If you’ve never offered health insurance to your employees, the hard part usually isn’t picking a plan. It’s knowing what order to do things in, and which rules nobody warned you about apply to you.
Who counts as an eligible employee
A small employer in Maine is a business with 50 or fewer eligible employees, and at least one has to be someone other than you or your spouse. An owner and spouse alone can’t form a group.
Eligible means an employee who averages 30 or more hours a week. Anyone below that line isn’t counted.
Coverage is guaranteed issue. No employee can be turned down, there are no pre-existing condition exclusions, and nobody has to answer health questions.
Start by writing down how many people average 30 or more hours a week.
The participation threshold, and the one window where it’s waived
Carriers require a minimum share of your eligible employees to actually enroll: 70 percent through SHOP, the small business side of the marketplace, and 75 percent outside of it.
However, non-enrolling employees with coverage through a spouse may be excluded.
Those thresholds are waived every year from November 15 through December 15. If a few employees are likely to decline and you can’t reach 70 or 75 percent, that window is when a plan can still go into place.
Tell us early if you expect declines. It decides whether you start coverage now or aim for November 15.
Deciding what the company will contribute
You’re choosing two things: how much of the employee’s own premium the company pays, and whether it pays anything toward spouses and children.
In Maine each employee and dependent is rated separately, and only the three oldest children under 21 are charged, so a family with five children costs the same as one with three.
Carriers also set a minimum employer contribution before they’ll issue a plan that vary by carrier.
It is wise to pick a number you can hold through a renewal increase, not just year one.
What to gather for a quote
- Legal business name, SIC code, address and county for each work location
- A census with each eligible employee’s date of birth, home zip code, tobacco use and dependents they’d cover
- Average weekly hours for anyone near the 30 hour line
- Your target coverage start date, almost always the first of a month
- What you’re willing to contribute, even as a range
Getting quotes and enrolling
Get professional help quoting and setting up your company’s benefits. We quote the fully insured small group plans available to you, and if your size and workforce make it worth looking at, level funded or PEO next to them.
Once you choose, your employees get an enrollment window, anyone declining signs a waiver, and the carrier issues the plan.
The obligations you may already have
Two Maine laws apply to you because you have employees, not because you offer insurance.
Maine earned paid leave requires employers with more than 10 employees to provide paid leave that accrues as people work. Maine Paid Family and Medical Leave requires payroll contributions from employers of every size, and benefits have been payable since May 1, 2026.
A written handbook and real policies matter from your first hire, and more so once you add a plan with eligibility rules and a waiting period. Our Mineral HR Platform page covers both laws in detail. We provide that to clients at no cost.
What this costs you in time
Expect a couple of hours with us, an hour or two gathering the census, and a short meeting with your employees. Renewal each year is lighter.