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Health Insurance Trends for Businesses With Under 50 Employees

Health benefits for small business

Businesses with fewer than 50 employees are not required by law to insure their workforce. However, about half of them do anyway. There are several options for very small businesses that want to provide health insurance to their workforce. Many still go the traditional route with group health insurance. Many, however, are finding other ways to provide coverage as health insurance premiums steadily rise.

The Rise of Health Care Costs

Employer-sponsored group health insurance premiums have been significantly increasing in the last couple of decades. According to the Kaiser Family Foundation’s 2015 Employer Health Benefits Survey, since 1999 employer-sponsored group health insurance premiums have nearly tripled from $2196 per year to $6251 per year in 2015.

With such steep annual increases in health insurance premiums, many small businesses are forced to cancel their group health insurance benefits because they’re not affordable.

As you can see, other than a couple of spikes, businesses with fewer than 50 employees offering health insurance to their employees has been steadily decreasing:

Percentage of Firms Offering Health Benefits

Employer Reimbursement

Many of the employers that are still offering health insurance are doing it in a different way than they used to: Employers are canceling their group plans and choosing to reimburse all or part of their employees’ individual plan’s premiums. There are a couple of reasons why this is a smart option.

Cheaper individual plans

Individual health plans are much cheaper than employer sponsored group plans. According to ZaneBenefits.com, this is the future of employer health insurance contributions for very small businesses. (The practice of reimbursing employees for their health insurance comes with some compliance requirements that Zane Benefits describes in their article.)

Government subsidies

There is another benefit in this approach. Employees that qualify for government subsidies with the Affordable Care Act get cheaper health insurance. So employers can end up reimbursing less if their employees just enroll on their own. Many small businesses saw this win-win situation and dropped group coverage once Obamacare was implemented.

Other Small Business Health Insurance Options

While it can be cheaper, not all very small businesses that offer health insurance benefits reimburse their employees. Some still buy small group insurance because it’s convenient and because there can be a tax benefit if they meet the requirements.

“The Small Business Tax Credit helps small businesses afford the cost of health care coverage for their employees and is specifically targeted for those businesses with low- and moderate-income workers.  Businesses that have fewer than 25 full-time equivalent employees, pay average annual wages below $50,000 (indexed annually for inflation), and contribute a uniform 50% or more toward employees’ self-only health insurance premiums may qualify for the small business tax credit.” – SBA

  • SHOP (Small Business Health Options Program) is a marketplace where employers can find group health coverage. If you meet the requirements for tax credits, this is probably the way to go.
  • Co-ops
  • Private small-group plans
  • Private health exchange

For more information on these options, check out this informative blog post.

6 Comments

  1. Amanda Drew
    Amanda Drew January 30, 2018

    That’s interesting that some small businesses are opting to just reimburse their employees’ individual plans rather than getting some sort of group plan. You’d want to make sure that you find the right option for your company and employees. It’s still very important to make sure you do offer health insurance of some sort because your employees will expect it. It would probably be a good idea to find a business health insurance broker who could help you find out what’d work for you.

  2. Penelope Smith
    Penelope Smith June 8, 2018

    I didn’t realize that businesses with less than 50 employees don’t have to insurance for their employees. I can understand why they still choose to do though. It seems like it would be safer, in the long run, to have insurance for your employees especially if you want them to stay a longer period of time. Personally, I wouldn’t want to work for a company that didn’t help me out with insurance.

  3. Dave Anderson
    Dave Anderson October 9, 2018

    I like the idea of getting an individual health plan. It would be very smart for an employer to do this since it is a cheaper plan then employer-sponsored group plans. If I were an employer, I would give my employees individual health plans.

  4. Catie
    Catie November 3, 2019

    This a smart way to cover-up health benefits even in a small enterprise. All employees deserved to experience the perks of having employees’ benefits.

  5. Mary J. Manchester
    Mary J. Manchester March 24, 2020

    Hello , Anyone suggest me which is the best health benefits for regular life.

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