Do you need health insurance for your small business in Pennsylvania?
Well you’re in luck.
Our easy-to-understand guide has all the information, tips and tools you need to know to get insured and keep your team happy and healthy.
In this guide you’ll learn about coverage options, alternatives to traditional insurance, top-rated plans, tax-saving tips and how to get started.
Let’s jump in!
Health Insurance Options for PA Small Businesses
Private Group Health Insurance Plans
Think of private group health insurance as your traditional health plans. They are purchased directly from insurance carriers or brokers and are highly customizable based on you and your team’s needs. In general, most private group health insurance plans in PA include:
- Comprehensive coverage such as medical, vision and dental coverage.
- Add-ons (usually for an additional cost). These include mental health support, employee wellness programs and much more.
- Access to a wide-range of health providers across the state of Pennsylvania.
- Most carriers allow you to provide multiple plan options to employees, so that they can choose what works best for them.
SHOP Marketplace for Pennsylvania
For those interested in private insurance plans tailored to the needs of a small business, the Small Business Health Options Program (SHOP) Marketplace is the place for you. SHOP plans are created specifically for business with 50 or less employees and provide a number of advantages for business owners:
- Multiple Plan Options: SHOP offers bronze, silver, gold and platinum plan tiers based on your preferred cost and level of coverage.
- Tax Credits: When you use SHOP to find a group insurance plan, you could be eligible to receive tax credits covering up to 50% of premium costs.
- Plan Flexibility: SHOP also allows you to offer multiple plan options to your employees. Additionally, you have flexibility in how much money you contribute to premium costs on a monthly basis.
In order to use the SHOP Marketplace, your business must meet the following qualifications:
- Must have 1-50 full-time equivalent employees.
- Must offer coverage to all full-time employees.
- At least 70% of the employees offered insurance must enroll in a plan.
- Must have an office or work site within Pennsylvania.
Alternatives to Traditional Health Coverage in PA
For business owners with unique circumstances, there are also a variety of non-traditional health coverage options. These include:
Health Reimbursement Arrangements (HRAs)
These accounts allow employers to allocate funds to their employers so that they can be reimbursed for certain medical expenses and insurance premiums. Rather than providing a group plan to all employees, with HRAs, employees select their own coverage plan.
A strong selling point of HRAs is that employer reimbursements are tax-free. HRAs include Individual Coverage HRAs (ICHRAs) which are designed for businesses of any size, and Qualified Small Employer HRAs (QSEHRAs) which are meant for businesses with less than 50 employees.
Health Sharing Programs
These programs work by pooling together the contributions of all plan members to cover medical costs. While these plans are regulated under the Affordable Care Act (ACA), they provide a cheaper alternative for many employers who aim to provide their employees with basic coverage. Keep in mind that since they are not ACA-compliant, they are not guaranteed to cover all of the medical services provided in a traditional health plan.
Short-Term Health Insurance
These plans provide basic benefits to employees for up to 12 months. They are ideal for employees or teams who only require health coverage for a temporary period of time. While these plans are generally cheaper than traditional plans, like health sharing programs, they often lack all of the comprehensive benefits you’d receive with a private/SHOP plan.
Association Health Plans (AHPs)
Depending on the industry your company is a part of, you may be eligible to become a member of their association, and obtain group coverage at a discounted rate. By combining resources, industry-specific associations are able to receive cost-effective plans, customized for their sector.
Overwhelmed with all of the small business health insurance options in PA? Don’t worry! Visit Group-Health-Quotes.com to get a free quote and get matched with a licensed agent to find a plan that fits your specific needs!
Types of Small Business Health Insurance Plans 
Like most other states, Pennsylvania offers a variety of plan types for small business owners. Each of the following plans has upsides and drawbacks, so we encourage you to explore each one to understand which option fits best for your team:
- Health Maintenance Organization (HMO): Premiums are generally lower and costs are more predictable than other options. Restrictions include employees having to stay within the plan’s network and must receive referrals in order to see specialists.
- Preferred Provider Organization (PPO): PPOs give employees flexibility as they have the options to visit in-network providers, and out-of-network providers with a referral.
- Exclusive Provider Organization (EPO): Like HMOs, EPO members must stick to the doctors in their specific network. Doctors outside of their network will not be covered except in the case of an emergency. Unlike HMOs, EPOs allow members to visit specialists with no referral.
- Point of Service (POS): These plans combine the best features of HMOs and PPOs. While members must use doctors within their network, and need referrals to see specialists, they can also see out-of-network providers for a higher cost.
- High Deductible Health Plan (HDHP) with Health Savings Account (HSA): HDHPs are insurance plans that offer lower monthly premiums, but higher deductibles. This simply means that employees will have to pay more money out-of-pocket before the insurance kicks in. When pairing a HDHP with a HSA, employers are able to save pre-tax money to cover qualified expenses.
For more detailed information about each plan type, take a look at our complete Group Health Insurance Plan Overview.
Top Providers for Small Business Health Insurance in PA
Here are some of the top-ranked health insurance providers in the state of Pennsylvania:
UPMC Health Plans
- Specialize in Pennsylvania coverage, offering a large network of providers across the states.
- Offer a variety of affordable plans intended for small business owners.
- Most plans offer wellness programs and telehealth services.
Highmark Blue Shield
- Plans focus on preventative care.
- Top-notch customer service, support and resources.
- Extensive provider network across the state.
Independence Blue Cross
- Specializes in providing coverage to businesses in the greater Philadelphia area.
- Plans focused on preventative care, mental health services and telehealth services.
Aetna
- Offers extensive, nationwide coverage.
- Pride themselves on a plethora of flexible options for small businesses.
UnitedHealthcare
- Has a vast network of providers across the nation.
- Offers easy-to-use digital tools to make managing your plan simple.
Tax Savings for Small Businesses in PA
For small businesses in Pennsylvania looking to take advantage of tax-saving incentives, you have a few options:
- The Small Business Health Care Tax Credit: If your company is composed of less than 25 employees, you may qualify for a tax credit of up to 50% of your premium expenses. In addition to the employee requirement, in order to qualify, your average employee salary must be around $56,000 per year or less, you must pay for at least 50% of full-time employees’ premium costs, and you must offer SHOP coverage to all full-time employees.
- Tax-Free HSA Contributions: As previously mentioned, employers who offer HDHPs can make tax-free contributions to their employees’ HSA, to reduce taxable income.
- Tax-Free Reimbursements with HRAs: If you offer ICHRA or QSEHRA, your employee reimbursements for premiums or other qualified expenses will be tax-free.
- Payroll Tax Deductions: All employer premium contributions are generally tax-deductible.
Health Coverage Made Easy with GHQ
While the variety of coverage options, plan types and tax incentives can be intimidating to navigate, you don’t have to do it all alone. At Group-Health-Quotes.com (GHQ), we’re here to help so you can get the best small business health insurance in PA. Here’s what we offer:
- Free instant quotes to make sure that the plan you decide on aligns with your budget.
- Plan comparison tools, so you can look at competing coverage options side-by-side.
- Expert assistance from our licensed insurance agents, who are available 24/7.
Don’t make things more complicated than they need to be! Instead, visit GHQ and find the perfect health plan. You’ll be happy to save money, and your team will be happy with their extensive benefits. So what are you waiting for?
To get started simply fill out a form on the right-hand side of the screen or call us directly at (888)-571-0291.
Was this blog helpful? If so, explore our full resource library, home to tons of helpful articles all aimed at helping small businesses succeed and save money!
