ResourcesSmall Business Health Care Hub

How to fund your health insurance plan

There are several ways to pay for your health insurance—some you may not have considered before. Each option comes with its own considerations, including cost, flexibility, and the level of financial risk your business is comfortable taking.

Your choice will depend on your company’s size, risk tolerance, and financial goals.

The video introduced your options — now use the tool to see which funding model fits your business.

Try the Funding Options Tool

Group funding options

Think of this as a one-size-fits-all approach to health insurance. Your business chooses a single plan for everyone and covers the cost, so everyone gets the same coverage and benefits. There are several ways to fund your business's health insurance, like fully insured or self-funded, each with its own costs and flexibility.

Explore other options

Many businesses tend to start with fully insured plans, but they are just one of many choices. Other options, like level and self-funded plans can provide greater flexibility and potentially align better with your business needs.

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Which funding options are right for me?

There are several ways to fund your business's health insurance, each with different advantages and drawbacks. Use this tool to explore options and identify choices that fit your company's size, risk tolerance, and financial strategy.*

Use the filters below to select which cost, risk and flexibility options meet your company’s needs:

Cost

How much your business may spend on health insurance, including premiums and, in some funding arrangements, health care claims. Some options offer more predictable monthly costs, while others may vary based on employee health care usage.

Financial risk

The level of responsibility your business assumes for employees’ health care costs. Some funding arrangements provide predictable costs and transfer risk to an insurance carrier, while others may offer potential savings in exchange for greater exposure to claims variability./p>

Plan flexibility

How much you can customize your benefits for your employees. Some funding arrangements offer limited customization, while others provide greater flexibility to tailor a plan to your workforce.

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* This material is intended to offer general guidance and should not be considered a personalized recommendation for selecting any specific health insurance plan. Businesses are encouraged to conduct further research and consult with professionals before making a final decision on their health insurance options.

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Individually funded HRA options

Here, you give your employees money to buy their own health insurance. It's flexible and low financial risk for your business, but some employees might still like having a company plan.

ICHRA NEW OPTION

Individual Coverage Health Reimbursement Arrangements (ICHRAs) are a flexible alternative for small businesses, allowing employers to reimburse employees for individual health insurance premiums and qualified medical expenses. Introduced in 2020, ICHRAs have become an increasingly popular option for organizations seeking customizable benefits solutions.

Learn more about HRAs

Understanding business size requirements

When you're choosing a health insurance plan for your business, you have to determine the number of full-time employees (FTEs) in your business, which can be complicated if you have seasonal, part-time or other contract workers.

Why does business size matter?

Plans are often bucketed into “small group” or “large group” plans. A "small group" usually means a business with 1 to 50 full-time employees, not including the owner. Some states define "small group" as up to 100 employees. State definitions vary and can affect your plan eligibility and pricing. Find your state’s specific rules on the State Resources page.

How many employees do I need to provide a group plan?

Generally, you need at least one full-time employee who is not the owner or the owner's spouse/partner. Specific requirements and definitions can vary by state. Find resources for your state on the State Resources page.

Need help figuring out your FTEs? You can use the FTE Calculator on Healthcare.gov to make it easier.

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Know how you’ll fund coverage — now compare the plans that work with it

Your funding model determines which plan types are available to you and how much flexibility you have in plan design. Compare your options next.

Compare plan options