The U.S. Department of Health and Human Services (HHS) released final regulations on February 22, 2013 in regards to various health insurance market rules. The new guidance includes information about minimum participation requirements in the small employer marketplace. In most states, small employers are defined as those with 50 or fewer employees.

Insurance companies today require a minimum percentage of employees to enroll in coverage. This is referred to as the participation requirements and helps insurance companies avoid adverse selection. Minimum participation requirements can be up to 75% today.