Small business health insurance in Florida helps you protect yourself and your employees. Knowing your options helps you make the most informed decisions when it comes to building your benefits packages. This guide is for business owners with 25 or fewer employees in Florida. Read on to learn everything you need to know about small business health insurance.
Understanding Small Business Health Insurance
2023 Florida statutes define a small business as an organization with 25 or fewer employees and an annual gross revenue of $1.5 million or less within the last two years. Small business health insurance is health insurance coverage small businesses offer to their employees.
Unlike individual insurance, which someone buys on their own, small business health insurance is chosen by employers and offered to their employees. Employees pay a portion of the policy’s cost.
Large group health insurance plans tend to be less comprehensive than small business health insurance plans since corporations have so many more people to cover. This can limit coverage options for individuals and qualifying family members. The costs may also be less favorable for large group health insurance plans.
Overview of the Florida Health Insurance Market
Florida has more expensive health insurance compared to other states. The average health insurance premium in Florida has risen from $599/month in 2023 to $613/month in 2024.
The rising cost of health insurance means employees and job hunters are seeking businesses that offer comprehensive, affordable policies. Small businesses can increase employee satisfaction by ensuring they have a good benefits package with small business health insurance that helps people offset the costs of coverage.
Benefits of Offering Health Insurance to Small Business Employees
Improve Wellbeing for Employers and Employees
Health insurance is not just a mandatory benefit; it is something we all need and deserve. By investing in high-quality small business health insurance, you can ensure that you are not only taking care of yourself and family members but your employees and their loved ones.
One of the biggest reasons people choose a job is its benefits package. Healthier employees are happier and more productive, as well as more loyal to their company. Investing in health insurance for small business employees is really an investment in their happiness and well-being.
Attract and Retain Talent
A good salary and on-the-job perks are not enough to retain talent in today’s landscape. The rising cost of living coupled with future insecurity and uncertainty mean modern employees want greater stability from their employers. This means offering them benefits that protect their longevity.
Health insurance is one of the most important job benefits a small business can offer. When building a benefits package, it’s advised to focus heavily on good health coverage that can help employees look after themselves and their dependents.
The benefit is twofold; not only does it help you attract more talent but it ensures people will be less likely to leave your business for a company that has better benefits.
Claim Tax Credit
There are no specific tax benefits for small businesses that offer health insurance, but there is a Small Business Health Care Tax Credit eligible businesses can claim. This credit entitles qualifying businesses that buy insurance through the Small Business Health Options Program (SHOP) Marketplace Up to 50% of premiums for employees and up to 35% for non-profit employees.
Ways to Offer Small Business Health Insurance
The cost of offering health insurance can be scary for a small business owner, but it is a lot more manageable than many realize. There are several ways you can go about offering coverage:
- Small business group health insurance plans come in various packages and are often quite comprehensive due to risk pooling. Risk pooling is an insurance concept that involves lowering risks by spreading the financial risk associated with health insurance across multiple people (rather than having it rest solely on one policyholder). This ultimately lowers the insurance company’s risks and allows them to offer more substantial coverage to small business employers and employees.
- The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) allows you to reimburse employees tax-free for their individual health insurance premiums and their medical expenses; this offers greater flexibility and gives employees the power of choice while still offering coverage.
- Integrated Health Reimbursement Arrangements (HRAs) combine a group plan with an HRA, allowing small business employees to relieve reimbursement for out-of-pocket medical expenses or their premium cost.
IRHAs and QSEHRAs offer a hybrid approach to employee health insurance that can make off-setting the costs easier for a small business. At the same time, they ensure you are still providing coverage and desirable benefits. These approaches each have unique advantages, allowing you to tailor your small business health insurance structure to suit your needs and budget requirements.
Options of Small Business Health Insurance Plans
There are various types of group health insurance plans for small businesses you can consider. The variety ensures you have a wide range of options when it comes to personalizing your benefits packages and offering your employees greater financial security. Group insurance is more affordable than individual coverage in many cases; it also allows employers to directly contribute to employees’ premiums.
Below are the types of group insurance plans available, how they work, and the pros and cons of each to consider.
HMOs (Health Maintenance Organizations)
HMOs require employees to select a primary care provider (PCP) from the insurance’s group of clinicians (called a network). The PCP must write a referral for the patient to see any other type of doctor in the network.
Pros
- Lower out-of-pocket costs
- PCP handles all referrals, which can enhance care coordination
- Focuses on preventative health and wellness
Cons
- Often limited networks of providers
- May lack specialists employees need
- Less flexibility when choosing healthcare providers
PPOs (Preferred Provider Organizations)
PPOs allow employees to choose their own specialists and see any doctor they want within the network. They do not need a referral. They can also seek out-of-network care at a higher cost, though they still have some coverage.
Pros
- Greater flexibility in choosing healthcare providers
- Ability to be seen out-of-network
- Coverage for out-of-network care, albeit at a higher cost
Cons
- Higher premiums than HMOs
- Higher costs when seeking care out-of-network
EPOs (Exclusive Provider Organizations)
EPOs work like PPOs, but they do not offer out-of-network coverage.
Pros
- Flexibility when choosing healthcare providers
- Ability to seek specialists without a referral
- Lower premiums due to no out-of-network coverage
Cons
- Coverage only exists within EPO network
- Offers no benefits for some patients who need care not offered by doctors in their network
HDHPs (High Deductible Health Plans)
An HDHP is ideal for a young, active person who is physically healthy and does not require ongoing healthcare. They are more interested in investing in a healthcare plan to protect them in case of emergencies, such as an accident, sudden illness, or hospitalization.
Pros
- High deductible means lower premiums
- Eligible for Health Savings Account (HSA), which has tax benefits
- Encourages more cost-conscious healthcare visits
Cons
- High deductibles mean more out-of-pocket costs for care
- Limited coverage until deductible is met, which could delay some patients to seek care when they need it
HSAs (Health Savings Accounts)
HSAs are paired with HDHPs to offer comprehensive coverage to employees outside of a typical health insurance plan. HSAs are tax-advantaged accounts that have tax-deductible contributions and funds that can be used for tax-free medical expenses.
Pros
- HSAs move with employees, so they don’t lose coverage if they change jobs
- Funds can be invested to support financial growth
- Contributions, growth, and withdrawals are tax-free
Cons
- Requires enrollment in HDHP
- Penalties for non-qualified withdrawals
Indemnity
Indemnity plans are known as fee-for-service health insurance. They allow employees to seek care for any health insurance provider they choose and request reimbursement for their medical expenses.
Pros
- Greatest level of flexibility with reimbursement
- No referrals required for specialist visits
- Predictable copayments and coinsurance for covered services
Cons
- Often have higher premiums
- Creates more administrative tasks due to employee reimbursement model
- Lack care coordination as employees are responsible for finding their own care providers
Average Costs
The average cost of health insurance for each plan time varies widely depending on factors such as the insurance provider you choose, the size of your business and the number of employees who sign up for coverage.
Costs can also fluctuate annually due to changes in company size, inflation, and trends in the healthcare market. On average, employers can expect to spend between $600 to over $800 per month per employee. These costs can be reduced depending on employees’ contributions.
Shopping for Small Business Health Insurance in Florida
Small businesses in Florida can seek health insurance directly from providers, or they can use the Small Business Health Insurance Options (SHOP) Marketplace. They can also seek assistance from a licensed insurance broker who helps them find the best company for their needs.
When choosing a health insurance company or broker for your small business policies in the state of Florida, it is important to assess not only their costs, but customer service because they will play such a pivotal role in getting your employees the coverage they deserve. You want to make sure you’re working with people who you feel you can trust. Moreover,you should know that you can always turn to them when you have questions, concerns or want to make changes to your coverage. It should be a smooth, seamless process that leaves you feeling confident.
Factors to Consider When Choosing a Health Insurance Plan
Although you may be buying a group insurance policy for multiple people, certain factors are equally important when buying coverage for yourself. These.are the most important factors that any small business owner should keep in mind when looking for health insurance for their employees.
Budget Considerations
You must consider the cost of health insurance premiums, deductibles, copayments and coinsurance when choosing the right health insurance plan for your employees.
Remember that you will have to pay a portion of these costs. So while a higher deductible may be more appealing because of lower premiums, it may not always be the right solution.
Higher deductibles also mean that it takes more money out-of-pocket for someone to access healthcare. You should look for a policy that helps balance the cost for you.and your employees so they can access care while still affording coverage.
Coverage Needs of Employees
Consider what other types of insurance your employees may need, such as dental and vision. Some health care providers also offer these under one larger policy. Explore your options thoroughly to ensure you and your employees are getting the most out of your investment. You should also look into the Affordable Care Act and ensure that any insurance policy you purchase includes the mandated free preventative health services.
Network Coverage and Provider Availability in Florida
You should ensure that any policy you choose does have good coverage in the state of Florida. This might.mean looking further into the actual networks available within Florida rather than just the policy itself. Furthermore, you should determine whether the insurance you offer is able to be used by remote employees who live out of state.
Prescription Drug Coverage and Other Additional Benefits
Drug coverage and additional health services vary greatly from one insurance provider to another. Be sure to consider the various needs that your employees may have. It can be helpful working with an insurance broker to ensure you find a policy that covers all your bases.
Flexibility and Customization Options
Some employers may not be extremely concerned about giving their employees the ability to customize their health insurance. However, people always appreciate the freedom of choice. Choose a health insurance provider that allows your employees to customize their coverage. This could include choosing from various levels of coverage, which may include a higher or lower deductible and higher or lower premium. You should also be sure to include plans that allow your employees to cover their qualifying loved ones.
Considerations for Businesses with Part-Time Employees
Employees who work at least 30 hours a week are entitled to health insurance from their employers in Florida.
Eligibility
Anyone who works for 30 hours or week or more for an employer in the state of Florida is eligible for small business insurance. Remember, a small business in Florida is classified as any business with 25 or fewer employees who generates $1.5 million or less in revenue in a two-year period.
Navigating the Enrollment Process
People who start a new job in the state of Florida are eligible to sign up for health insurance at any time of the year because starting a new job is considered a Qualifying Life Event.
Usually, employees can only make changes to their health insurance during the annual Open Enrollment Period, which runs from November to the end of January.
When signing up for health insurance, you will need to provide identifying information, such as your name, company name, Social Security Number, and address. The good news is that many payment processing programs, like JustWorks and Gusto, make it easy for employees to review their employers’ health benefits and pick the right plan for them.
The deadline for signing up for health insurance is 60 days after your start date or other Qualifying Life Event.
Understanding Florida-Specific Health Insurance Regulations
The Affordable Care Act (ACA) offers guidelines for small business health insurance in the United States. Employers and insurance companies cannot deny an employee coverage based on their health conditions, and all employees who are eligible for coverage are entitled to essential health benefits. These are a defined set of services the Affordable Care Act guarantees everyone.
Furthermore, there is a community rating set by the ACA that dictates premiums cannot vary drastically based on a person’s health. This helps keep health insurance fair for your employees who have medical conditions.
COBRA allows employees with health insurance and other benefits to continue their coverage after certain qualifying events, such as being terminated or having their hours reduced. Employers must offer COBRA, but employees pay the full premium cost and an administrative fee. Some employers have a reimbursement program to offset the cost of COBRA premiums.
Resources for Small Business Owners in Florida
There are several helpful websites that can help you learn more about buying group health insurance for your small business in Florida.
- Small Business and the Affordable Care Act (ACA) | HealthCare.gov
- SHOP Coverage for Employers | HealthCare.gov
- Chapter 627 Section 6699 – 2018 Florida Statutes
- Florida Small Business Health Insurance Plans & Quotes
When looking for a reputable health insurance agent or broker, make sure they are experienced in Florida small business health insurance policies and licensed to work in the state.
All of Live Health’s brokers are trained, certified, and licensed to help you find the right policy for your employees. Contact us today to connect with an expert.
Frequently Asked Questions
Are small businesses required to provide health insurance in Florida?
Small businesses with 25 or more employees who work 30 hours or more per week must offer health insurance. If you have questions about health insurance requirements for businesses, it’s best to speak with a small business lawyer.
Do I need a small business insurance broker?
A small business insurance broker can help you get the right policy for your needs. Because they have access to a diverse range of policies from different providers, they can help you find the best coverage. Unlike agents, who work exclusively for one insurance company, health insurance brokers work independently and help connect their clients to the right policies based on unique factors such as their business size, budget, and preferences.
