Small Business Health Insurance

Small Group Medical, Dental, Vision and more…

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How does small business health insurance work?

Getting coverage through a small business health insurance plan can be more affordable than buying coverage by yourself. Here’s what you need to know:

  • Coverage is generally guaranteed issue
  • You need at least one employee to qualify
  • You must contribute toward employee premiums
  • And you can shop for coverage at any time of the year

How to choose the right small business health insurance plan

Assess your needs

First, determine what your small business needs in a health insurance plan. Consider the following:

  • Who will be covered? Consider the needs of your employees and their dependents to find a plan that will suit
    the diverse medical and financial needs of the group.
  • How much cost sharing can you afford? Premiums for small business health insurance are paid by the employees and the employer. Make sure consider how much cost sharing makes sense for your business.
  • What kinds of benefits are important for you and your employees? While federal privacy laws prohibit employers from inquiring about employees medical history, it’s important to ask your employees which types of benefits are important to them.

Compare small business health insurance options

There are a lot of factors to consider when weighing your small business health insurance options. At Vanessa Amaya Insurance Services, we recommend using the following 5 criteria to find plans that best match your needs:

  • Monthly premiums: Know what you and your employees will be able to pay on a monthly basis.
  • Deductibles, copayments and coinsurance: Ensure these types of payments will be manageable for you and your employees when you receive medical care.
  • Medical provider networks: If you already have a preferred doctor or facility, make sure they’ll be included in your new coverage.
  • Prescription drug coverage: We have a prescription drug comparison tool to see which plans cover costs of certain prescriptions.
  • Coverage add-ons: With Vanessa Amaya Insurance Services, you can add things like vision, dental care, acupuncture/chiropractic care and term life insurance to ensure your employees are fully covered.

Small business health insurance enrollment process

  • Enrollment is the process of getting your employees and their dependents signed up for your new health plan. Once you’ve selected a plan, an Amaya Insurance agent can walk you and your employees through the enrollment process in-person or online.

What is the SHOP Marketplace?

The Small Business Health Option Program (SHOP) Marketplace helps small businesses provide health insurance to their employees.

The SHOP Marketplace gives employers flexibility in how much of an employee’s premiums they want to pay. Employers can choose from up to 4 levels of health coverage and offer health only, dental only, or both health and dental insurance. Coverage can typically start at any time of the year.

Which small businesses qualify to use the SHOP marketplace?

Companies with 1-50 full-time equivalent (FTE) employees qualify as small businesses and may choose to offer health insurance through the SHOP Marketplace, if available in their state. (In Virginia, the SHOP Marketplace is open to employers with 1-100 FTE employees, and there may be other state-by-state exceptions.)

Companies can calculate their FTE employees by adding together full-time and part-time employees.

  • Add together full-time employees who work 30 or more hours per week.
  • Add together all the hours of part-time employees (those that work less than 30 hours per week) and divide by 30. Round your results down to the nearest whole number.

The small business health care tax credit

How to qualify for employer health care tax credits

  Full-Time Equivalent Employees Average Salary Employer pays at least this % of each employee’s medical premium
Qualification for Minimum Tax Credit < 25 < $52,000 50%
Qualification for Maximum Tax Credit < 10 < $25,000 50%


To qualify for the minimum tax credit:

  • The company must have fewer than 25 full-time equivalent (FTE) employees.
  • Employees must earn an average salary of $52,000 or less for tax years 2015 and 2016.

To qualify for the maximum tax credit:

  • The company must have fewer than 10 FTE employees
  • Employees must earn an average of $25,000 or less.

The tax credit is worth up to 50 percent of the costs of employee’s health-care premiums or 35 percent for nonprofit employers. Other terms and details may apply in calculating eligibility for tax credits.

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