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Insurance and Healthcare Consultant

Tammy Burns is an experienced health insurance advisor. She is ACA-certified for health insurance and other ancillary, life, and annuity product.

Small-Business-Health-Insurance-Group-Options-Badge

Group health insurance can support your small business, strengthen your benefits package for employees, and support your team’s health. It can also help you avoid paying a shared responsibility payment to the IRS. The best small-business health insurance plans can cover employees’ health care needs while staying on target with your budget.

Understand your group health options with this guide.

What You Should Know About Small-Business Health Insurance Plans

  • Insurance is required if you have 50+ full-time employees: Once your business has at least 50 full-time employees, you’ll have to offer affordable insurance. Affordable is defined as no more than 9.5% of an employee’s household income. Under the 50+ threshold, you may not be required to provide insurance, but state guidelines vary.
  • Tax credits are available: If your business gets insurance through the Small Business Health Options Program (SHOP), you may be eligible for the Small Business Health Care Tax Credit. The credit applies if you have less than 25 full-time employees and pay average wages under the maximum income threshold. It credits 50% of the premiums your business has paid.
  • Group plans require employees: Any small business with at least one employee who isn’t a spouse can qualify for a group health plan.
  • Employees can combine Medicare with group health: Older employees may receive  Medicare, which can be combined with group health plans. If a company with 20-plus employees employs an employee or spouse, the group health plan pays first. Otherwise, Medicare pays first. Employees pay any costs not covered by either the group plan or Medicare.
Health insurance company Financial strength rating Customer satisfaction rating Value rating Coverage rating Overall rating
Aetna: Best for options 5 5 5 5 5
Anthem: Best for combined plans 5 3 4 4 4
Blue Cross Blue Shield: Best for nationwide coverage 5 5 5 5 5
Cigna: Best for nationwide coverage 4.5 4.3 4.1 4 4.2
Humana: Best for large networks 4.3 5 5 5 4.8
Kaiser Permanente: Best for specialty services 5 4.5 4.3 4 4.5
UnitedHealthcare: Best for employee-funded benefits 4 4.8 4.8 4.8 4.6

How We Rate Health Insurance Companies

Financial strength: The financial strength rating is based on the insurance company’s AM Best financial strength rating. AM Best is a credit rating agency specializing in the insurance industry, which rates an insurer’s ability to meet ongoing obligations.

Customer satisfaction: The customer satisfaction rating takes into account Kaiser Permanente’s Better Business Bureau, National Committee for Quality Assurance, and Consumer Affairs ratings. These ratings are calculated using customer complaints and satisfaction ratings.

Value: The value rating calculates an insurer’s overall value based on monthly premium, annual deductible, office visit cost, ER visit cost, and annual maximum out-of-pocket cost.

Coverage: The coverage rating considers the insurer’s availability of coverages, plan types, and network size.

What is the Best Affordable Small-Business Health Insurance?

Smallbusiness group health plans may include a single insurance plan or a selection of plans available to employees. Group health insurance plans are among the most affordable plan types, and premiums are considerably lower than traditional individual health insurance plans.

These are your options for providing affordable small-business group health insurance:

  • SHOP: SHOP was created in conjunction with the Affordable Care Act to allow small businesses, usually with one to 50 employees, to search for and purchase affordable small-business group health insurance plans online. SHOP plans are generally the only way small-business owners can claim the Small Business Health Care Tax Credit.
  • An agent or a broker: Captive agents or brokers can only sell for one insurance carrier, while independent agents or brokers can sell for multiple insurance carriers. Choosing an independent agent will likely give you more insurance plan options, as they can provide quotes from multiple providers.
  • An insurance carrier: Purchasing group plans directly through an insurance carrier cuts out the middleman. Employers can usually search for and purchase health insurance from a carrier’s website.
  • Health reimbursement arrangements: HRAs aren’t traditional group health plans, but you can use them to help employees pay for medical expenses. The types of HRAs available depend on your company’s size and can be found through an agent, broker, or insurance carrier.
  • Through the healthcare marketplace: If you’re a business owner with no employees, you can use the Health Insurance Marketplace to enroll in a health plan. Employees without group health benefits can also sign up at gov.

Aetna Small-Business Health Insurance: Best for options

Aetna Medicare Insurance Logo

Company Overview
Overall rating: 5
Company founded 1853
Coverage area All 50 states
A.M. Best rating A+
BBB rating A+
NCQA accreditation Yes
NCQA rating 4.5 to 2.5
Provider network
  • About 1.2 million health care professionals
  • Over 700,000 primary care doctors and specialists
  • Over 5,700 hospitals nationwide

Established in 1853, Aetna is one of the oldest, leading diversified health insurance providers nationwide and has various employer plans. Aetna offers flexible, integrated, and affordable small-business group health insurance plans, including PPO, HMO, indemnity, EPO, and stop-loss options. Ancillary plans include dental, vision, pharmacy, and supplemental coverage. However, not all plans and benefits are available in every state. Discover the options Aetna offers.

Is Aetna a Good Small-Business Health Insurance Provider?

What we like about Aetna health insurance plans: The drawbacks of Aetna health insurance plans:
  • Plans are available in every state
  • Variety of medical plan types for employers
  • Bundled benefits to keep costs stable
  • Some plans have exclusions and limitations in some states
  • Not all plans are available in every state

What do Aetna Small-Business Health Insurance Plans Cover?

Aetna offers several health insurance options, including:

  • Dental
  • EPO
  • HMO
  • Indemnity
  • Pharmacy
  • PPO
  • Stop loss
  • Supplemental
  • Vision

How is Aetna Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Aetna.

Financial strength rating: 5 Customer satisfaction rating: 5 Value rating: 5 Coverage rating: 5

Anthem Small-Business Health Insurance: Best for combined plans

Anthem Logo

Company Overview
Overall rating: 4.3
Company founded 2004
Coverage area 25 states
A.M. Best rating A+
BBB rating F
NCQA accreditation Yes
NCQA rating 4.5 to 2.5
Provider network Large

Formed in 2004, Anthem offers a diverse portfolio of integrated health care plans for individuals, families, and employers in 25 states. Anthem provides numerous HMOs, PPOs, and High Deductible Health Plans for small businesses of two to 50 employees and large businesses with 51 or more employees. It has one of the largest provider networks in the country. Businesses can combine many medical plans with pharmacy benefits, or you can add on affordable dental, vision, and supplemental plans. Understand what type of insurance plans Anthem offers.

Is Anthem a Good Small-Business Health Insurance Provider?

What we like about Anthem health insurance plans: The drawbacks of Anthem health insurance plans:
  • Offers plans in 25 states
  • A wide range of add-on coverage is available
  • Large provider network
  • Plans offered by subsidiaries vary
  • Received an “F” rating from the Better Business Bureau
  • Business plan rules vary in Colorado

What do Anthem Small-Business Health Insurance Plans Cover?

Anthem offers several health insurance options, including:

  • Dental
  • High Deductible Health Plans
  • HMO
  • PPO
  • Supplement plans
  • Vision

How is Anthem Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Anthem.

Financial strength rating: 5 Customer satisfaction rating: 3 Value rating: 4 Coverage rating: 4

Blue Cross Blue Shield Small-Business Health Insurance: Best for nationwide coverage

Blue Cross Blue Shield Logo

Company Overview
Overall rating: 5
Company founded 1929
Coverage area All 50 states
A.M. Best rating A+
BBB rating A+
NCQA accreditation Yes
NCQA rating 4 to 3
Provider network More than 1.7 million doctors and hospitals

Blue Cross Blue Shield has provided quality health insurance coverage since 1929. It offers plans in all 50 states, but not all plans are available everywhere, and regional offices have varying costs and coverages. BCBS has national networks, and most health care providers accept BCBS insurance plans. Learn more about BCBS health insurance products.

Is Blue Cross Blue Shield a Good Small-Business Health Insurance Provider?

What we like about Blue Cross Blue Shield health insurance plans: The drawbacks of Blue Cross Blue Shield health insurance plans:
  • Provides coverage in all 50 states
  • Nearly all health care providers accept BCBS
  • Regional organizations have varying costs and coverage
  • Some plans aren’t available in every state

What do Blue Cross Blue Shield Small-Business Health Insurance Plans Cover?

Blue Cross Blue Shield offers several health insurance options, including:

  • Dental
  • High Deductible Health Plans
  • HMO
  • PPO
  • Vision

How is Blue Cross Blue Shield Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Blue Cross Blue Shield.

Financial strength rating: 5 Customer satisfaction rating: 5 Value rating: 5 Coverage rating: 5

Cigna Small-Business Health Insurance: Best for small-business options

Cigna Logo

Company Overview
Overall rating: 4.2
Company founded 1981
Coverage area
  • Arizona
  • Colorado
  • Florida
  • Illinois
  • Kansas
  • Missouri
  • North Carolina
  • Tennessee
  • Utah
  • Virginia
A.M. Best rating A
BBB rating A-
NCQA accreditation Yes
NCQA rating 4 to 2.5
Provider network
  • A global network of over 1.5 million health care providers, clinics, and facilities
  • Over 67,000 contracted pharmacies

Established in 1981, Cigna is a global health service company that partners with providers who offer high-quality, cost-effective care for individuals, families, and employers. It offers an array of affordable small business group health insurance plans, including HMO and PPO medical plans. Plans can be paired with health savings accounts, flexible spending accounts, health reimbursement arrangements, and other products to improve your overall benefits package. Because Cigna plans are only available in 10 states, explore its limitations before choosing it as your provider.

Is Cigna a Good Small-Business Health Insurance Provider?

What we like about Cigna health insurance plans: The drawbacks of Cigna health insurance plans:
  • Provides an array of medical plans
  • Offers numerous add-on coverages
  • High satisfaction ratings
  • Coverage limited to 10 states

What do Cigna Small-Business Health Insurance Plans Cover?

Cigna offers several health insurance options including:

  • Dental
  • FSA
  • HMO
  • HRA
  • HSA
  • Pharmacy
  • PPO
  • Supplement plans

How is Cigna Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Cigna.

Financial strength rating: 4.5 Customer satisfaction rating: 4.3 Value rating: 4.1 Coverage rating: 4

Humana Small-Business Health Insurance: Best for large networks

Humana-Small-Business-Health-Insurance

Company Overview
Overall rating: 4.8
Company founded 1961
Coverage area All 50 states
A.M. Best rating A-
BBB rating A+
NCQA accreditation Yes
NCQA rating 4 to 2.5
Provider network Large

Since 1961, Humana has provided quality health insurance coverage. As one of the largest insurers in the nation, it offers employer plans in all 50 states. Its straightforward, affordable small-business group health insurance plans are tailored to businesses with two to 99 employees. Humana also offers solutions for large businesses with 100 or more employees. Evaluate Humana’s group health options to determine if it’s the right provider for your needs.

Is Humana a Good Small-Business Health Insurance Provider?

What we like about Humana health insurance plans: The drawbacks of Humana health insurance plans:
  • Can add on dental, vision, and life insurance
  • Offers a variety of plans nationwide
  • Has an array of HMO and PPO plans
  • Certain plans aren’t available in some states

What do Humana Small-Business Health Insurance Plans Cover?

Humana offers several health insurance options, including:

  • Dental
  • HMO
  • Pharmacy
  • PPO
  • Vision

How is Humana Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Humana.

Financial strength rating: 4.3 Customer satisfaction rating: 5 Value rating: 5 Coverage rating: 5

Kaiser Permanente Small Business Health Insurance: Best for specialty services

Kaiser-Permanente

Company Overview
Overall rating: 4.5
Company founded 1945
Coverage area
  • California
  • Colorado
  • Georgia
  • Hawaii
  • Maryland
  • Oregon
  • Virginia
  • Washington
  • Washington, D.C.
A.M. Best rating A+
BBB rating A
NCQA accreditation Yes
NCQA rating 5 to 4
Provider network Over 22,000 Permanente Medical Group physicians and clinicians

Kaiser Permanente has led the way with innovative health insurance approaches since 1945. It’s one of the nation’s largest managed-care organizations and not-for-profit health plans. Kaiser Permanente offers coverage for large businesses and small businesses of two to 50 employees, or two to 100 in California and Colorado. It provides flexible health plans for every sized business and specialty services like acupuncture, chiropractic, dental, and vision at reduced rates. See what Kaiser Permanente has to offer.

Is Kaiser Permanente a Good Small-Business Health Insurance Provider?

What we like about Kaiser Permanente health insurance plans: The drawbacks of Kaiser Permanente health insurance plans:
  • Specialty services at reduced rates
  • Change your doctor anytime
  • Most preventive care services are offered at no cost
  • Only available in eight states
  • Closed network of providers
  • Small-business rules differ in California and Colorado

What do Kaiser Permanente Small-Business Health Insurance Plans Cover?

Kaiser Permanente offers several health insurance options including:

  • Dental
  • HMO
  • HRA
  • POS
  • PPO
  • Vision

How is Kaiser Permanente Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated Kaiser Permanente.

Financial strength rating: 5 Customer satisfaction rating: 4.5 Value rating: 4.3 Coverage rating: 4

UnitedHealthcare Small-Business Health Insurance: Best for employee-funded benefits

UnitedHealthcare Logo

Company Overview
Overall rating: 4.6
Company founded 1977
Coverage area All states except New York
A.M. Best rating A-
BBB rating A+
NCQA accreditation Yes
NCQA rating 4.5 to 2.5
Provider network
  • 1.3 million physicians and care professionals
  • 6,500 hospitals and care facilities nationwide

UnitedHealthcare was established in 1977 and provides health benefits for individuals, families, and employers. Its wide spectrum of insurance plans covers nearly every need, including group health insurance plans for small-business owners in every state except New York. Employers can choose from HMOs, PPOs, and High Deductible Health Plans, some with tiered pharmacy benefit options. Small-business owners can also add employee-funded benefits or split the cost on dental, vision, and life insurance coverage. Research the benefits and drawbacks of choosing UnitedHealthcare.

Is UnitedHealthcare a Good Small-Business Health Insurance Provider?

What we like about UnitedHealthcare health insurance plans: The drawbacks of UnitedHealthcare health insurance plans:
  • Comprehensive group health options
  • Extensive network of providers
  • Extra perks for employees
  • Coverage not available in New York State
  • Some plans aren’t available everywhere

What do UnitedHealthcare Small-Business Health Insurance Plans Cover?

UnitedHealthcare offers several health insurance options including:

  • Dental
  • High Deductible Health Plans
  • HMO
  • Pharmacy
  • PPO
  • Vision

How is UnitedHealthcare Rated?

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how we rated UnitedHealthcare.

Financial strength rating: 4 Customer satisfaction rating: 4.8 Value rating: 4.8 Coverage rating: 4.8

How to Compare Small-Business Health Insurance Companies

  • Find plans available in your area. Insurance providers typically offer an online search tool on their websites. Simply input your zip code and the system pulls up what’s available in your area for you to compare. You can also work with an insurance agent or broker who can guide your decisions.
  • Research the network. Browse the list of in-network providers who’ve agreed to provide health care services to ensure a plan provides enough local options. Seeing providers outside a network incurs much higher out-of-pocket costs for your employees.
  • Research prescription drug coverage. Group health plans often include prescription coverage with tiered coverage and varying out-of-pocket costs to your employees. Research coverage levels to determine which provides the best cost for common prescription needs.
  • Compare monthly premiums. Employers often share the cost of premiums with employees, so understand the factors that affect your premium costs. The type of plans offered and bundling ancillary options make a big difference.
  • Compare deductibles. Deductibles can also vary based on plan type and coverage tiers. High Deductible Health Plans lower premiums and can be combined with Health Savings Accounts to help cover employee costs, but compare all your options first.
  • Compare copays. Most group plans require your employees to make copayments after their deductible has been met, which aren’t shared by employers. Copays vary based on the service received, so compare all possible copays to keep your employees’ out-of-pocket expenses affordable.
  • Research dental coverage. Group dental plans can be added to group medical plans. Dental coverage is varied and can be customized for your business, so research the size of the dental provider network, preventive care coverage, and deductible amounts to meet your needs.
  • Check insurer ratings. Always compare insurance providers’ ratings to see how they stack up against each other based on performance and product offerings to help you find comprehensive, affordable small-business group health insurance plans.

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