Kim Holland

If you’re a small business owner, you may be wondering if you should be offering Affordable Care Act (ACA) health insurance plans to your employees. That depends on a wide range of factors. It’s important to consider deductibles, providers, subsidies, and the coverage for dependents when making this critical decision.

HealthMarkets can explain how to determine the right choice for your business below.

Health Insurance Questions for Small Business Owners

If your group plan is not right for an individual employee’s unique needs and budget, they likely don’t have great alternatives. There’s the option of choosing an individual plan on the government Marketplace, but if they turn down your group plan in favor of an individual one, in most cases, they’ll no longer have eligibility for subsidies. The employee could be stuck between two unattractive prices.

Thus, if you’re offering group coverage, you should make sure it’s in your employees’ best interest. Here’s a list of questions to think about while determining whether your group plan is really serving the needs of the people who move your business forward.

1) Does your plan pay enough for dependents?

Even if your plan offers dependents coverage, it may not be financially feasible for your employees. Some plans will help cover employee premiums, but will pay less or nothing at all for employees’ spouses or kids. The reason is simple: cost. Small businesses are often in no more a position to pay expensive premiums than their employees are. But if your average employee has a large family, they could be spending more than they can afford on medical care even with your plan.

2) Are your deductibles too high?

For cost reasons, small businesses often go with high-deductible insurance plans that offer lower premiums. These plans are great if you have employees who don’t need regular medical care, or who only need basic checkups, which are covered even if you haven’t met your deductible yet. But employees who take lots of medications, need regular doctor visits to regulate ongoing health concerns, or have chronic conditions may pay a lot for their medical care before your plan is ever useful to them.

3) Who’s in network?

Does anyone in your company travel to get to work? If your plan offers a limited service area, chances are they’ll have to travel to get affordable health care as well. HMOs and PPOs only fully cover services provided by “in-network” healthcare professionals—providers who have contracted with the plan to offer lower rates. A network often has a limited geographic area. Your employees may come to you with established physicians whose services they’ll no longer be able to use.

4) Would your employees qualify for subsidies if they had individual health insurance?

This may be the most important question to ask yourself. If you have employees with household incomes that would qualify them for subsidies on their individual health insurance, you may be preventing them from accessing those subsidies by offering group health. It’s a “greatest good” situation; if you have two employees who would qualify for subsidies and 30 who wouldn’t, then subsidies are less of a concern for you. But if a majority of your employees would be able to access tax breaks or out-of-pocket assistance for individual plans, you may want to free them up to take one of those plans.

HealthMarkets Can Help Your Employees Find Health Insurance

I can help you review your options, at no cost to you. Your employees could get individual, tailored plans and could access savings.

Give me a call today. You can find out whether your group plan is beneficial your employees, as well as learn how I could help save you and your employees money.


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