Can a One-Person Business Get Group Health Insurance in Washington?

By Brandon Hoobler | 11/03/2026

Information current as of November 3, 2026. Written by Brandon Hoobler, licensed Washington insurance broker.

This week several Washington business owners asked us the same question: “It’s just me, or just me and my spouse. Can we get a group health plan?” Sometimes the answer is yes. Often it’s no. What decides it is less about how many people work in the business and more about how the business is set up for taxes and who is on payroll.

The quick answer

To buy a small-group health plan in Washington, a business needs at least one common-law employee enrolled on the plan. As a practical matter, that means someone paid through payroll on a W-2. Owners count only when they are also employees of their own business, which usually means a corporation paying its owner a W-2 salary. A sole proprietor with no employees doesn’t qualify, and a spouse on payroll doesn’t always fix that. When a group plan isn’t available, the individual market is the route, and open enrollment for 2027 is happening now.

Where your business probably lands

These are the patterns we see most often. Carriers make the final call from your tax documents, and their rules aren’t identical.

Sole proprietor or single-member LLC with no employees

Not eligible for small-group coverage. HealthCare.gov describes this as self-employed with no employees, and points you to the individual market.
Look at an individual plan through Washington Healthplanfinder or directly from a carrier, and ask your tax advisor about the self-employed health insurance deduction.

Partnership or multi-member LLC with only partners working

Partners generally aren’t employees of their own partnership. Federal rules let a group health plan treat a bona fide partner who works in the business as a participant, and carriers ask for the partnership return and every owner’s K-1.
Possible with some carriers, but confirm before you count on it.

S corporation or C corporation that pays the owner a W-2 salary

Often eligible as a group of one. The IRS treats corporate officers who perform services as employees, and their pay as wages.
Expect to provide the corporate tax return, K-1s for S corporation owners, and a W-2 or recent payroll.

Owner plus spouse on payroll, no other employees

This is the case where carriers differ the most. Federal rules say an owner and spouse are not employees of a business they wholly own, so a spouse’s paycheck alone may not create a group. Some carriers still accept a corporation whose owner and spouse are both on W-2 payroll. Others won’t.
If one carrier accepted your group, don’t assume the next one will. We check with the carrier before we quote.

Owner plus at least one W-2 employee who isn’t a spouse

Eligible as a small group, as long as you meet the carrier’s contribution and participation rules.

Why “one employee” has a specific meaning

Washington law defines a small employer as one that employed an average of at least one but no more than 50 employees in the previous calendar year, employed at least one on the first day of the plan year and has a bona fide employer-employee relationship. It borrows its definition of “employee” from ERISA, the federal benefits law.

The older text of RCW 48.43.005 still mentions sole proprietors and self-employed people buying coverage as a “group of one.” That language no longer controls. In a November 9, 2015 notice to carriers, the Washington Office of the Insurance Commissioner said the ACA and federal rules require at least one common-law employee to buy group coverage, and that this requirement supersedes the state’s group-of-one language. Kaiser Permanente quotes that notice in its current Washington underwriting guidelines.

The federal rule behind it comes from the U.S. Department of Labor. A plan with no employees as participants isn’t an employee benefit plan. An individual and spouse aren’t employees of a business they wholly own, whether or not it’s incorporated, and partners aren’t employees of their partnership. That’s why owner-only plans need extra proof.

On the tax side, the IRS treats a corporate officer who performs services for the corporation as an employee, and the officer’s pay as wages. That’s why an S corporation or C corporation owner on a W-2 is usually the cleanest owner-only case.

Premera’s 2027 group-size attestation puts it in one line: count business owners, corporate officers and partners “only if they are common-law employees.”

What carriers ask a group of one or two to send

Groups with one or two enrolled people get the most paperwork, because the carrier has to confirm the business is a real employer. Here’s what the current Washington forms ask for.

Business setup	What carriers typically ask for
Every group of 1 or 2	Most recent Washington quarterly wage report filed with the Employment Security Department (Form 5208A and 5208B), or recent payroll, W-2s or W-4s for anyone not on that report
Sole proprietorship	Form 1040, first two pages, plus Schedule C or F
Partnership or multi-member LLC	Form 1065, first four pages, plus K-1s for all owners, totaling 100%
C corporation	Form 1120, first four pages, plus the owner’s W-2 or payroll
S corporation	Form 1120-S, first four pages, plus K-1s for all owners and the owner’s W-2 or payroll
Recently changed from a sole proprietorship	Form 2553 (S corporation election) or Form 8832 (entity classification), in addition to the above

Sources: Premera Blue Cross HMO Group Size Attestation, form 062430 (01-01-2027), and Regence BlueShield’s Washington sold-quote checklist. Kaiser Permanente requires the quarterly wage report and employer tax documents for all new groups of five or fewer employees.

If your business isn’t required to file the quarterly wage report, Premera’s form asks you to say why, and payroll records fill the gap.

Deadlines and rules that hit small groups hardest

Paperwork is due earlier for groups of 1 or 2.

Premera wants the attestation and tax documents 60 days before the effective date, for new and renewing groups with fewer than three subscribers. For a February 1, 2027 start, that’s December 3, 2026.
Regence needs completed forms by the 15th of the month before the effective date.
Kaiser needs new-group materials by the 20th of the month before.

Contribution and participation are stricter.

Premera’s 2027 small-group application requires groups of one to three to pay 100% of the employee’s premium, with 100% participation.
Kaiser’s 2026 guidelines require at least 50% of the employee premium, and 50% participation for groups of one to three.
Washington law lets carriers require up to 100% participation for groups of three or fewer.

There’s a once-a-year exception. Kaiser’s guidelines describe the annual window: if a small employer’s completed application arrives between November 15 and December 15, Kaiser will accept the group even if it misses the participation or contribution minimums. Ask us which carriers apply the same window to your group.

Rates are set per person. In Washington small-group plans, rates can vary only by geographic area, family size, age and wellness activities. Choosing which person is the subscriber doesn’t change those factors, though it can change how much of each person’s premium the business must pay under a carrier’s contribution rule.

Level-funded and association plans have their own floors. The level-funded carriers we quote for small businesses start at two enrolled employees. Association plans set their own eligibility rules. Neither is a fix for a true group of one.

Thinking about an S corporation election?

Owners sometimes ask whether they should elect S corporation status just to get group coverage. That’s a tax decision first, and your CPA should make it with you. A few points to raise with them:

You’ll need to be on payroll. The IRS expects S corporation shareholders who work in the business to receive reasonable compensation as wages.
Health premiums are handled differently for owners. For a more-than-2% shareholder-employee, premiums the S corporation pays are included in W-2 Box 1 wages but aren’t subject to Social Security or Medicare tax. The owner may then be eligible for the self-employed health insurance deduction.
Carriers want proof. If the business changed from a sole proprietorship since its last tax filing, Premera and Regence ask for the IRS Form 2553 (or Form 8832 for other changes) along with the usual documents.
Timing matters. If the election takes effect January 1, a group plan based on it may not be possible until the carrier can verify the new setup. Plan for that gap.

If a group plan isn’t an option yet

Shop the individual market now. Washington Healthplanfinder open enrollment for 2027 runs from November 1, 2026 to January 15, 2027. Enroll by December 31 for coverage starting January 1. Depending on your household income, you may qualify for federal tax credits or Cascade Care Savings, which are only available through Healthplanfinder.
Compare off-exchange plans too. If you won’t receive tax credits, plans sold directly by carriers can be worth comparing. Our individual and family insurance page explains both routes.
Ask about the tax deduction. Self-employed people may be able to deduct health insurance premiums using IRS Form 7206.
Revisit group coverage when you hire. Once you have a W-2 employee who isn’t your spouse, a small-group plan or an ICHRA becomes possible. Our guide for first-time employers walks through the first year.

Common mistakes we see

Adding a spouse to payroll only to qualify. It may not work, and it can create payroll tax and unemployment filings you didn’t plan for.
Electing S corporation status in December and expecting a January group plan. Carriers verify the change with IRS paperwork, and that takes time.
Missing the 60-day deadline. For Premera groups of one or two, the paperwork deadline for a January 1 start was November 2.
Canceling current coverage too early. Regence’s checklist says not to cancel existing policies until the carrier confirms it has accepted the group and sent the group ID number.
Rounding up the employee count. Carriers ask you to sign an attestation about your group size. Premera’s form reminds employers that knowingly giving false information to an insurer is a crime.

Frequently asked questions

Can I get group health insurance if I’m the only person in my business?

Only if you are a common-law employee of your own business, which usually means a corporation that pays you a W-2 salary. A sole proprietor or single-member LLC with no employees can’t buy a small-group plan in Washington and should look at the individual market.

Does paying my spouse a W-2 wage make us a group?

Not always. Federal rules say an owner and spouse aren’t employees of a business they wholly own. Some carriers accept a corporation where the owner and spouse are both on W-2 payroll, and some don’t. Ask before you change payroll to qualify.

Can an S corporation owner get a group plan with no other employees?

Often yes, if the owner is on W-2 payroll. Carriers usually ask for Form 1120-S, the K-1s for all owners and a W-2 or recent payroll. If the S corporation election is new, they may also ask for the IRS Form 2553.

What is a “group of one” in Washington?

It’s a small-group plan with only one enrolled employee, often a corporate owner on payroll. Washington law still mentions groups of one for sole proprietors, but since 2015 the Office of the Insurance Commissioner has required at least one common-law employee to buy group coverage.

What documents do I need for a one- or two-person group?

Expect to send your most recent Washington quarterly wage report (Form 5208A and 5208B) or recent payroll, plus your business tax return. That means Form 1040 with Schedule C, Form 1065 with K-1s, Form 1120 or Form 1120-S with K-1s, depending on your setup.

How far ahead do I need to apply?

It depends on the carrier. Premera wants documents from groups with fewer than three subscribers 60 days before the effective date. Regence wants completed forms by the 15th of the month before, and Kaiser by the 20th of the month before for new groups.

What if my business doesn’t qualify for a group plan?

Shop individual coverage through Washington Healthplanfinder, where tax credits and Cascade Care Savings may be available, or compare off-exchange plans. Open enrollment for 2027 runs through January 15, 2027. Ask your tax advisor about the self-employed health insurance deduction.

Ready to find out where your business lands?

Send us how your business files its taxes, who is on payroll and the start date you want. We’ll tell you plainly which carriers can accept your group, what paperwork they need and when it’s due, or whether the individual market is the better fit this year. Call (206) 653-9636 or contact us to schedule a no-obligation benefits review.

General information, not legal or tax advice. Eligibility is decided by each carrier from your documents, and your plan documents and carrier rules control. Talk with your tax advisor before changing how your business is taxed.

About the author

Written by Brandon Hoobler, founder of Washington Insurance Brokers and a licensed Washington insurance broker (WA OIC #824207, verify a license). He has worked in insurance since 2009 and helps Washington employers compare group benefits, from owner-only corporations to companies with 500 employees. Questions about whether your business qualifies? Call (206) 653-9636.

Sources

Posted in Employee Benefits, Individual & Family