· With few exceptions, small employers cannot be turned down. This is called guaranteed issue. If you employ at least 2 people, but not more than 50 people, health insurance companies must sell you any small group health plan policy they sell to other small employers if your group meets the participation requirements. An eligible employee is one who works 24 hours or more a week on a regular basis, including household employees.

However, insurers can require that a minimum percentage of your eligible employees sign up for coverage. They can also require you to pay a minimum share of your workers’ premiums. If you are buying a large group health plan policy for 51 or more employees, your group can be turned down.

· Under no circumstances may you be turned down or charged more because of the genetic information of someone in your group. In addition, insurance companies may not even ask about genetic test results or family history of people in your group when you apply for coverage.

· Your insurance cannot be canceled because someone in your group becomes sick. This is called guaranteed renewability and it applies to group plans of all sizes. Insurers can impose other conditions, however. They can require you to meet minimum participation and contribution rates in order to renew your coverage. Additionally, they can refuse to renew your coverage for nonpayment of premiums or if you commit fraud, or if they are discontinuing that health plan or if they are withdrawing from the small employer market. In the case of discontinuance, they must give you a chance to buy other plans they sell to groups of your size.