coverage for a newborn or multiple children, it might be more cost-effective to go with a business plan.

  • Adult Children

    Children ages 19 through 25 can be included as dependents on a group plan, and thus, not be subject to medical underwriting. This is good news for young adults with pre-existing medical conditions, as they could be non-approved for private health insurance. Also, he or she is not required to be a student, single, or live with the parents, in order to be a dependent on the group policy

  • Employee Coverage

    At some point you may want to add employees to your California self-employed health insurance. If you are planning to grow your business and workforce, being able to offer a health benefits package is a great way to attract solid candidates. 

Do I qualify for California group health insurance because I'm self-employed?

To get private California self-employed health insurance, you must pass medical underwriting and be approved on an individual basis, but to qualify for group coverage your business has to meet certain criterion. Self-employed proprietors are eligible for small group insurance when there are two people on group coverage. One owner and one employee will often qualify. Also, husband-wife businesses where both owners' names are listed on the Business License, Fictitious Name Statement, Seller’s Permit, or other similar document can qualify. Kaiser Permanente California requires a minimum of two people to work at the company in order to qualify for business medical coverage. However, in some instances, the husband and wife do not both have to enroll on the Kaiser Permanente employer’s plan in order to have California self-employed health insurance. If one spouse is covered under another group plan, this would qualify as a "valid waiver" and the other spouse could be enrolled on a group plan by himself or herself. See the list below for examples of valid and invalid waivers.

Valid waivers: 

If your spouse is insured under any of these plans, you could still be eligible for small business California self-employed health insurance with one enrollee:

  • Medicare
  • Medi-Cal
  • Group medical insurance through another employer
  • Veterans’ Plan.

Invalid waivers: 

If your spouse is covered under any of the following plans, you would not be eligible for California self-employed medical insurance coverage, unless you have at least one other eligible employee:

  • COBRA ("Consolidated Omnibus Budget Reconciliation Act")
  • MRMIP ("Major Risk Medical Insurance Program")
  • HIPAA ("The American Health Insurance Portability and Accountability Act of 1996")

If you have further questions about California self-employed health insurance or would like a quote over the phone, call us at 1-800-514-0958.