Small Business Health Insurance in USA : know the best companies for it

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Small Business Health Insurance : Blue Cross Blue Shield is the best health insurer for small business because of its wide range of coverage options. The company has a nationwide PPO network, and offers extra benefits to employees including a discount program.

You may have several options depending on where you live to provide health insurance for your employees. These include the Small Business Health Insurance Options Program, a government-run marketplace for small-business health plans, and purchasing a traditional health plan through a broker.

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Small Business Health Insurance :We evaluated the major health insurers based on their financial strength, customer service, coverage options, wellness and telehealth benefits, digital tools and more. Here are our top choices.

Best Small Businesses Health Insurance Companies in USA 2024

Blue Cross Blue Shield

Why We Choosed It

Blue Cross Blue Shield offers small businesses flexible options, including access to the country’s largest PPO network. BCBS employee plans are available in many states and include a wide range of extra benefits.

Pros & Cons


  • Nationwide availability
  • Discounts on health and wellness
  • Many states offer workplace wellness programs
  • Poor J.D. Power rankings in some regions


  • Poor J.D. Power ranking in some regions

Small Business Health Insurance in USA: Blue Cross Blue Shield offers many options to employers. It is our choice for the most comprehensive health insurance company. Plans that offer access to the BlueCard PPO Network, which provides coverage for employees traveling across the country, are among them. BCBS offers self-funded and level-funded plans in some states. Blue Cross Blue Shield consists of a number of companies. Benefits and plans will vary depending on the region. However, many members offer additional benefits.

Small Business Health Insurance : Anthem, for example, offers a free employee assistance program to members to help them deal with stressful situations, such as legal problems or the search of care. BCBS plans are available in many states with 24/7 telehealth, as well as mobile apps for plan management. Blue365 is a discount program with a variety of discounts, including perks like gaining a $25 gym membership.

Small Business Health Insurance :The National Committee for Quality Assurance, an independent organization that evaluates insurance plans based on their quality providers and customer satisfaction, gave BCBS and Anthem a combined rating of 3.5 out of 5 stars. Customer satisfaction ratings can vary depending on the region. Power U.S. Power U.S. Commercial Member Health Plans Study to find out how BCBS fares in your region. BCBS did well in Florida, despite poor rankings in other regions.

Kaiser Permanente

Why We Choosed It

Small Business Health Insurance :The NCQA and J.D. Power have awarded Kaiser Permanente the highest customer satisfaction ratings. Power, as well as an award-winning mobile app and a range of virtual care options.

Pros & Cons


  • 4.2-star average NCQA rating
  • J.D. Power – Top ranked in the U.S. Power is available in many regions.
  • Manage HRAs, HSAs and FSAs
  • Support for chronic illnesses
  • Only eight states and Washington D.C. offer this service


  • Only available in eight states and D.C.

Small Business Health Insurance in USA: Kaiser Permanente is the best-rated health insurer in our review. It has a top J.D. Power ranking and a 4.2 star average NCQA rating. 1 Kaiser Permanente offers many options to employers. Kaiser offers preferred providers organization (PPO), as well as health care maintenance organization (HMO). Some plans can be paired with a Kaiser health repayment arrangement (HRA), health saving account (HSA), or Flexible Spending Account (FSA). They can submit HRA or FSA claims with their mobile phones.

Small Business Health Insurance in USA:Wellness coaching is provided at no charge. Members at risk of chronic conditions will be automatically enrolled into a disease management plan with remote monitoring and comprehensive support. Kaiser also offers additional benefits to its employees, such as dental, vision care, acupuncture and chiropractic. Kaiser is our top choice for digital tools. It has an award-winning mobile app, 24/7 virtual health care, mental healthcare apps, and online therapy.

Small Business Health Insurance : Kaiser Permanente’s main disadvantage is that it is not available in all states. Only eight states, plus the District of Columbia, offer Kaiser Permanente plans. Kaiser offers a SHOP plan (Small Business Health Options Program), in Georgia and Virginia.


Why We Choosed It

UnitedHealthcare provides small business plans across the country, including unique coverage solutions for contractors, seasonal workers, and part-time employees.

Pros & Cons


  • Offers a unique benefit program for workers who are not eligible to receive benefits
  • Wellness resources and incentives are available
  • AM Best gives A+ rating to financial strength
  • J.D. Power ratings are different in each region


  • J.D. Power ratings vary by region

Small Business Health Insurance in USA: UnitedHealthcare is the best choice for small business owners with a variety of employees, contractors and seasonal and part-time workers. FlexWork, a program of UnitedHealthcare, offers coverage to employees who are not eligible for benefits. The program provides group-premium-equivalent rates for three plan types designed for different types of workers, and you can add extra benefits like $0 telehealth, dental, and vision.

Small Business Health Insurance :UnitedHealthcare offers its members a variety of other benefits, including Self Care (a health app), fitness incentives and an online weight-loss program. UnitedHealthcare also offers a network of over 1.3 million healthcare professionals.

UnitedHealthcare has also been awarded an A+ rating by AM Best for its financial strength and a NCQA average rating of 3.5 stars. J.D. Although J.D. UnitedHealthcare scored the highest in Texas and Virginia, even though J.D. In addition to Maryland, Massachusetts and New York, the company offers SHOP plans.


Why We Choosed It

Aetna offers self-insured health plans that are tailored for small businesses. It is also nice that they offer virtual primary care as well as a CVS allowance.

Pros & Cons


  • Self-funded plans offer up to 25% in upfront savings
  • Health expense funds are available in a wide range.
  • Optional robust mental health benefits
  • MinuteClinic offers affordable health care to members of certain plans
  • Some states do not include MinuteClinic in their fully insured group plans
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  • Fully insured group plans in some states don’t include MinuteClinic benefits

Small Business Insurance Options

Small Business Health Insurance in USA: According to Robert Slayton an employee benefits consultant, there are a few choices when selecting small business health insurance.

Small Group Health Insurance

Small Business Health Insurance in USA:A small group plan can be purchased directly through a commercial insurance company serving small businesses, or via a broker. Slayton said that this gives employers the control to choose which plans they want to offer, and it also provides assurances for employees about their coverage. You may need to offer COBRA and mini-COBRA. Some states require mini-COBRA plans for businesses with less than 20 employees.

Self-Funded plan

Small Business Health Insurance in USA:It may be possible to save money if you take on the responsibility for paying employee health claims. It is called a self insured or self-funded plan. This type of plan relies on commercial health insurance to manage the provider network, assist with enrollment, and process claims.

Health Reimbursement Agreement (HRA)

Small Business Health Insurance in USA:A health reimbursement arrangement is another option. This is a group plan funded by the employer that reimburses employees for certain health expenses, up to a dollar amount per year. The expenses may include the premiums of an employer-sponsored health plan as well as copays or coinsurance.

There are different types of HRAs. One is the Qualified Small Employer HRA, which is for companies that have fewer than fifty full-time workers. A second type of HRA is the individual coverage HRA, which allows employees to use pretax dollars to purchase their own health insurance. Funds can be used to pay for copays or deductibles. Slayton said that employers can choose an amount they want to give employees so that they can buy their own insurance. Employees who want to claim reimbursement for this must have a Medicare or individual plan.


Small Business Health Insurance :Small Business Health Insurance Options Program lets you compare plans on the Marketplace for small businesses and provide one or more options to your employees. The Small Business Health Care Tax Credit is usually only available through these plans. 4 They are only available on the federal marketplace and state-run exchanges of 13 states

How we selected the best health insurance companies for small businesses

Small Business Health Insurance in USA:The best health insurers for small business are determined by comparing our research on the top health insurance companies to the options that these insurers provide for small businesses who want to purchase plans for their employees.

In order to identify the health insurance companies that we would review in our final list, we looked at business and market insights databases, health insurance company share and user-generated Google data to determine public interest.

Small Business Health Insurance in USA:The National Committee for Quality Assurance, an independent organization which rates healthcare plans based on their quality and satisfaction with patients, provided us with data. Data was also collected from databases and websites of state and federal insurance marketplaces, as well as directly from companies through their websites, media contacts and existing partnerships. The data collection took place from Sept. 29, 2023 to Oct. 23, 2103

The model is based on 27 factors that are divided into four categories. These criteria are critical in evaluating a company’s benefits and offerings. For this article, we weighted each category as follows:

  • Plan for Quality and Customer Satisfaction : 20%
  • Plan Features: 40%
  • Cost: 25%
  • Availability: 15%

Best Small Business Health Insurance Providers Of 2024

Small Business Health Insurance in USA:The Editorial Notice: We receive commissions from links to our partners in Forbes Advisor. Commissions are not a factor in the opinions of our editors or assessments.

Health insurance coverage can aid small businesses in recruiting and retain employees. One option for small-scale companies to get health insurance is to use it being covered under the Affordable Healthcare Act (ACA).

Small Business Health Insurance :We compared the major insurance companies who provide ACA marketplace plans in order to determine the most reputable health insurance providers across the nation. Kaiser Permanente and Blue Cross Blue Shield were rated the top in our study.

How Does Small Business Health Insurance Work?

Small Business Health Insurance in USA:The Affordable Care Act (ACA) defines the term “small business” as a company with not more than fifty full-time workers (FTE) however, certain states might determine it in a different way.

Small Business Health Insurance in USA:Small business owners enroll in the group health insurance plan provided by a private insurer and offers employees with the chance to sign up for the plan. Employers pay a portion of the monthly premiums, whereas employees typically pay lower premiums and also their copays, deductibles and deductibles. the cost of coinsurance, and any other services which aren’t covered under the policy.

Small-scale business owners contract through health insurance firms. They determine the number of options they will give employees.

Do Small Businesses Have to Provide Health Insurance?

Small Business Health Insurance in USA: lSmall-sized entrepreneurs aren’t legally required to provide health insurance for their employees, however there are guidelines for those who choose to do so.

However, you must make sure you are aware of what your state’s definition of a small-sized business, since it will affect the type of insurance you have to offer in the event that you choose to provide health insurance for your employees.

Small Business Health Insurance Options

Small-sized business owners can purchase medical insurance plans for employees from authorized insurance companies that are part of The Small Business Health Options Program (SHOP).

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Insuring through the SHOP Marketplace permits employers to offer health plans from a variety of insurance companies. It also qualifies they can be eligible for Small Business Health Care Tax Credit which may help in offering insurance.

Your company must meet these conditions to be eligible for the tax credit SHOP:

  • A little less than 25 equivalent full-time (FTE) employees
  • The average salary for employees is around $56,000 or less per year.
  • At minimum 50 percent of your full-time employees the cost of their premiums
  • Provide SHOP coverage for all full-time employees.

Small Business Health Insurance in USA:Small business owners are able to engage an healthcare insurance agent who will conduct all research and comparisons to identify the best plan for your company without cost. You can purchase directly through a health insurance firm.

If you choose to purchase insurance via marketplaces like the ACA marketplace, the plans are categorized in “metal” tiers: gold, silver, bronze as well as platinum. The tiers differ in the amount of premiums as well as out-of-pocket expenses. For example plans with silver and bronze have lower premiums, but higher coinsurance and deductibles. Platinum and gold plans have higher premiums, but lower out-of-pocket expenses.

Employers are able to choose the types of plans they select to provide their employees.

Small Business Health Insurance Requirements

Small Business Health Insurance in USA:Small-scale business owners aren’t required to offer health insurance for their employees. If they choose to offer health insurance they must comply with specific requirements set out in the ACA. The requirements vary from state to state.

  • Inclusion: Health insurance must be available to all employees, not only managers or the other groups.
  • Health coverage of the essential benefit: Under the ACA the health insurance plan provided by a small-business proprietor must provide coverage for the basics like emergency services, pregnancy-related medical and services, newborn and maternity treatment, outpatient services, prescription drugs and much more.
  • minimum contribution It is the ACA requires small companies to contribute at minimum 50 percent of the monthly costs of the plans they offer in order to be eligible in tax credits for Small Business Health Care Tax Credit. Additionally, to comply with these regulations states generally require a minimum amount of participants for health plans provided by small companies.

How Much Does Health Insurance for Small Business Cost?

Small Business Health Insurance in USA:The median cost for small-sized entrepreneurs is $612 for each employee per month, while $1,274 for family monthly coverage, according to Kaiser Family Foundation’s 2023 Employer Health Benefits Survey.

Small Business Health Insurance :The exact price depends on many factors, such as prior health insurance claims. For example, a year of rising healthcare costs for employees could result in increased health insurance rates set by the insurance provider the next year.

How To Get Health Insurance for a Small Business

Small Business Health Insurance in USA: There are a variety of options available when you are looking for the ideal plan for small businesses:

  • Make your own research: Small business owners can look through the group health insurance choices from various insurance providers to compare costs and benefits and then enroll in the plan that best suits the requirements of their business. Health insurance firms generally offer different plans for small companies. You can view plan options and costs by entering only a few details in the ACA marketplace site.
  • Find an insurance broker Insurance brokers are knowledgeable about the specifics of health insurance plans along with federal and state regulations. Make sure that you’re working with an independent broker who can show you the various options available to meet your requirements.
  • Discover the SHOP Marketplace On there are useful calculation tools and clear alternatives for high-quality plan for group health insurance.

How to Compare Small Business Health Insurance Plans

Small Business Health Insurance in USA:The process of choosing a small business health insurance plan will require you to follow the same procedure as the consumer purchasing an individual health insurance plan from market Affordable Healthcare Act (ACA) marketplace.

Here’s what you should consider when comparing health insurance for small businesses. insurance plans.

Benefit design

Check out the types of health plans the company provides, such as:

  • Preferred provider organisation (PPO)
  • Organization for health maintenance (HMO)
  • Exclusive provider organization (EPO)
  • Point of Service (POS)

The benefit structure determines if employees are able to access out-of-network health care and require referrals to specialists. Some employees may prefer the lower costs of an HMO and have no issue staying in the network, whereas others may prefer the flexibility offered by an PPO with the understanding that they’ll be paying more for costs. Giving employees options can assist in ensuring satisfaction for employees.


A premium for health insurance is the cost that employees pay in order to be covered. The cost is typically taken out of pay checks. Employers pay the bulk of costs, and businesses have to determine how much insurance will cost them as well as their employees.

Charges outside of the pocket

Deductibles for health insurance, coinsurance and out-of-pocket limits play crucial factors in how much members are charged when they require medical services. A plan with higher deductibles could cost businesses and employees more in the cost of premiums, but it increases the cost for the employees who require healthcare.

Provider network

Health insurance companies have contracts with medical providers and other facilities such as hospitals. The contracts determine the amount of money that providers receive and can also establish requirements for providers, like the requirement that they provide an acceptable standard of treatment. A smaller network may cause employees to look for an appointment with a doctor, which could result in additional out-of-network expenses.

Small Business Health Insurance in USA


We looked at 84 points of data about quality and coverage for seven major health insurance providers to find the most reliable health insurance provider for small business owners. Our scores are dependent on:

  • complaints to the state insurance agencies (30 percent of the scoring): We used information on complaints taken from National Association of Insurance Commissioners.
  • Ratings of plans obtained from National Committee for Quality Assurance (30 percent of the rating): The National Committee for Quality Assurance (NCQA) is an independent, non-profit organization that certifies health plans and gives ratings based on specific indicators, including the experience of patients prevention, treatment, the overall rating of the health care plan and the rating of the quality of care.
  • Silver plan average deductible (20 percent in score): The deductible is the amount you need to spend on healthcare over one year prior to when the health insurance begins to cover some of the cost. Health plans with companies that have low deductibles scored higher scores.
  • Health plans’ breadth (10 percent of the score): Health insurance businesses can offer four kinds of benefit plans (PPO, HMO, EPO and POS). The companies that had more kinds of plans earned more points.
  • Metal tier options (10 percent of scores): The ACA marketplace includes four levels of metal tiers. We awarded points to companies which offered more tier plans options.
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The Bottom Line

Small Business Health Insurance :Blue Cross Blue Shield has the most options available for employers. Many plans offer access to the BlueCard network, 24/7 telehealth and a variety funding options. Aetna is the best self-funded option for small businesses, offering CVS benefits, behavioral health options, and a variety of funding options in many states. Kaiser Permanente is the best for customer satisfaction with its high ratings from third parties and excellent digital tools. UnitedHealthcare, on the other hand, has a unique FlexWork program that makes it a top choice for nontraditional workers.

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Small Business Health Insurance in USA Frequently asked questions

What exactly is self-insured healthcare plan?

Employers collect premiums for health insurance for the form of a self-insured health insurance policy and is responsible for the payment, rather than an insurance company. Self-insured health insurance plans are often an option for larger businesses.
A potential benefit of self-insured policies is that they can help businesses save money when they collect higher premiums than the claims they pay out. However this could create problems if claims are higher than the amount of premium.
Self-insured health plans generally requires employers to engage with a third-party to enroll members, handle claims, and establish network of providers.

What is the cost of group health insurance costs for small-sized companies?

The annual average price of healthcare insurance for small-sized companies is $8,722 for each employee. From that employers pay $7,349 per employee and employees contribute the remainder in Kaiser Family Foundation’s Employer Health Benefits Survey for 2023.
Smaller companies pay lower premiums for health maintenance organizations (HMO) programs than the other types of plans. Small businesses pay $6,644 per year in an average HMO insurance per worker, compared to the $6,970 cost for a point of service (POS) plan, and $7,729 with a preferred provider organisation (PPO) plan as per Kaiser Family Foundation.
According to the Kaiser Family Foundation added that smaller businesses are more likely to cover all premiums for employees over larger firms. The study found that 30% of employees employed in smaller firms do not pay a single premium in health coverage. This is in contrast to only 6percent in larger companies.

How many employees will a small company have health insurance for?

Small-scale businesses don’t need to provide coverage for health care However, companies that have over 50 full-time employees who work minimum 30 hours a week must have coverage in place or risk tax penalties.
Small-scale businesses that offer coverage could benefit from tax credits.

Do business owners have the option of purchasing plans on the market?

Small-sized businesses can purchase health insurance for employees in the marketplace for health insurance via The Small Health Options Program (SHOP). SHOP allows employers to compare plans as well as they can also avail the Small Business Health Care Tax Credit can save businesses money.

Do small businesses have to provide health insurance?

You are not required to provide health insurance for your employees if you employ less than 50 full-time workers. National Federation of Independent Business reports that more than half of companies of this size offer health insurance. According to a survey conducted by the U.S. Chamber of Commerce in 2022, 88% of employees rated health insurance as their most valued employer benefit. If you choose to not offer health insurance that meets federal standards and have at least 50 employees, you will be charged a penalty known as a Shared Responsibilities Payment.

What is the cost of small business health insurance?

Experts suggest keeping employee benefits costs between 10% and 20% of total revenue.

What is a self-insured health plan?

Self-insured plans are a form of group health insurance where the employer pays for claims and collects premiums. These plans can either be self-managed or a business may choose to work with an insurer for administrative support and stop-loss insurance (which limits your risk). Self-funded plans have several advantages. Employers are able to keep excess premiums or receive a portion back from the stop-loss insurer. Plans can also be tailored to a greater extent and certain ACA provisions can be avoided. Self-funded insurance is becoming more popular among small businesses. Self-funded plans may not be right for all businesses.

Can an S Corp pay for health insurance?

Yes,Most health insurance companies will require that you have two employees in order to qualify for a group policy. If you own an S Corp and do not have any employees, then you’ll have to purchase individual health insurance through the ACA Marketplace. You can’t also offer an HRA to someone who owns more than 2% of your company.

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