Health Insurance Coverage For Small Business Owners

Health Insurance Coverage For Small Business Owners – Small businesses are the backbone of the US economy – 99.9% of US businesses are small businesses. Half (46.4%) of all American workers are employed by one person. This means small business owners are responsible for providing affordable health insurance to America’s 61.7 million workers.

You are a small business owner weighing the pros and cons of providing employee health insurance and trying to determine what type of group health plan to offer. There are many things you can do with health insurance:

Health Insurance Coverage For Small Business Owners

Health Insurance Coverage For Small Business Owners

Read on to learn more about what you can do for small business health insurance and why it’s important to offer it to employees.

What Insurance Do You Need For A Small Business?

According to, health insurance is “an agreement whereby your health insurer pays some or all of your health care costs in exchange for a payment.” Health insurance can be purchased individually or as a group.

Health Insurance Coverage For Small Business Owners defines group health insurance as “a health plan provided by an employer or employee organization that provides health insurance to employees and their families.”

According to the Kaiser Family Foundation (KFF), small businesses are the most likely to offer group health insurance. In 2022, the percentage of businesses offering group health insurance was:

Health Insurance Coverage For Small Business Owners

How Much Does Business Insurance Cost?

The health insurance provider you choose will depend on the health plan you decide to offer.

The major providers of fully funded plans are five legacy carriers known as BUCAHs: Blue Cross Blue Shield (BCBS), UnitedHealthcare, Cigna, Aetna, and Humana.

Health Insurance Coverage For Small Business Owners

Some legacy providers also offer subsidized plans, but modern health insurance companies like Sana and Oscar are more technology-enabled and specialize in subsidized offerings for small businesses.

Health Insurance For A Family Business Doesn’t Need To Be Complicated

Small business owners can also choose to provide health insurance through a Professional Employer Organization (PEO), which serves as the official employer for many small businesses. PEOs allow small businesses to outsource their HR functions and provide access to health insurance at a lower cost than they would get on their own. Top PEOs include Paychex, Justworks, TriNet, ADP TotalSource, and Insperity.

Health Insurance Coverage For Small Business Owners

There is no getting around the fact that healthcare is generally expensive. Also, health care costs are increasing every year – they are expected to increase by 6.5% in 2023.

But there are ways to lower your health insurance costs while still providing better benefits to your employees. While traditional, fully funded plans are the most popular (think the big guys like Blue Cross Blue Shield, Aetna, Humana, United, etc.), their cost and unpredictability make many small businesses look elsewhere. Where necessary, a solution will surely follow.

Health Insurance Coverage For Small Business Owners

Top Problems For Small Business Owners

Self-funded plans are an alternative to traditional plans and are attracting small businesses across the country. It is important to understand the difference between a fully funded health plan and a privately funded health plan.

A fully funded health plan is funded by the insurance provider instead of the employer. The carrier assumes all risk and holds the policy. Your company pays the carrier a fixed monthly fee to pay your workers’ compensation claims and manage the plan for you. No matter how many claims your employees make or how expensive those claims are, the carrier, not your company, is willing to pay (or deny) them.

Health Insurance Coverage For Small Business Owners

While a fully funded plan is predictable from month to month, it is not predictable from year to year. You can know exactly what you will pay each term, but there is no way to know what you will pay next year. If your company’s total health care claims exceed your provider’s expected and estimated premiums, you can expect your rates to increase next year.

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A self-sponsored health plan is sponsored by an employer rather than an insurance provider. That means your company takes all the risk and pays your employees’ claims as they come. Your company is responsible for managing and administering the program.

Health Insurance Coverage For Small Business Owners

It may seem overwhelming, but a sponsored health plan has significant cost advantages. First, by removing the service provider, you avoid marking fees and get several tax benefits. You also pay for health care used by employees. You pay less when workers’ compensation claims are low and more when they are high. A traditional carrier works like your auto insurance: you pay a fixed premium whether or not there is a claim.

For more protection against high claim costs, there is a type of self-funded health plan called a standard sponsored health plan. A fully funded plan includes stop loss insurance to protect you from “catastrophe” claims that might strain your budget. Stop loss insurance covers the excess amount that you have to pay above the specified threshold (threshold). If the claim is higher than your maximum, stop loss insurance kicks in, and if the claim is lower, your company gets a discount to cover the difference. You’ll never see a discount from a traditional, fully funded plan.

Health Insurance Coverage For Small Business Owners

Small Business Health Insurance Plans From Aetna

Another advantage of some tier-sponsored health plans is that your employees are not required to choose “in-network” providers regardless of which plan they choose. For example, employees who want a more expensive plan with a higher deductible may have to sacrifice the ability to choose their own doctors and specialists. Giving your employees this flexibility is a great way to add a benefits package that businesses with traditional health insurance may not be able to.

The Affordable Care Act specifies that small businesses with fewer than 50 employees do not have to pay health insurance benefits to their employees or pay a non-payment penalty to the IRS. That doesn’t mean they shouldn’t provide health insurance benefits.

Health Insurance Coverage For Small Business Owners

Regardless of the size of the employer, health insurance benefits are a big deal for employees. A 2020 survey of 2,000 people found that 84% put health insurance at the top of their list of desired benefits, and the Society for Human Resource Management (SHRM) found that 92% of employees say benefits are important to their overall job satisfaction. .

The Big Opportunity In Insurance For Small And Midsized Businesses

These figures demonstrate that benefits are an important contributor to talent acquisition and retention. Happy, healthy, and caring employees are more loyal, productive, and appreciative of your business. Yes, health insurance plans can be expensive, but with so many small businesses (and your competition) offering health insurance benefits, can you afford it? Think of health insurance benefits as an expense and more of an investment, resulting in a higher quality workforce.

Health Insurance Coverage For Small Business Owners

If you are a startup or small business without health insurance benefits, now is the time to get a plan if you have the budget. The longer you wait, the more likely you are to lose good skills. To maintain high morale and enhance your brand reputation, health insurance benefits should be a priority.

Offering health benefits will depend on the size of your company. If you only have a few employees, you may not be ready to jump in right now and prefer to grow first. Remember that benefits have become an expectation even for employees at small companies. Some companies see their plan as another “rent,” allocating a portion of the budget they spend on a health insurance plan for a new employee to cover all employees. Startups often build the cost of a benefits package from investors into their financing plan.

Health Insurance Coverage For Small Business Owners

Best Health Insurance For Small Business Owners Of 2023

Your employees have different health care needs and budgets, so offering a variety of plan options is a great way to ensure that those who want to participate can find the plan that’s right for them.

Once you choose health insurance and plan your options, you can offer health insurance to your employees if the carrier gives you the green light. Open enrollment is the period during which your employees must be registered, which is set by insurance. Not all employees need to enroll, as some may already have a plan for a spouse or parent, or decide to find their own health insurance.

Health Insurance Coverage For Small Business Owners

When open enrollment ends, non-participating employees cannot enroll until the next open enrollment period, usually one year later. There are exceptions, such as if an employee loses their current health plan, gets married or divorced, has a child or adopts a child, or has a Qualifying Lifetime Program (QLE) that changes their place of residence. Despite open enrollment dates, new hires can sign up during hire.

Small Business Insurance Quotes

Healthcare is exciting, so promote it to your employees in creative ways across multiple channels. Be sure to allow time for questions and answers. Your health insurance should be able to answer questions you can’t answer yourself.

Health Insurance Coverage For Small Business Owners

This greatly reduces health care costs for small business owners and makes it easier for small businesses with HR departments (or none) to provide health insurance for the first time. Get a quote today.

For many businesses, employer-sponsored health insurance is the second largest expense after payroll. When planning your health insurance budget, choose a monthly amount you can contribute, assuming employers pay at least 50% of the employee premiums.

Health Insurance Coverage For Small Business Owners

Health Insurance Tax Benefits For Small Business Owners

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