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Michael Jakob

Understanding Health Insurance Minimum Participation Requirements (MPR)

One key factor when offering employees health insurance is the minimum participation requirement (MPR). Many insurers require a certain percentage of eligible employees to participate in the company-sponsored health plan. This ensures that the risk pool is large enough for the plan to remain sustainable and affordable for the business and the insurer.


Typically, the MPR is set at 75%, meaning that three-quarters of eligible employees must enroll in the health plan. However, the premium that the employer pays can influence this requirement. For instance, insurers may allow for a lower participation threshold if an employer contributes a larger portion of the premium.


Importantly, employees who have alternative insurance options, such as coverage through a spouse or domestic partner, are generally not counted towards the MPR. This helps businesses maintain compliance without needing to enroll every single eligible employee.


Why Meeting the MPR Matters

If your business falls below the MPR, you may face increased premiums or lose your group health plan coverage. Encouraging participation and making your health plan as appealing as possible to employees is essential.


At NYSmallHealth, we understand the challenges of meeting these requirements and offer support to help you maximize enrollment. In our next blog, we'll dive into strategies to promote health plan participation and discuss incentives that can boost employee enrollment. Stay tuned!

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