Small Group

Understand New and Renewing Requirements for Groups of 1-2

April 9, 2026

In February we announced important underwriting updates for groups with one to two enrolled employees. These changes put Premera Blue Cross and Premera Blue Cross HMO at parity with the industry and went into effect for new and renewing groups beginning May 1, 2026.

We’ve received your feedback and we’re following up to provide greater detail on key requirements and scenarios for eligibility in the small group market for employers with 1-2 subscribers.

Common eligibility scenarios

Scenario

Eligible to purchase small group health plans

Owner (or owner/spouse) ARE common law employees and

There is at least one other common law employee enrolling in the plan.

Yes, assuming the group meets participation and contribution requirements.

Owner (or owner/spouse) ARE common law employees and

There is at least one other common law employee but they are NOT enrolling in the plan.

Yes, assuming the group meets participation and contribution requirements.

Key changes
The Group Size Attestation forms were updated for Premera Blue Cross and Premera Blue Cross HMO. This form must be completed for new and renewing groups.

Premera Blue Cross and Premera Blue Cross HMO will require additional tax documentation as part of the eligibility process. Acceptable tax documentation is identified in the Group Size Attestation form.

The Group Size Attestation and tax documentation must be received by Premera Blue Cross or Premera Blue Cross HMO 60 days prior to the effective date.

Premera Blue Cross Group Size Attestation form

Premera Blue Cross HMO Group Size Attestation form

New and renewing groups beginning May 1, 2026, are required to submit the Group Size Attestation and related tax documentation. Premera Blue Cross or Premera Blue Cross HMO will contact you no later than 30 days prior to the group’s effective/renewal date with a determination on the group’s eligibility.

Quick tips on documentation

Complete the Group Size Attestation form entirely and have it signed by an authorized group contact
Note on the applicable tax documentation any employees who are not enrolling and provide the reason why:
1. Seasonal, part time, or probationary period
2. Terminated
3. Waived. If waived, identify the reason why. (Examples include employees with other verifiable group medical coverage, Medicare, or Medicaid coverage.)
Ensure appropriate tax documentation is included (see Group Size Attestation form)

Following these tips will help with a timely review of your group’s application.

Contact your general agent for questions.