In Idaho, when a small business offers group health insurance (aka a “small employer health benefit plan”), it must follow both federal law (such as the Affordable Care Act) and Idaho‑specific statutes and rules — especially those in Idaho Code Title 41, Chapter 47 (“Small Employer Health Insurance Availability Act”) and the implementing rules (IDAPA 18.04.12). More information: doi.idaho.gov/consumers/health-insurance/group-health

1. Who Qualifies as a Small Employer in Idaho?
A small employer is defined as one that employs at least two (2) eligible employees but no more than fifty (50) eligible employees, with the majority of such employees employed in Idaho. Eligible employees typically work at least 30 hours per week (or by agreement, between 20–30).
2. Employee and Dependent Eligibility
Eligible employees work 30+ hours per week, and employers must offer coverage to all eligible employees. Some insurance companies will allow you to offer coverage to part time employees who work at least 20 hours per week.. Dependents include a spouse and unmarried children under 25, or any age if disabled and dependent.
3. What Insurers Must Do (and What You Cannot Be Denied)
Idaho insurers must offer guaranteed issue coverage to small employers (2–50 employees) without denial based on health status. Premiums may vary only by age, geography, tobacco use, and family composition.
4. Enrollment & Participation Requirements
Carriers may impose minimum participation (often 70%) and contribution (commonly 50% of employee-only premium) requirements. Waiting periods for new hires may apply (0–60 days).
5. Enrollment Periods & Special Situations
Employees must be offered coverage during the initial enrollment period or special enrollment due to qualifying events (marriage, birth, loss of coverage).
6. Plan Renewability & Termination
Plans are renewable at the employer’s option unless canceled for reasons like nonpayment, fraud, or failing participation/contribution requirements.
7. Tax Credits & SHOP Program
Idaho small employers (1–50 FTEs) can use the SHOP Marketplace via Your Health Idaho. Businesses with fewer than 25 FTEs and average wages under about $56,000 may qualify for the federal Small Business Health Care Tax Credit.
8. Important Idaho‑Specific Rules
Refer to Idaho Code § 41‑4703 and IDAPA 18.04.12 for legal definitions and compliance standards. Carriers must market all plans to small employers and cannot medically underwrite employees individually.
9. Tips for Idaho Small Employers
• Start enrollment early.
• Verify who qualifies as eligible employees and dependents.
• Track participation and obtain signed waivers.
• Maintain compliance and records.
• Consult Idaho‑licensed brokers or DOI for guidance.
10. Key Takeaways
• Small employers in Idaho = 2–50 employees.
• Must offer coverage to all eligible workers.
• Guaranteed issue—no denial based on health status.
• Must meet participation/contribution rules.
• May qualify for federal tax credits via SHOP.