Best Affordable health insurance for small business In 2024

Small businesses play a crucial role in the economy, and the well-being of their employees is paramount.  However, providing affordable health insurance can often feel like navigating a complex maze. Balancing the need to provide comprehensive coverage with budget constraints can be challenging.

In this guide, we’ll embark on a journey to unlock the secrets of affordable health insurance for small businesses. We’ll explore the options, strategies, and resources available to help you make informed decisions that benefit both your bottom line and your employees’ health.

You’ll discover the options, tips, and guidance to create a win-win situation for both your employees and your bottom line. 

How Does Health Insurance For Small Business Work?

The Affordable Care Act, commonly known as the ACA, outlines the criteria for defining a small business, generally as a group with up to 50 full-time employees. However, it’s essential to note that specific states, such as California, may have their own variations, categorizing small businesses as those with no more than 100 FTE. 

While small business owners are not legally obligated to provide health insurance to their workforce, there are specific regulations in place for those who choose to do so. Small business owners have the option to participate in a group health insurance plan provided by private insurance companies, which they can then extend to their employees. 

In this arrangement, the employer typically contributes a portion of their employees’ monthly insurance premiums, while the employees themselves are responsible for expenses like deductibles, copayments, and any services not covered by the insurance plan. This approach offers flexibility to both employers and employees while ensuring that healthcare needs are met within the business.

Health Insurance For Small Business Requirements

Health insurance for small business

Employers of small businesses are not required to offer their staff health insurance benefits. In the event that they decide to do so, they will need to fulfill the conditions outlined below by the ACA. States may have different requirements.

  • Coverage of essential health benefits

A small business owner’s health plan is required by the Affordable Care Act (ACA) to cover essential medical services, emergency services, maternity and newborn care, prenatal care, outpatient care, prescription drugs, and more.

  • Minimum contribution

Under the Affordable Care Act (ACA), small businesses seeking the Small Business Health Care Tax Credit must contribute a minimum of 50% of the monthly premium cost for the health insurance plans they offer to their employees. Complementing these requirements, individual states often impose their own criteria, including the need for a specific percentage of employees to participate in these health insurance plans.

As Bruce Jugan, the president of, an insurance broker in Montebello, California, explains, states implement these participation rules to achieve a balance. For instance, if a company has ten employees, and only three opt for health coverage, it can create an imbalanced risk pool, as those three might have more significant health needs. 

To promote fairness and cost-sharing, it’s encouraged for the enrollment to include a diverse mix of individuals with varying health conditions. This ensures that the burden of healthcare costs is more equitably distributed among the workforce.

  • Inclusivity

All workers must have access to health insurance, not just managers or any other group.

Best Affordable health insurance for small business In 2023.

1. Blue Cross Blue Shield

Blue Cross Blue Shield offers extensive coverage across all U.S. ZIP codes, with a range of national networks to cater to the diverse needs of businesses. However, it’s crucial to note that since BCBS comprises a group of companies, benefits can vary by region, and so can customer satisfaction ratings. 

When considering BCBS as your healthcare provider, it’s essential to assess your specific BCBS company, taking into account factors such as customer feedback and complaints. BCBS’s workplace wellness initiatives are tailored to each state. For instance, in BCBS Mississippi, company leaders are trained to lead fitness classes, and employees who commit to exercising at least twice a week receive substantial reductions in their health insurance premiums. 

Other regional benefits differ as well. Anthem, for example, offers a comprehensive package that includes 24/7 virtual care, a user-friendly mobile app, a variety of plan options, and the ability to bundle health coverage with dental, vision, life, and disability insurance. Additionally, the Blue365 discount program provides employees with attractive discounts on a wide array of wellness-related products and services.


  • Offers workplace wellness plans in many locations
  • Offers a variety of workplace wellness programs
  • Blue365 provides employees with discounts on health products and services
  • Highly rated by small businesses


  • Plans vary by location
  • Higher than average healthcare premiums

2. UnitedHealthcare

Health insurance for small business

UnitedHealthcare provides insurance coverage across the majority of U.S. states. Their offerings go beyond employer-sponsored plans, extending to Affordable Care Act plans, Medicare, Medicaid, short-term health insurance, and supplementary insurance like critical illness coverage.

In addition to these options, certain UnitedHealthcare plans come with added benefits. These may include perks such as no-cost primary care physician visits and copays, unrestricted access to virtual medical consultations, adult vision and dental coverage, and the convenience of prescription drug delivery services. 


  • An extensive network of healthcare providers
  • A diverse suite of products and services including helpful in-app services
  • A+ (Superior) financial strength rating with AM Best
  • Offers options for part-time and seasonal workers


  • Customer satisfaction varies by region
  • Does not offer a platinum plan health insurance policy
  • Legal issues over wrongfully denied claims

3. Kaiser Permanente

Kaiser provides an appealing option for individuals fortunate enough to reside in the states where they extend their coverage, offering notably low monthly plan premiums. It’s important to note, though, that these lower premiums can sometimes equate to higher copayments when compared to competitors. 

Nevertheless, if you’re not someone who frequently requires healthcare services, a Kaiser Permanente Bronze plan can be a smart choice. However, it’s crucial to be aware that Kaiser operates exclusively in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and the District of Columbia. 

Additionally, if you prefer a more flexible approach to your healthcare providers, it’s essential to understand that Kaiser primarily offers HMOs that rely on their own integrated healthcare system, encompassing physicians, clinics, and hospitals.


  • High NCQA star rating indicating customer satisfaction
  • Offers low-priced Catastrophic plans
  • Lowest overall premiums


  • Available in only eight states and the District of Columbia

4. Aetna

Aetna, while not as expansive as some industry giants, boasts 169 years of rich history, offering a wealth of institutional experience. Many online sources suggest that Aetna’s pricing remains competitive when compared to other insurance providers.

According to data from the National Association of Insurance Commissioners, Aetna holds a complaint index of 1.94, signifying it has received approximately twice as many complaints as the average insurance company within the same time frame.

Notably, in 2020, Aetna faced a significant penalty of $500,000 for wrongfully denying numerous emergency room claims in California. This incident serves as a reminder that even major health insurance providers often contend with high complaint levels and fines. It’s prudent to exercise caution and conduct thorough research to gauge public sentiment towards Aetna in your specific state or region.


  • Friendly user experience with online, in-app, and over-the-phone service available
  • Allowance for CVS-branded wellness products
  • Lowest-cost plans if using a premium tax credit
  • No- or low-cost CVS MinuteClinic visits


  • Higher than average complaint rate
  • History of wrongfully denying claims
  • Limited availability