Health Insurance for Small Businesses | Employers & Employee Essentials

Grabbing health insurance for your small business can be tricky depending on the size of your company and the kind of coverage you want. You might have many questions — what does the ACA say about small business health insurance coverage? What qualifies your small business for health insurance benefits from the government? How many different plans can you offer?

Luckily, we have a comprehensive analysis of health insurance for small businesses — including the answers to your lingering questions. Do you need to know about your eligibility now? Call one of our talented agents at (855) 968-5736 for the most up-to-date information.

Check out our unique quoting tool if you’re looking for individual coverage. It gives you an accurate estimate of plans through the Federal Marketplace and lets you know how much you’ll pay with the tax subsidy.

Health Insurance for Small Businesses Under ACA

The Affordable Care Act (ACA) establishes a baseline standard for health coverage to make health insurance affordable to all citizens of the United States. But did the ACA create guidelines for small business health insurance? Here’s how the ACA has affected small businesses:

The ACA established the Small Business Health Options Program (SHOP) for small employers.
Employers are required to provide information about the Federal Marketplace to their employees, whether they offer health insurance or not.
When an employee becomes eligible for health coverage, employers must give them a 90-day waiting period to sign up for health insurance.
Employers must provide employees with a “Summary of Benefits and Coverage” form that explains health plan coverage and costs.
Employees can’t contribute more than the annual dollar limit set by the IRS to their Flexible Spending Account (FSA). Employers have no set limitations.

Small Business Health Options Program (SHOP)

The Small Business Health Options Program (SHOP) created a separate Marketplace to help small business owners offer health insurance to their employees. SHOP plans work similarly to plans on the Federal Marketplace as they cover the essential health benefits (doctor visits, preventive care, hospitalization, prescription drugs, and more) and there are various levels of coverage available to employers and employees alike.

If you’re looking for SHOP coverage for your small business, call one of our agents at (855) 968-5736. They are experts at navigating the Marketplace and helping discover your perfect coverage.

Who Can Enroll in SHOP?

There are a few qualifications you need to meet to enroll in a SHOP:

SHOP plans are available to small business owners with 1 to 50 employees.
At least one employee who isn’t the owner, business partner, or spouse of the owner or business partner must enroll in coverage.
Health coverage must be offered to full-time employees (30-hour work week)
At least 70% of your employees must be enrolled in your plan.
You need an office or work site in the state where you would like to purchase SHOP coverage.

The government offers an Eligibility Determination Form if you are uncertain of your small business’s eligibility. You can also call us at (855) 968-5736, and we can guide you towards coverage that’s right for you.

What Are the Categories of SHOP Plans?

There are four categories of SHOP plans to choose from. The different plans only differ in the cost of care shared between your employees and the insurance company you’re working with. Here are the different plans available through the SHOP Marketplace and the standard amount of coverage employees can expect to pay for services:

Plan Type	Insurance Plan Pays	Employee Pays
Bronze	60%	40%
Silver	70%	30%
Gold	80%	20%
Platinum	90%	10%

Why Should You Offer SHOP Coverage?

There are plenty of reasons why you should offer SHOP coverage if you’re a small business owner. Not only will you make health coverage more available to your employees, but it can also appeal to new hires looking for specific coverage options. Here are a few more reasons why you should be looking at SHOP plans:

SHOP insurance offers choices and flexibility. You can choose how many plans to offer, how many plans employees can enroll in, whether to add dental coverage to your plan, how much their monthly premium will cost, and more.

Information about and enrollment into SHOP coverage can be found online or through an agent. Information about SHOP plans can be found online through the HealthCare.gov website. You can also get information and enroll in a SHOP program through an insurance agent.

Small Business Health Care Tax Credits are available to small businesses enrolled in a SHOP plan.

Generally, the only way to qualify for a Small Business Health Care Tax Credit is to enroll in a SHOP plan, and have fewer than 25 full-time equivalent employees who make an average of $56,000 or less.

What Are Some Things You Should Consider for Your Employees?

Before you purchase your SHOP plan, there are a few things you should consider for your employees. The three biggest considerations are prices, benefits, and features. How much will the plan cost for employees? What benefits would employees enjoy? What are some added features that come with the SHOP plan?

Here are some other items you should consider when choosing a SHOP plan:

Should you offer your employees one plan or give them a choice?
How much of your employees’ premiums will you pay?
Should coverage extend to dependents and part-time employees?
When will coverage start?
How long will new employees wait before they get a coverage offer?
Should you offer medical coverage, dental coverage, or both?

Small Business Health Care Tax Credit

The Small Business Health Care Tax Credit can cover up to 50% of the costs you pay for your employees’ premiums (35% for non-profit employers). The only way to claim this tax credit is by enrolling in a SHOP plan. Qualifying for all the tax credits available requires you to follow these guidelines:

You must have fewer than 25 full-time equivalent employees
The average employee’s yearly salary must be $56,000 or less
You pay at least 50% of your full-time employees’ premium costs
SHOP coverage is offered to all full-time employees

Generally, the fewer employees you have, the higher the tax credit. However, each situation is unique.

How Can You Find SHOP Coverage?

You can find SHOP coverage through the HealthCare.gov website, but going through an agent can offer you immediate benefits. The best part about having an agent for SHOP plans is that they can provide you with the most up-to-date information and guide you through the complexities of the different health plans.

Agents can also help enroll you in a plan, manage or update your current plan, and help with your plan renewals or changes. If you’re looking for an insurance agent, call us at (855) 968-5736 any weekday from 9 a.m. to 5 p.m. Our agents are on standby to help show you the various plans available through the Marketplace.

Conclusion

Getting health insurance for your small business can benefit you and your employees. Luckily, government programs like SHOP can give many options and prices that work for your small business. Navigating the SHOP Marketplace can be daunting, but we’re here to help you find the coverage that can work for you.

Call us at (855) 968-5736 to be connected to an agent. Our agents are available from 9 a.m. to 5 p.m. every Monday to Friday and want to help you find the coverage that works for you, your business, and your budget.

You can use our free, unique quoting tool that shows you the plans available with the tax subsidy you’d qualify for If you’re looking for individual coverage through the Federal Marketplace.

Frequently Asked Questions

How Does Small Business Health Insurance Work?

Small business health insurance is offered through the Small Business Health Options Program. When you sign up for a program, you’ll need to fulfill the enrollment guidelines, and you can start offering health insurance to your employees.

Is Dental Coverage Available on SHOP Plans?

Dental coverage is available on SHOP plans, but they are not offered on all SHOP plans. Read through your plan carefully to find out what coverage is available to you on your plan.

Can You Get SHOP Coverage for One Employee? What If Your Employees Are Family?

Yes, you can get SHOP coverage if you have one other employee. However, if your employee is an owner, business partner, spouse of the owner, or spouse of the business partner, you won’t be able to enroll in SHOP.