top of page
Image by Tim Mossholder

Small Business
Resources

1

EMPLOYEE GROUP HEALTH 101

A group health insurance plan helps your business (you and your employees) pay for health care expenses. Businesses with one or more employees are eligible to purchase group health insurance. Group health insurance plans are designed to be more cost-effective for businesses. Employee premiums are typically less expensive than those for an individual health plan. Because insurance premiums are paid with pre-tax dollars, it helps employees pay less in annual taxes. Employers pay lower payroll taxes and can deduct their annual contributions when calculating income taxes.

2

AFFORDABLE CARE ACT (ACA) MARKETPLACE GROUP PLAN (SHOP)

The Small Business Health Options Program (SHOP) helps small businesses with 1–50 employees provide private insurance to their employees. It’s also generally the only way to access the Small Business Health Care Tax Credit, which can save eligible employers up to 50% of their employer contribution. You can enroll in SHOP plans through an insurance company or with the help of a SHOP-registered agent or broker. This may be different than how you may have enrolled in SHOP in the past. Specific enrollment steps may vary by the insurance company, but see the next page for some guidelines to help you with the enrollment process. 

3

THE SMALL BUSINESS HEALTH CARE TAX CREDIT 

You may qualify for the Small Business Health Care Tax Credit which could be worth up to 50% of the costs you pay for your employees' premiums (35% for non-profit employers). 


Enrolling in a Small Business Health Options Program (SHOP) plan is generally the only way for a small business or non-profit to claim the Small Business Health Care Tax Credit. To qualify for the tax credit, all of the following must apply: 

​

  • You have fewer than 25 full-time equivalents (FTE), employees 

  • Your average employee salary is about $56,000 per year or less 

  • You pay at least 50% of your full-time employees' premium costs 

  • You offer SHOP coverage to all of your full-time employees. (You don't have to offer it to dependents or employees working fewer than 30 hours per week to qualify for the tax credit.) 

​

The tax credit is highest for companies with fewer than 10 employees who are paid an average of $27,000 or less.

4

Call us at 1 (720) 744-0065 to see if you qualify.

5

SMALL BUSINESS SIMPLIFIED FUNDING OPTION WITH STOP LOSS 

Simplified Funding Option Plans offers a different way for businesses to provide health insurance benefits. The complexity of new healthcare laws and their potential to raise insurance rates may leave some employers looking for an alternative to fully insured plans.
 

 

The Affordable Care Act (ACA), also known as Obamacare, requires fully insured employer group plans to cover essential health benefits (EHB) as defined by the legislation. The law also puts certain rating restrictions on employer group insurance, which, along with the requirements for EHB, could increase the total cost of providing health insurance to employees. The program to cover your employees under a self-funded health benefit plan coordinated with stop-loss insurance protection.
 

 

The self-funded plan provides the required coverage to meet the ACA’s mandate. Governed by federal law under the Employee Retirement Income Security Act (ERISA), self-funded plans allow employers more

generous latitude in designing coverage. From the options available, you can select the plan that best meets your employees’ needs. Your single monthly payment is applied to the claims account, plan administrative expenses, and stop-loss insurance premium.
 

Claims account Funds are deposited into an account set up expressly for the group’s covered medical claims. The amount deposited is based on the anticipated medical claims for the group.

Administration Plan administrative expenses, such as billing, customer service, and claims payment, are also included as part of the monthly payment.
 

 

Stop-Loss Insurance: includes employer stop-loss coverage.

Subscribe to Our Newsletter

(Important Updates and Money Saving Info Only)

  • GMB-Icon-on-Yellow-1024x750
  • Facebook
  • Twitter
Connect for Health Colorado Health Plans
Covered California Health Plans

Copyright 2022 – Trust Financial LLC, DBA HealthCare Affairs® – All Rights Reserved.

​

This website is operated by HealthCare Affairs and is NOT the Health Insurance Marketplace website. In offering this website, HealthCare Affairs must comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. HealthCareAffairs.Com is privately owned and operated by Trust Financial Corp. We are not a government website. For more details, please call us at 1 (720) 744-0065. We do not offer every Medicare plan available in your area. Therefore, any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.

bottom of page