When we discuss health insurance for small company owners, we mean insurance provided by the employer. Usually, the employer and employee divide the expense of this perk. Those with health insurance can afford to pay for routine check-ups, preventative treatment, and unexpected medical expenses.
A small business is often regarded as an employer with one to 50 employees, excluding the owner, their spouse, and any family members, when it comes to health insurance coverage. Yet, some private organizations define a small firm as one that employs between one and 100 people. Although small company owners are not legally required to offer healthcare to their staff members, many do so to draw in and keep talent.
We’ll examine the many plan options accessible to small businesses in this post before providing a list of the top small business health insurance providers.
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How does a small company owner manage health insurance?
For small company owners to acquire group health insurance, there must be at least one full-time employee who isn’t a spouse or family member. Also, all full-time workers must have access to health insurance through their employment. Health insurance cannot be restricted to select people, such as managers or employees with advanced degrees.
70% of your full-time, uninsured workers must choose the plan you’re selecting, then you will be able to offer employer-provided health insurance. This 70% rule, however, does not hold from November 15 through December 15 of any given year.
Small Business Health Options Program (SHOP), a government-run insurance marketplace established as part of the Affordable Care Act, makes it simple for small company owners to compare health insurance options. Also, they can speak with specific businesses or health insurance brokers to learn more about prices and coverage.
Small Business Health Insurance Requirements
- Inclusivity- All employees must have access to health insurance, not only supervisors or any other group.
- Coverage of Basic Medical Services- According to the ACA(affordable care act), a health plan provided by a small company owner must cover essentials like emergency services, care and services connected to pregnancies, maternity and newborn care, outpatient treatment, prescription medicines, and more.
- Minimal Involvement – In order to be eligible for the Small Business Health Insurance Tax Credit under the Affordable Care Act, small businesses must contribute at least 50% of the monthly premium costs of the plans they provide. States generally mandate a minimum level of employee participation in health insurance plans provided by small enterprises in addition to these restrictions.
How can I pick a good small business health insurance plan?
You should consider several factors while choosing health insurance for small businesses:
- Benefit Design – Benefit designs, which include cost-sharing choices like copays, deductibles, and coinsurance, set the guidelines for the types of coverage, providers, and services that are offered to insured people. A well-thought-out benefits design will encourage customers to utilize necessary services while discouraging unnecessary service use.
- Premiums – Monthly payments for healthcare coverage are known as health insurance premiums. The expense of employer-provided health insurance premiums is normally split between employers and employees. Employers may be eligible for the small company healthcare tax credit if they cover 50% or more of the entire cost of their workers’ premiums.
Different small business health insurance plans
- Health Maintenance Organization(HMO) Plan – Plans offered by health management organizations (HMOs) are constrained forms of insurance with a focus on lowering medical expenses. Healthy people with limited financial resources and a comfort level with just seeing doctors in a predetermined network of healthcare providers benefit greatly from HMO plans.
- Preferred Provider Organization(PPO) Plan – Patients who use preferred provider organizations (PPOs) often pay more for premiums and care since they have access to a wider network of providers and more flexible care alternatives. PPO plans are excellent for those who wish to compare providers, who are willing to spend more money and may require special care for a medical problem.
- Point of Service(POS) Plan – An HMO and PPO’s advantages are combined in a point-of-service (POS) plan. Customers still require a primary care doctor to refer them to a specialist, but they pay less for out-of-network treatment. A POS often has costs that fall between those of an HMO and a PPO.
- Exclusive Provider Organization(EPO) Plan – Customers who use an exclusive provider organization (EPO) plan for their health insurance are urged to stick with the doctors and hospitals in their network, but they are not required to receive a referral if they decide to go outside of it. The affordable health insurance alternative gives small firms more freedom.
Top Small Business Health Insurance Providers
1. United Healthcare
With almost 70 million members, it has the highest membership of any insurance company in the US. United Healthcare collaborates with more than 1.3 million medical professionals, 6,500 hospitals, and care facilities. In addition to its extensive network and accessibility in all 50 states, it gets marks for offering a wide variety of services and programs, including alternatives for part-time and seasonal workers.
For small enterprises, United Healthcare provides a range of plan options, including HMO, PPO, EPO, and POS plans. Customers who combine their health insurance with dental and vision coverage are also eligible for savings, and the company also distributes useful materials like free exercise, nutrition, and self-care guidelines.
In addition to providing a variety of plan alternatives, United Healthcare leads the sector in technology integration. It has features that can save potential clients time and effort, including claim filing and mental health services (available with some small company plans via a specialized app).
Pros :
- A vast network of Healthcare Professionals.
- Benefit alternatives for seasonal and part-time workers
- There are options for specialized healthcare and virtual therapy.
Cons :
- It does not provide health insurance coverage under the platinum plan.
2. Blue Cross Blue Shield(BCBS)
Blue Cross Blue Shield (BCBS), which operates via the 36 local and independent corporations of the BCBS Association and covers all 50 U.S. states, is another provider of top health insurance for small businesses. Almost 106 million Americans are covered by BCBS, which is also approved by over 95% of doctors and 96% of hospitals. PPOs, HMOs, and high-deductible insurance plans are just a few of the many different types of health insurance that BCBS provides.
Although BCBS has a well-deserved reputation for providing exceptional service and products, such qualities come at a cost. According to internet reviews, BCBS is more expensive than comparable plan alternatives provided by other companies. Some plans also have deductibles that are higher than the industry average, which means that patients will have to pay more out of cash.
In the end, BCBS is a good choice for any small business owner wishing to provide their staff with a wide range of alternatives and rock-solid coverage. Nevertheless, before you choose BCBS for your small business’s healthcare requirements, confirm the coverage options and customer service ratings of your local affiliate.
Pros :
- It provides worksite wellness programs throughout several locations.
- Rated highly by small businesses
Cons :
- Plans change depending on where they are.
- more than average healthcare costs
3. Humana
Due to the numerous group coverage plans they give, Humana, one of the biggest health insurance companies in America, may be regarded as one of the top health insurance providers for small businesses.
With more than 20 million customers, Humana ranks fifth among health insurance providers in the United States. Humana’s costs skew towards the upper end of the range, yet they are not extraordinarily exorbitant. According to quotes from the Humana website and several online review sites, the company’s pricing tends to be a little more than those of its rivals.
HMOs and PPOs are among the plans available to business owners. Compared to other insurers, Humana provides more flexibility because clients may bring in well-liked add-ons like dentistry, vision, and hearing insurance to their projects.
Humana was fined $630,000 in 2021 by the insurance regulator in North Carolina for several violations, including unethical claims handling procedures and subpar customer service. A further $227,206 in member compensation was mandated by the department to Humana. While annoying, it’s crucial to keep in mind that a lot of insurance companies get into difficulties with regulatory bodies. Choosing an insurance company requires careful research on your part as a customer.
4. Kaiser Permanente
In our investigation, Kaiser Permanente emerged as the most affordable health insurance choice for proprietors of small businesses. It also varies from the other suppliers in a crucial aspect. Kaiser Permanente is a closed organization that manages a network of exclusive private hospitals for its members alone in addition to offering health insurance.
Kaiser Permanente is a very small organization with 12.6 million members spread throughout eight states (Maryland, California, Colorado, Oregon, Washington, Virginia, Georgia, and Hawaii) and the District of Columbia. Yet, because of its distinctive business strategy, it is perfect for companies wishing to offer their employees high-quality healthcare at a reasonable cost.
Members pay less for medical treatments in Kaiser’s private facilities thanks to the closed system approach. To cut down on medical expenses and maintain the health of its members, it places a strong emphasis on preventative treatment. Copayment HMOs, deductible HMOs, and HRA and HSA-qualified plans are all available via Kaiser Permanente.
Although consistently receiving high rankings for service quality from U.S. News Health and other review services, Kaiser Permanente does have several serious flaws. Because of its limited geographic scope and limited network of medical care providers, it is not a good fit for businesses that employ people across the country.
5. Cigna
Due to the exceptional caliber of its customer support, Cigna has earned a spot on our list. In addition to offering many of the things we’ve seen elsewhere, including dental and vision add-ons, Cigna also provides live customer assistance 24 hours a day, 365 days a year.
PPO, HMO, and Open Access plans are just a few of the group health alternatives Cigna provides. Free access to wellness programs, as well as savings and spending strategies, are included in the plans. Moreover, Cigna has connections with more than 1.5 million medical professionals globally and more than 99% of pharmacies in the United States.
Cigna has operations in 12 states, including Arizona, California, Florida, Maryland, North Carolina, Colorado, Connecticut, Georgia, Missouri,South Carolina, Tennessee, and Texas.
Pros :
- Provides dental and vision insurance.
- Several alternatives for group plans
Cons :
- Limited to 12 states only
- Costly monthly premiums
6. Aetna
Because of its focus on preventative care alternatives, Aetna made our list. Aetna has substantially shifted its focus toward Value-Based Care(VBC) in recent years. This approach to healthcare places a strong emphasis on the value of proactive measures including preventative care and good lifestyle decisions. All plans have VBC components that encourage plan participants to make healthy lifestyle decisions including exercising, eating well, and quitting smoking.
Aetna operates in only 16 states, so it’s not nearly as big as some of the powerhouses on our list. Aetna, however, contributes a significant amount of institutional experience with its 169-year history.
- Cost-Quality Balance – For small business employers, Aetna offers health plans that are competitively priced and include wellness programs and finance choices.
- Self-financed insurance – Small companies may benefit from self-funding, stop loss protection, and expense control with Aetna Financing AdvantageSM health insurance.
- Services for members – The online portal of Aetna makes it simple to manage benefits, look for information on claims, and more. Also, members could have access to perks like gym memberships, health counseling, round-the-clock nurse hotlines, and weight loss programs. Information about the advantages will need to be found in your unique plan because they might differ.
7. Anthem
With services available in 14 states, Anthem is the largest for-profit managed healthcare provider in the Blue Cross Blue Shield Association. Since that Anthem has one of the largest networks in the nation, many of your small company employees may already have doctors who are part of the Anthem network.
- Anthem uses combined health plans, which connect patient data to more efficiently manage treatment, to provide medical care in an integrated manner.
- With the help of Anthem’s online resources, employees can easily locate doctors, arrange video appointments, or have questions addressed by contacting Anthem’s 24/7 NurseLine.
- The materials available on Anthem’s website may be used by members to be educated, active, and healthy. Learn more about subjects including Medicare, carer assistance, mental health, utilizing health insurance, and more.
- You can also enter your age and gender into Anthem’s user-friendly Health Care Calendar to receive suggestions on preventative screenings and vaccines that are personalized for you based on the most recent health recommendations.
With Anthem, you and your workers get access to services that make administering your group’s medical coverage easier as well as the advantages of a large physician network.
In The End
Group health insurance policies are a great way for small businesses that want to grow to safeguard and inspire their employees, especially in times of medical emergency. Modern digital insurance firms work to improve healthcare access by offering cutting-edge goods and services. To stay fit and healthy, one can access primary care, preventative healthcare, and wellness programs. When choosing the best plan for your business, make sure you are aware of the advantages of the plan and whether it meets your needs.
In the above article, I have discussed small business health insurance and its importance in the growth of your organization. I have listed the various health insurance plans provided by different organizations. last, I have listed out the best small business health insurance providers in the USA.