Ohio Small Business Health Insurance: Complete Guide

SHOP Coverage for Employers Ohio best pans health small business insurance
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It takes a lot of effort to build a successful company. Small-business health insurance doesn’t have to be out of reach financially. When it comes to health insurance, small businesses have a much harder time than larger ones. Fortunately, the new healthcare law makes it easier for small businesses to obtain reasonably priced health coverage. In this article, I explain everything about the best small business health insurance plans in Ohio and the providers. I also gave an in-depth explanation of what SHOP coverage for employers in Ohio is and how to get it. Enjoy the ride!

Overview of Ohio Small Business Health Insurance

Regular checkups, preventative care, and immediate medical attention are all made more affordable by Ohio small business health insurance. Employees and their families frequently rely on health insurance supplied by their employers, making this perk a perennial favorite. Group health insurance is a perk that is offered by many small businesses to their employees. Finding your way through the maze of health insurance plans, policies, and jargon while shopping for a provider for your small business can seem like an insurmountable task at first.

We have compiled a list of the best Ohio small business health insurance providers to help you narrow down your choices. If you don’t currently have insurance for your company, you may want to go through our top-rated insurers to locate the best policy for your company’s budget and needs.

What Is Ohio Small Business Health Insurance Provider?

Employer-sponsored healthcare insurance is what we mean when we discuss Ohio small business health insurance providers. Typically, the company and the worker will share the expense of this perk.

Many small business owners in Ohio provide health insurance to their employees, despite the fact that it is not required by law. Furthermore, since health insurance premiums paid by an employer are exempt from federal income and payroll taxes, many employees would rather receive compensation in this form.

How Does Ohio Small Business Health Insurance Work?

To encourage specific types of small businesses, the government offers tax reductions. Group health insurance is only available to businesses with at least one full-time employee who is not the owner or their immediate family. In addition, businesses that provide health insurance must extend such coverage to all full-time workers (those who put in 30 or more hours each week). Health coverage must be made available to all employees, not just managers and professionals.

In order to qualify as an employer that provides health insurance, at least 70% of your full-time employees must be uninsured and willing to participate in the plan. The Affordable Care Act also established a government-run marketplace called the Small Business Health Options Program (SHOP), where business owners can shop around for health insurance. They can also call specific businesses or health insurance brokers to inquire about prices and coverage.

Types of Ohio Small Business Health Insurance

Small businesses can select between two main types of Ohio small business health insurance:

  • Individual health insurance
  • Group health insurance

Read further to see how the two types of Ohio small business health insurance work.

#1. Individual Health Insurance

Personal or family health coverage can be obtained through the purchase of an individual health insurance policy. Individual medical coverage applications are open to anyone. Due to minimum contribution (or minimum participation) rules, small business owners who want to provide health insurance for their employees must instead purchase individual and family policies for themselves and their families. Individual health insurance applications cannot be denied by insurers due to a pre-existing condition that began in 2014. Furthermore, additional tax advantages are available to both employers and employees for the purchase of individual health insurance beginning in 2014. Self-employed individuals who pay for their own health insurance may be eligible for a tax deduction. A “Pure” Defined Contribution Health Plan is commonly established by small businesses that opt to repay employees tax-free for individual health insurance premiums.

#2. Group Health Insurance

Group health insurance is a type of coverage provided by employers. Employees and employers often split the bill, and family members may be included in some plans. Group health insurance plans may be available to sole proprietors in some areas.

Types of Ohio Small Business Health Insurance Plans

There are a wide variety of small business health insurance plans in Ohio to choose from, whether you’re shopping for individual coverage or coverage for your entire company. The following are the types of small business health insurance plans in Ohio:

  • PPO Health Insurance Plans
  • HMO Health Insurance Plans
  • HSA-Qualified Health Insurance Plans
  • Indemnity Health Insurance Plans

What you and your employees want, as well as how much you’re willing to spend, will determine the type of plan that works best for you. Here’s a quick rundown of the four most popular small business health insurance plans in Ohio:

#1. PPO Health Insurance Plans

The most prevalent type of health insurance plan is known as a PPO, which stands for “Preferred Provider Organization.” If your employer has a PPO plan and your employees are enrolled in it, they can only receive reimbursement for medical expenses incurred if they are treated by doctors and hospitals that are on the insurance provider’s list of preferred providers.

#2. HMO Health Insurance Plans

The abbreviation “HMO” means “Health Maintenance Organization.” A wide variety of medical services are available through HMO plans and their contracted networks of doctors, hospitals, and other medical professionals. HMO participants are required to establish a primary care physician (“PCP”) who will manage the majority of their healthcare needs and coordinate care with other HMO providers as appropriate.

#3. HSA-Qualified Health Insurance Plans

PPO plans that meet HSA requirements are the most common type of HSA-qualified plan. An HSA is a tax-deferred savings account set up for the express purpose of paying for future medical costs. Because of the benefits to businesses, Section 105 Healthcare Reimbursement Plans (HRPs) are increasingly replacing HSAs.

#4. Indemnity Health Insurance Plans

Indemnity plans give policyholders the freedom to choose their doctors and hospitals. After that, the insurance company will pay its predetermined percentage of the bill. Some services may require employees to pay in full out of pocket before the insurance company can reimburse them.


Ohio Small Business Health Insurance Providers

The following are the Ohio small business health insurance providers:

#1. Aetna 

Aetna is a major insurance provider that serves the entire state of Ohio. Multiple PPO and HMO network options are available through Aetna, and businesses can offer their employees a choice of up to five different coverage levels. Countless clinics and hospitals are part of Aetna’s extensive PPO and HMO networks.

If you’re a small business owner trying to save money and expand your professional network, an Aetna plan is now one of your best options.

#2. Blue Cross Blue Shield

BCBS, like many of the other health insurance companies on our list, provides a variety of coverage types, such as PPOs, HMOs, and high-deductible policies. BCBS is actually comprised of 34 separate, locally-based businesses. This means that the policies and protections offered by various firms may differ. Get in touch with your local BCBS provider to learn more about the services and plans they offer in your area.

Online reviews reveal that, compared to other competitors on our list, BCBS is more expensive for similarly equipped plan alternatives. This is despite BCBS’s well-deserved reputation for great service and offers. Some plans also have deductibles that are higher than the norm, which means that customers will have to shell out more cash before receiving any medical care.

If you own a small business and want to offer your employees comprehensive health insurance, BCBS is a good choice. Anthem Blue Cross also provides health, dental, and vision insurance and is a division of Wellpoint. The BCBS BlueCard network provides nationwide coverage, and all Anthem plans include access to a robust statewide network. In the state of Ohio, Anthem only has one PPO option available.

When it comes to small business health insurance, Anthem’s policies are now among the most affordable and valuable options out there.

#3. Humana

One of the best Ohio small business health insurance plans is provided by Humana. Humana’s individualized insurance plans are where they truly shine, earning high marks alongside the company’s above-average coverage quality and below-average complaint rate. HMOs and PPOs are just two of the options available to business owners. Humana is more adaptable than its competitors since it allows policyholders to include popular riders like dental, vision, and hearing protection.

Over 20 million people are covered by Humana, making it the sixth-largest health insurance provider in the United States. Humana’s prices are not the most exorbitant, but they are on the higher end of the scale. Humana’s costs are slightly higher than average, according to quotes gathered from the company’s website and several online review services.

Humana also provides only one PPO option in the state of Ohio. Humana’s PPO network is extensive; however, it is smaller than the PPO networks of other companies. Unlike many other Ohio small business health insurance providers, Humana will cover sole proprietorships and husband-and-wife-run enterprises at no extra cost. 

#4. Medical Mutual

Medical Mutual is a regional insurance provider based in Ohio. For its small business plans, Medical Mutual works with the SuperMed PPO. The SuperMed PPO network covers a broad area in Ohio and provides access to several medical facilities. Although Medical Mutual’s plans are more expensive than those given by national carriers, they are still fairly competitive in Ohio. 

#5. United Healthcare

HMO, PPO, EPO, and POS plans are just some of the options available from United Healthcare for companies of all sizes. It distributes useful materials like free fitness, diet, and self-care guidelines and offers discounts to clients who bundle health insurance with dentistry and vision coverage.

United Healthcare not only has a lot of plan choices, but it is also a leader in integrating technology. Potential clients can save time and energy with its in-app services, including claim filing and mental health treatments (accessible with select small business plans via a dedicated app).

Medical, dental, and vision insurance are all available in Ohio via United Healthcare, the largest insurance provider in the country. Access to the extensive United Healthcare network is included in United Healthcare PPO plans. United’s plans are equivalent to those of other national carriers; however, they are more expensive.

#6. Elevance

According to online reviews, Elevance is a good option for companies that want to offer their employees access to a wide range of Ohio small business health insurance providers. There have been complaints about Elevance’s customer service and coverage denial rates dating back at least a few years.

However, do some research on your local Elevance insurance office before making a decision. The states of Colorado, California, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, New Jersey, New York, Ohio, Virginia, and Wisconsin now have access to Elevance.

SHOP Coverage for Employers Ohio

SHOP is a program designed to make it easier for small businesses to offer medical insurance to their staff. Employers in Ohio need SHOP coverage for their companies.

Companies with between one and fifty full-time equivalent employees (FTEs) can provide their workers with SHOP insurance. When purchasing SHOP insurance, small businesses with less than 25 employees may be eligible for the Small Business Health Care Tax Credit. Explore the Small Business Health Care Tax Credit and the SHOP eligibility rules. Individual coverage is available through the Health Insurance Marketplace if you are a sole entrepreneur or self-employed with no employees. As SHOP coverage is very essential for employers in Ohio,why not get yours too?

Enrolling in SHOP Coverage for Employers Ohio

There are two ways for businesses to sign up for SHOP insurance:

  • By means of an insurance agency
  • With the help of a SHOP-approved broker or agent

Finding out if You are Eligible For SHOP Coverage For Employers in Ohio

SHOP insurance is provided to businesses with between one and fifty full-time equivalent (FTE) employees (in some states, this number might go as high as one hundred). The following are the requirements for SHOP coverage for employers in Ohio:

  • All employees who regularly clock 30 or more hours per week must be offered SHOP coverage.
  • For an employer to be able to offer coverage in many states, at least 70 percent of employees must either accept the offer or be covered by some other means. 
  • You need a physical presence in the state hosting the SHOP if you wish to conduct business there.

Benefits of SHOP Coverage for Employers in Ohio

The following are the benefits of SHOP coverage for employers in Ohio:

  • The policies you provide and the contributions you make to employees’ premiums are entirely up to you.
  • Private, high-quality health insurance policies can be tailored to the specific needs of your company and its employees.
  • You have the option of providing either medical or dental insurance to your employees. If an employer provides dependent coverage and an employee takes advantage of it, the dependents of that worker have the option of enrolling in health care only, dental coverage only, or both.
  • Your coverage start date is not tied to the calendar year.

The Small Business Health Care Tax Credit can cover as much as half of your premium payments (or 35% if your company is exempt from federal income tax). The remaining portion of your premium costs after the tax credit has been applied can still be deducted. Employers who provide SHOP plans are the only ones eligible for the tax credit. Check your elig

Choosing the Right Ohio Small Business Health Insurance

Choosing the right health insurance for your company requires careful consideration of a number of criteria. The following are things to check out as you’re getting Ohio small business health insurance:

#1. Benefit Design

The insured’s cost-sharing obligations, such as copayments, deductibles, and coinsurance, are all part of the “benefit design” that defines the insured’s coverage, provider, and service options.

Workers may use their health insurance for unnecessary reasons if their employers foot the bill for a large portion of their premiums. Users will be encouraged to use just necessary services if the benefits package is well-designed, and unnecessary services will be discouraged.

#2. Premiums

Monthly payments are provided in exchange for healthcare coverage through health insurance premiums. Health insurance premiums paid by an employer are frequently split between the company and its employees. To be eligible for the small business healthcare tax credit, employers must cover at least half of their employees’ premiums.

As a business owner, you need to weigh the costs of insurance premiums each month against the value of your company’s assets. When insurance costs are lowered, employees must make do with less coverage and higher deductibles. Before deciding, it’s a good idea to get input from workers or investigate how comparable health plans are priced.

#3. Costs

To be eligible for the small business healthcare tax credit, companies must pay at least half of their employees’ health insurance premiums. However, many prefer to pay a far higher percentage as part of a workplace incentive program.

#4. Instigators of Networks

Some medical insurance programs mandate or incentivize patients to see doctors from a limited network. To keep customers, insurance companies negotiate discounted rates with doctors and hospitals that participate in their networks. Primary care physicians, dentists, psychiatrists, optometrists, and other medical specialists may all be part of an insurance plan’s in-network treatment options.

 #5. Strategies

The healthcare plan’s benefits are what set it apart from others. Bronze, silver, gold, platinum, and catastrophic are the typical levels of coverage provided by most employers. The least priced bronze plan provides the fewest advantages while the most expensive platinum plan provides the most comprehensive protection.

A catastrophic plan, which offers bronze-level coverage for reduced monthly rates in exchange for very high deductibles, is available to anyone under the age of 30 (with some limitations). Health savings accounts are a good option for people who opt for catastrophic coverage policies.

Benefits of the SHOP C

Is it mandatory in Ohio that I provide health insurance to my employees?

Despite the requirements of the Affordable Care Act (ACA), no business in Ohio is obligated to provide its employees with health insurance. However, the Affordable Care Act does not apply to all businesses. You are not required to offer health insurance to your employees if your business has between 1 and 50 full-time workers. However, if you provide insurance, your company will be seen as a more competitive alternative by potential employees.

If your workforce is disproportionately older and more high-risk (high-risk behaviors include smoking and a lack of physical activity), you may incur greater health insurance premium costs.

Do Companies in Ohio Have to Offer Health Insurance?

The vast majority of people in Ohio have access to medical coverage through their workplace. However, it must be understood that insurance is provided by employers on a voluntary basis and is not mandated by law. Your company’s insurance plan could be solely for your benefit, or it could extend to your family as well.

How to Get Free Health Insurance in Ohio?

In Ohio, Medicaid assistance may be available to the following people:

  • You must be a U.S. citizen or eligible for an exemption from citizenship to receive Medicaid.
  • People living on a tight budget.
  • Pregnant women, moms-to-be, and kids of all ages.
  • Senior citizens.
  • Individuals with disabilities.

Can I Use My Ohio Health Insurance in Another State?

Emergency care received at any hospital in the continental United States, with the exception of Hawaii, is covered by all health insurance policies. However, primary care visits and other non-emergency medical services may not be covered.

How to Find Insurance in Ohio?

Check Healthcare.gov marketplace to get details on how to acquire medical insurance. HealthCare.gov offers low-cost options for Ohio residents who do not have access to insurance through their employers, Medicare, or Medicaid.

Final Thoughts

Ohio small business health insurance is affected by a number of variables, including the age and gender distribution of policyholders, as well as their lifestyle choices and geographic location. If your workforce is disproportionately older and more high-risk (high-risk behaviors include smoking and lack of physical activity), you may incur greater health insurance premium costs.


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