Group Health Insurance

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Standard Small Group coverage is designed to cover fifty or less employees. Generally, two of the three employees cannot be related to each other. Also, sole proprietors don’t qualify for Small Group
coverage either. If you do not qualify for Small Group, you also have Association Group and Sole Proprietor Small Group coverage options as well. For companies that do qualify, Small Group health insurance can be a great way to attract and keep the best employees. Many small business would like to offer health benefits to employees, but often they skip coverage due to confusion about process and options. Some companies prefer to not offer it due to cost, but in most states, the benefits outweigh the costs. Typically, businesses offer health benefits by purchasing a Small Group plan which provides insurance for employees. Sometimes this is extended to their families. Small business owners qualify as employees themselves, so long as your business has two or more employees that are not immediate family members, you most people qualify for a Small Group plan. The hardest part for most companies is determining which type of Small Group coverage is best. We can help you determine that at no cost. Here are the options to consider.


Direct-To-Carrier - Traditional Small Group

These plans always health services such as maternity care, mental health coverage, or pre-existing conditions. These plans give you freedom to
choose from PPO, HMO, POS and HSA options. Additionally, these plans have unlimited coverage limits, pay for doctor visits and prescriptions with a co-pay, and provide you discounts on some payroll taxes,and in some cases workers compensations costs and are fully tax-deductible. Some companies may qualify for special tax-credits from the IRS. These plans take more time to put in-place and require a broker to assist you. These plans are typically the lowest cost option available but come with the biggest challenges to put in-place.


Association Group and Sole-Proprietor

These plans are identical in structure and cost to traditional Small Group plans, but they have several different things to consider when purchasing one of these plans. First, you won’t get any payroll credits nor workers comp discounts. You would still get the full tax-deduction, and if you qualify, any federal tax-credits. These plans are slightly higher in cost that traditional Small Group, but they have a vast number of benefits.

  • Full choice of PPO, HMO, POS and HSA plan options are available.

  • Far less red-tape. Unlike traditional Small Group, these plans can typically be completed in days, not weeks.

  • Spouses, families, and even sole-proprietors qualify for these plans.

  • There is more choice of plans between employees than traditional Small Group plans.

  • They still provide full PPO access like the traditional Small Group plans.


Tax-Free Monthly Employee Stipend

Give your employees a tax-free monthly stipend that you provide as part of standard payroll that allows them to purchase coverage on their own. Employees can purchase any
coverage they like, or you can dictate what lever of coverage you require them to have. The only real downside to this option is that the choices of coverage your employees have is limited typically to HMO plans on the marketplace. Here are the benefits to this option that you should consider:

  • A broker can still help you with this option at no-charge and will work with each of your employees individually.

  • No red-tape. Unlike Group plans, you just give your employees cash and then your tax preparer fills out a form.

  • Each employee obtains a tax credit (if qualified) from the Marketplace which is based on their age, income and family size.


Before you make any decision, contact us or schedule an appointment with a small business broker and we’ll match you to a broker. It’s free to use a broker and it will save you time and frustration in the end.