Plan Participation Requirements

Please note that all insurance carriers mandate than an employee benefits plan purchaser maintain a minimum percentage of the total eligible employees in an employee benefits plan. If you as the employer pay 100% of the premium due for an employee benefits plan, then ALL employees must participate. If the employees contribute any payment toward the premium of any employee benefits plan, the following minimum participation requirements apply.


Since insurance carriers in Illinois require life insurance to be purchased with a medical plan, most carriers require at least 50% of all eligible employees to participate in an employer’s sponsored medical plan and at least 75% of all eligible employees in the life insurance portion of the employee benefits plan.


If you offer dental coverage, carriers require at least 75% of all eligible employees to participate in the plan. Groups of less than 5 employees are required to maintain 100% participation. The dental plan that Executive Fidelity provides to you at no cost has a no minimum participation requirement.


If you offer long and/or short term disability coverage, carriers require at least 75% of all eligible employees to participate.

If for any reason, your group does not meet the above participant requirements, your employee benefits carrier will allow 60 for you to meet the minimum participation requirement. If you do not meet the participation requirement with the 60 days, your coverage will be terminated.


Eligibility for coverage is determined by you, the employer. Only full time employees are eligible for any employee benefits package. You, as the employer, set the minimum number of hours required for an employee to be considered a full time employee. The default number of hours worked to be considered full time is 30 hours per week. You have the ability to reduce the number of hours to a minimum of 20 hours or increase the number of hours to a maximum of 40 hours per week.

You also have the ability to exclude classes of employees from eligibility. The class exclusion is limited to hourly, salary, union or non-union. At the original contracting date with your employee benefits carrier, you determine the eligibility guidelines for your group. As such, you cannot change the contracting eligibility terms with your present insurance carrier.