How to Compare Small Business Health Insurance Plans

Choosing a small business health insurance plan requires you to act similar to a consumer buying an individual health insurance plan on the Affordable Care Act (ACA) marketplace.

Here’s what to look at when comparing small business health insurance plans.

Benefit design

See what types of health plans a company offers, including:

  • Preferred provider organization (PPO)
  • Health maintenance organization (HMO)
  • Exclusive provider organization (EPO)
  • Point of service (POS)

The benefit design dictates whether employees can get out-of-network care and need referrals to see specialists. One employee may like the lower premiums in an HMO and not have a problem staying in-network, while another may prefer the flexibility of a PPO with the understanding that they will pay more in premiums. Providing employees options can help with employee satisfaction.


A health insurance premium is what members pay to have coverage. This usually gets deducted from paychecks. Employers pay most of the premiums, so businesses will need to figure out how much coverage will cost them and their employees.

Out-of-pocket costs

Health insurance deductibles, coinsurance and out-of-pocket maximums play vital roles in how much members pay when they need health care services. Choosing a plan with high deductibles may cost businesses and employees for premiums, but it also puts more costs on employees when they need healthcare.

Provider network

Health insurance companies contract with providers and medical facilities like hospitals. These contracts decide how much providers get paid and may set requirements for providers, such as requiring that they meet a minimum quality of care. A small network could result in employees needing to search for a doctor and lead to extra out-of-network costs.

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By Aban

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