How to Pick the Best Small Business Health Insurance Plan
There are an estimated 30 million small businesses in the United States. Each small business is unique in its background, goals, and finances. When it comes to attracting and keeping employees, health insurance coverage plays a big role. However, the number of options can be tough for many small business owners. That's why we've broken down small business health insurance options into the basics.
Why Choosing the Right Small Business Health Insurance Matters
Budget, company size, and flexibility all play a role in selecting the best plan. Balancing workers' interests with costs is the most important factor in choosing health insurance. There are also other factors, including out-of-network doctors and trust in a provider. Providing employees with a good health insurance plan can often solve a few issues. It helps small businesses attract and retain employees, increase job satisfaction and foster a healthy company culture with healthier, more productive employees.
Where Do Small Business Owners Begin?
There are many health care coverage companies that offer plans to attract new business. Understanding your choices is often tricky; let's break down the basic terms, networks, and tiers.
What are the Differences Between Health Insurance Provider PPO and HMO?
A PPO network gives the member flexible benefit design options at an affordable price. Your employees will have a wide range of benefits and the freedom to visit any doctor they choose. Benefits will be paid at a higher level when the doctor is in the plan’s provider network.
An HMO network typically provides lower premiums and in-network costs. The member must choose a primary care physician who is in-network who will coordinate their care. Out-of-network benefits are limited or unavailable.
What are the Important Small Business Health Insurance Terms?
It's important to gain a basic understanding of these common terms. That way, it's easier to settle on a plan that suits your business.
What is a deductible?
A deductible is the amount the member pays for most covered services before their health plan starts to pay. The deductible resets at the beginning of the calendar year or when the member enrolls in a new plan.
What is a health insurance premium?
A premium is the ongoing amount that must be paid for a health plan to remain active. The employer and employee usually pay it monthly, quarterly or yearly. The premium isn’t the only amount the member pays for insurance coverage. Typically, they will also have a copay and deductible amount.
What does out-of-pocket maximum mean?
The out-of-pocket maximum is most a member will pay for covered services in a plan year. After the member spends this amount on deductibles, copays and coinsurance, the health plan pays 100 percent of the costs of covered benefits. The out-of-pocket maximum doesn't include the premium or anything spent that the plan doesn't cover.
What is coinsurance?
Coinsurance is the percentage of the costs of a covered health care service or prescription drug the member pays after they've met their deductible. A plan that has 60%/40% coinsurance means the company covers 60 percent of the costs and the member is responsible for 40 percent of the costs.
What Information Do Business Owners Need?
- Location: Where a small business is will determine what options are available. The headquarters' ZIP code determines what carriers offer plans in your area.
- Company Size: The number of employees that are eligible for health care benefits. To qualify as a small business, your company needs between 2 and 50 full-time employees (including the owner).
- Employee Information: Employee names and birth dates. This includes family members (if applicable).
- Required Documents: Proof of wages documentation is required for enrollment.
- For example, your company’s most recent Illinois Employer’s Contribution and Wage Report (Form UI 3/40) would be an acceptable document.
Completing Enrollment and Getting Started
Once the goals are weighed against the cost of a small business health plan, it is time to select a health care plan.
