Health Insurance Requirements for Small Businesses

Small Business

Health Insurance Requirements for Small Businesses

Published on December 07, 2016

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Updated August 8, 2019
The Affordable Care Act (the law commonly known as “Obamacare”) does not require small business owners to provide health insurance to their workforce if they have less than 50 employees. If small businesses do decide to purchase health insurance coverage, one of the main requirements that they should know about is employer contributions to employee premiums. Small businesses should also consider opportunities for tax deductions or tax credits potentially available from offering health coverage to employees.

Health insurance requirements under the Obamacare law

If you’re a small business owner and worried that the Obamacare law requires you to provide coverage for your employees, the good news is that the requirement may not apply to you. In general, only businesses with 50 or more full-time workers (or the equivalent in part-time workers) are required to provide group health insurance coverage or face tax penalties. Most small businesses have far fewer than 50 full-time workers and so are exempt from the provision of the law mandating employer-sponsored coverage.
Due to the repeal of the individual mandate, small business owners and their employees are no longer required on an individual basis to have health insurance coverage that meets the requirements of the Affordable Care Act. This means that they can choose to buy coverage on their own in the individual and family health insurance market, or else purchase or enroll in small business group health insurance.

Other health insurance requirements for small business owners

Small business owners who do opt to purchase group health insurance coverage should know that some state and federal rules and requirements may apply.

  • For example, when you purchase a group health insurance plan, you are generally required to pay at least 50 percent of the monthly health insurance premiums for your employees.
  • You’re also typically required to allow employees to cover their dependent children until age 26, even if they no longer live at home.

You are typically not required to purchase dental or vision coverage along with a health insurance plan. You are also generally not required to pay toward the monthly health insurance premiums of your employees’ dependents, though rules may vary from one state to another.

Special opportunities for employers offering group health insurance

Though they’re not required to provide group health insurance coverage under the Affordable Care Act, many small businesses choose to provide group coverage anyway. Some consider it their responsibility as employers to offer coverage, and many believe that offering health insurance helps them hire and retain the best workers.

Source: eHealth 2018 Small Business Health Insurance Report
When you do offer group health insurance to your employees, you are generally able to deduct the amount of money you pay toward their coverage from your business taxes. If you purchase your group health insurance plan through a government-run SHOP exchange (where available), you may qualify for special federal tax breaks or a small business health insurance tax credit. State-based tax breaks may also apply. To learn more about how offering health insurance coverage can affect your taxes, contact a licensed financial expert or accountant.
Small business owners who are interested in learning more about the group health insurance options in their area should work with a licensed online health insurance agent or private exchange. Through a licensed agent you can get a broad view of the coverage options available to you. You can also get personal help and advice. Once you’ve purchased a group health insurance plan, a licensed agent can also help you enroll your employees and their dependents during your annual open enrollment period.
To explore all of your small business health insurance options, visit eHealth.com or speak with one of our licensed health insurance agents today.
This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.

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