State RegulationsNY specificDifficulty 2/5
A machine shop in Syracuse has 60 employees and asks its agent to buy medical coverage through New York's small employer market. Under Reg 145, how should the agent respond?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under Reg 145 (11 NYCRR Part 360.2(f)), small employer status turns on headcount: the group must have at least 2 and no more than 50 employees. A firm with 60 employees exceeds the ceiling, so it is not a small employer and cannot purchase through the small group market's special rules.
Why the other options are wrong
- B) Ownership structure has no bearing on the employee-count test that defines a small employer.
- C) Agreeing to pay more does not convert an out-of-range group into a small employer; the definition cannot be waived by rate agreement.
- D) There is no first-year grace period; the 2-to-50 employee test applies whenever the question arises.
Memory hook
Sixty is too many: the small group door stops at 50 employees.