How many employees do I need for group health insurance in Washington?

Usually 2, including at least one employee who isn't an owner or an owner's spouse. Prescience works with Washington groups of 2 or more employees.

Can Prescience cover employees outside Washington?

Yes. Prescience covers teams across all 50 states, and the carrier network is national.

What is a small employer in Washington State?

Under RCW 48.43.005, an employer that averaged 1–50 employees in the prior calendar year and has at least one employee on the first day of the plan year.

Does Washington have state continuation coverage?

Washington requires insurers selling small group plans to offer a continuation option. The length depends on the policy, so check your plan documents.

Small business health insurance in Washington State

Washington's small group market covers employers with 1 to 50 employees, and state law requires insurers to offer small groups a continuation option for people who lose eligibility. For Seattle-area startups competing with Amazon and Microsoft for engineers, the plan design matters more than the rules.

By Aditya Jain, MD, Cofounder and COO, PresciencePublished October 3, 2026

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Small group size: 1–50 employees
State continuation: Insurers must offer an option
Individual mandate: None
Prescience admin fees: $0

Small business health insurance in Washington State (Prescience guide by Aditya Jain, MD)

The rules that matter in Washington

Washington rules for employer health coverage
Rule	What it means
Small group definition	Under RCW 48.43.005, employers averaging 1–50 employees in the prior year.
State continuation	Insurers selling small group plans must offer employers a continuation option for people who lose eligibility. Length and terms depend on the policy.
Individual mandate	None at the state level.
Federal rules	COBRA at 20+ employees; the ACA employer mandate at 50+ full-time equivalents.

Competing with big tech in Seattle

When your candidates come from companies with self-funded plans and low deductibles, a standard small group plan with a $3,000 deductible is a hard sell. That's the gap Prescience closes: an effective $0 deductible and a physician-led care team, at a contribution usually below comparable fully insured coverage. More in How does FAANG offer top health benefits?

How a Prescience plan works in Washington

At Prescience, we design and run your company's health plan, from setup and enrollment to claims, compliance and COBRA. What your team gets:

An effective $0 deductible, so the plan helps from the first visit.
Simple copays shown before a visit, capped by a low out-of-pocket maximum.
A broad national PPO network, plus providers we contract with directly.
24/7 physician-led care navigation: a care team that finds the right provider, books appointments and explains costs up front.

What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees. You keep your payroll provider, and the plan can start mid-year.

We work with Washington employers of 2 or more employees, and with distributed teams that have employees in Washington and other states.

See what your team would pay with Prescience

Answer a few questions about your team and get a quote in about 60 seconds, or talk it through with one of our benefits experts.