Small Business Requirements For Health Insurance

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Are Small Business Employers Required To Provide Health Insurance?


If your business has 50 full-time employees or fewer,1 you are classified by the Affordable Care Act (ACA) as a small business and are not required to provide health insurance to your employees. Yet many small business owners choose to offer health insurance benefits even though it is not a requirement.

Why Offer Health Insurance As A Small Business?


As a small business employer, you might consider the long-term value of group health insurance.


Attract and retain employees - Health insurance benefits offer added value to new talent in a competitive job market and provide an incentive for current employees to stay with your company.


Keep a healthier, more productive staff - Your group health insurance plan gives employees access to lower healthcare premiums, so they are more likely to pay into a plan and use health insurance benefits when they need them - translating into fewer sick days and a more productive business.


Save money - Under the Affordable Care Act, employers who have fewer than 25 full-time employees, who pay average wages of $56,000 or less, or who cover at least half of their employees’ premiums may be eligible for tax credits for their small group health insurance plans.



How To Enroll For Small Business Health Insurance


As a small business owner, you have a few options when it comes to enrolling in small business health insurance.

  • Explore plans that fit your business through private insurers like Anthem.
  • Use a licensed agent or broker to help you compare plans.



What Are The Small Business Health Insurance Plan Options?


HMO (Health Maintenance Organization)
An HMO is designed to keep costs low and predictable by only using doctors and hospitals within the HMO network. It typically has low premiums, deductibles, and fixed copays for doctor visits. Primary care physicians (PCPs) are the primary point of contact for all medical care, including specialty referrals.


PPO (Preferred Provider Organization)
PPO networks let the member choose where to go for care, without a referral from a PCP or having to only use providers in your plan's provider network. These plans typically have higher monthly premiums and out-of-pocket costs like copays, coinsurance, and deductibles.


EPO (Exclusive Provider Organization)
An EPO offers a local network of doctors and hospitals to choose from. If you’re looking for lower monthly premiums and are willing to pay a higher deductible when you need healthcare, you may want to consider an EPO plan.


POS (Point of Service)
A POS plan requires that you get a referral from your PCP before seeing a specialist. This plan covers out-of-network doctors at a higher out-of-pocket cost than in-network doctors.


HDHP (High Deductible Health Plan)
An HDHP has low premiums but higher immediate out-of-pocket costs. Employers often pair HDHPs with a Health Savings Account (HSA). This is a tax-free fund used to offset costs such as deductibles.



When Can I Enroll For Small Business Health Insurance?


There is no limited enrollment period when it comes to selecting small business health insurance. Typically, if you enroll in a plan by the 15th of each month, coverage can usually begin on the 1st of the following month for your staff.





Find Small Group Health Insurance That Fits Your Business

Compare health insurance plans and find one that works for your business and your employees.

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1Number of eligible employees may vary by state.