Nevada Small Business Health Insurance Options
The Complete Nevada Small Business Health Insurance Guide (2025 Edition)
The HSA for America Nevada Small Business Health Insurance Complete Health Plan Guide. This guide is for Nevada-based companies that have 30 or fewer workers.
This guide is designed to provide small businesses and freelancers with the information they need in order to offer their employees health insurance that’s cost-effective. This will allow you to remain competitive and offer the compensation and benefits you need in order to keep your best talent.
Nevada Small Business Health Insurance Benefits Options
Nevada small businesses have many options to choose from when it comes time to provide health benefits for their employees. One of the most common but most expensive options is to implement an old-fashioned group health insurance program.
Prices vary according to age. According to information from the Kaiser Family Foundation in 2022, the average annual cost for employer-sponsored health insurance that covers a worker and their family is $20,103.
Nevada employees on average contribute $5,818 to their health coverage costs.
Nevada’s businesses can save a lot of money by choosing other options. These include the following:
- Health savings Accounts (HSAs).
- Health reimbursement agreements (HRAs)
- Direct Primary Care (DPC) Memberships
- Health Sharing Programs
The best small business strategy is dependent on many factors. These include the size of your organization, your budget, as well as the age of your staff and their dependents.
Read on the go, download our Complete Guide To Small Business Healthcare Plans.
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Nevada Small Business Health Insurance Geographical Issues
Nevada’s unique healthcare landscape is also important to consider. This includes the more rural regions around Winnemucca and Hawthorne as well as busy cities such Las Vegas, Reno and Carson City.
Nevada business owners need to be careful about the way their workers are distributed throughout the State. If executives are based in Las Vegas, they may not want to pick an HMO plan which only lets their employees see providers in their network. However, many employees who live and/or work in Jean will be far away from that provider’s network.
Nevada Small Business Group Health Insurance
For most Nevadan employers, the traditional health group insurance plan is their most preferred option.
Also, it’s the most costly.
What’s the process?
The employer enters into a contract with an insurance company, which is usually for profit. This insurance will provide workers’ health coverage and their families if they so desire.
All employers that have at least 50 employees are required to offer ACA qualified health insurance for all their employees who work over 30 hours per week. If they don’t, then they must pay a fine.
This means that the health insurance policy must cover the ten essential minimum coverages (MECs) as required under the Affordable Care Act. This includes:
- A ambulatory service is an outpatient treatment that you can get without going to the hospital.
- Emergency services
- Hospitalization includes overnight and surgical stays.
- Before and after the birth of a newborn baby, you will need to take care of your pregnant woman, your maternity period, and yourself.
- Treatment of mental disorders and substances use disorders including counseling, psychotherapy and other behavioral health services
- Prescription drugs
- Rehabilitative devices and services (devices that help those with chronic illnesses, injuries or disabilities to regain mental or physical skills).
- Laboratory Services
- Prevention and Wellness Services and Chronic Disease Management
- Dental and Vision coverage for adults isn’t an essential benefit.
Also, ACA stipulates that the health plan must cover both birth control and nursing.
It is true that traditional health care insurance can be expensive, but it does have the advantage of guaranteed enrollment.
When a worker enrolls for health insurance, whether it is during an initial enrollment when they initially qualify or a special open enrollment period that begins on the first of November each year or because of some qualifying event in their life, no insurer will deny the application or charge them a higher rate based on medical history.
Nevada Small Business Health Insurance Is Optional
Under the Affordable Care Act, employers with fewer than 50 workers are not required to offer health insurance at all.
There is also no requirement under Nevada state law. If you have fewer than 50 employees, you don’t have to offer health insurance at all.
You won’t pay a penalty.
However, it’s a great idea for employers of all sizes to offer health benefits—even for very small companies—because it may be much more difficult to recruit and retain quality employees without offering a competitive health benefit.
Especially in Nevada, where unemployment is generally low and competition for talent among employers is keen.
Nevada employers can potentially save a lot of money by offering a medical cost sharing or health sharing plan (more info below), and pay some or all of the costs for your employees.
Nevada Small Business Health Insurance HRA Alternative
To help your employees afford their personal health insurance, you could offer them a QSEHRA.
QSEHRAs can provide the following benefits to employers
1.) Minimum contribution limit is not set
QSEHRAs allow you to set your own budget for HRA benefits and change it as needed each year, based on the cash flow in your business. It is up to you as an employer to decide how much money will be allocated for HRA benefits. This budget can change every year based upon the cash flow of your company.
QSEHRAs allow you to manage your healthcare budget.
2.) Flexibility
It is possible to offer different amounts to employees depending on their marital and family status. It is possible to discriminate and offer a bigger benefit for employees with families compared to those without.
3.) Employees and employers are both eligible to receive tax-free treatment.
Employer contributions are deductible at full tax as a compensatory expense. Contrary to cash compensation, however, employees are not taxed on QSEHRA benefits if they continue their health insurance plans that include the ten minimum essential coverages as specified by the Affordable Care Act.
In this case, a QSEHRA will be more effective than providing employees with a health insurance allowance that they can use for other purposes or to pay their health insurance premiums.
4. QSEHRAs Promote Employee Choice
There are too many group health plans that limit employees to just one or a few options.
The HR department and the company’s management select these items, which are overpriced or unsuitable to workers.
A QSEHRA offers workers and families a wide range of options and gives them the power to select a health plan which is right for them.
Nevada Small Business Health Insurance Taxation
As an employer, you can deduct the full amount of health insurance premiums that you pay. This is true under federal and Nevada state laws. Additionally, the premiums paid by employers are tax-free for employees.
The overall cost of health sharing plans is lower. Employees can deduct the monthly costs. Employer assistance in paying for health-sharing costs is taxable.
Nevada Employer Group Medical Insurance: Its Disadvantages
There are some disadvantages of traditional health care for employees and employers.
- Cost
We have already mentioned this before that the cost to provide health insurance is high. This can be especially true for industries with a large labor force, where costs per employee are higher than revenue.
Some of the reasons why traditional health care insurance is so expensive are due to overkill. Government regulators at Washington and Carson City have packed health insurance policies up with mandated coverages, and requirements that do not make sense for many workers.
For instance, many employees don’t require or want maternity and drug/alcohol addiction coverage.
The result is that they are much less effective and economical than needed.
- Inflexibility
Many group health insurance plans are a “one size fits all” approach that does not always meet the budgets and needs of employees. Group health insurance programs sponsored by the employer tend to be one-size fits all and may not adequately address specific employee needs or budgets.
It may make sense for workers to buy their own plans on the market. They could take advantage of the Affordable Care Act’s subsidy.
It may be cheaper to use a health-sharing plan. Innovative and affordable health insurance alternatives can provide a solution, especially to workers in excellent health with no existing conditions.
Here’s a more detailed look at health-sharing plans.
- Administrative burden
A full-featured health benefit comes with substantial administrative expenses. This includes managing paperwork and compliance. You’ll also need to audit plans and ensure no non-qualified employees enroll into them. They are vital to the smooth running of a health care program in an organization.
The plans can be very burdensome for employers with fewer employees who cannot justify hiring a staff member to handle the HR plan full-time.
Business owners could also consider strategies like the Health Care Stipends, or Health Reimbursement Arrangements.
This alternative approach encourages workers to obtain their own coverage under the Affordable Health Care Act. Workers may then be able to take advantage of available subsidies. It removes employers from the process and reduces administrative and overhead costs.
Nevada Health Sharing Plans
Nevada small business owners can benefit from health sharing plans as an affordable and viable alternative to expensive insurance.
Medical cost-sharing plans are becoming a popular alternative to traditional group insurance in Nevada. They offer a more affordable option. Companies can save as much as 50% by switching to health-sharing plans from traditional group insurance.
Nevada small businesses may be able to save upwards of $10,000 per year on coverage per employee for families and over $3,500 each year for individuals.
These programs offer a modern way of funding healthcare. Companies can provide their employees with access to top-quality healthcare and still control costs. Shared resources are the basis of health-sharing programs.
As an alternative to traditional health insurance which requires paying premiums, health sharing programs allow participants to make a set amount of cash per year.
Health Sharing Plans vs. Health Insurance
A health-sharing plan is different from a medical insurance.
In contrast, healthsharing ministries are non-profit associations that bring together people of similar minds to share in the costs of medical care. Contrary to most health insurance providers, who are for-profit companies, healthsharing ministries are nonprofit.
Nevada Small Business Health Insurance Mandated Coverage
Health insurance plans don’t have the same requirements. While state and federal laws require health insurance to cover many things people do not want, or need. These requirements do not apply to health-sharing organizations.
It is not necessary for medical cost-sharing to cover addictions treatments for individuals who have never used drugs. Also, they do not need to cover any injuries caused by a member’s drunk driving.
Pre-Existing Conditions
Health sharing plans are different from traditional insurance policies in that they may require waiting periods to share costs for pre-existing condition treatment.
Many also require waiting periods before undergoing surgery… unless the injury or accident was not anticipated at the time of enrollment.
Health sharing organizations can offer a wide range of great benefits, at a fractional cost compared to a standard ACA group health plan.
Under the Affordable Care act, health sharing doesn’t qualify to receive subsidies. Although the cost savings can be so large, switching to health sharing is still a good option for most people, even if their situation allows them to qualify.
Nevada employers will often benefit more from switching to health share because small group insurance plans aren’t eligible for a premium credit.
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Nevada Health Sharing and Network Restrictions
Health sharing plans provide more flexibility when selecting healthcare providers. They are different from traditional managed-care plans, such as PPOs and HMOs.
Nevada health sharing organizations do not usually restrict the patients’ choice to only providers who are part of their network. In most cases, members of health sharing plans are free to select any provider or doctor. Giving people the choice of doctors.
Are You a Business That Can Benefit From Health Sharing?
Each business is unique. It takes careful consideration to choose the right plan for your business, regardless of whether you’re using a healthsharing plan or traditional group health coverage.
It’s simple for Nevada business owners to receive a complete case analysis with recommendations specific to their organization and employees.
To begin the process, click on this link for an appointment with a Personal Benefits manager licensed in Nevada.
If you’ve prepared a census of your employees, it will make things easier.
It is possible to save up to thousands of dollars on health insurance per employee. It may not make sense to share health insurance with workers who already have a pre-existing condition.
You can always consult with us and get an analysis for free.
Nevada Small Business Health Insurance HRA
The Health Reimbursement Arrangements, or HRAs as they are also known, is a benefit funded by the employer that allows employees to receive tax-free reimbursement for healthcare expenses.
Nevada small businesses often do away with the benefit of group health insurance. They establish HRAs and give their workers cash in order to pay for individual insurance with money pre-taxed.
Workers can then take advantage of any available subsides, which will further reduce the costs to the employer and employee.
The HRA can be used to pay other expenses such as deductibles. co-pays. prescriptions. and durable equipment. HRAs are also tax-free.
When you offer an HRA as a replacement for formal group health coverage, employees have the option to pick and choose health insurance that meets their individual needs.
You can learn more by clicking here.
HRAs for Nevada Small Business Health Insurance
QSEHRA – pronounced as “Cue Sarah”, is a specific type of HRA available to small businesses.
This is a benefit for small businesses that don’t have more than 50 full time employees.
Within certain limitations, businesses are allowed to determine their own QSEHRA maximum allowances. Nevada employers will be able to contribute as much as $5,850 per employee (upwards of $487.50 monthly) or up to $11,800 per family member (upwards of $983.33).
They can use the money they receive to purchase individual or family health insurance, either through an Personal Benefits Manager site on the internet health insurance exchange. They can still qualify for the subsidy if they purchase their own insurance through an online health insurance exchange or a Personal Benefits Manager in the individual and family market.
If you are the employer, then you have two options: You can either reimburse employees only for their insurance premiums or both their premiums as well as any medical expenses.
QSEHRAs (Qualified Special Enrollment Health Savings Accounts) and Special Periods of Enrollment
You will have to offer your workers a Special Registration Period if you are replacing your insurance plan with HRA. During the 60-day Special Enrollment Period, employees are able to choose their own ACA insurance plan and receive guaranteed issue.
If you choose to switch from a group health care plan entirely to a QSEHRA, your employees will not be affected by the change.
The Advantages of HRAs
Health Reimbursement Arrangements offer many advantages.
Your employees are not taxed on the amount you spent for HRA.
HRAs are not paid to the workers until you give them control. The money is available as operating capital. The money does not have to be held by a third-party.
HRAs can be designed in many different ways by employers. This includes the expenses that you want to reimburse, so there’s great flexibility in them.
When workers change status from employee to contractor, their coverage of health insurance isn’t affected. The QSEHRA system allows workers to own and manage their policy. Not the employer.
The Disadvantages of HRAs
Many workers do not wish to take on the task of researching and selecting their own healthcare plan. Some workers need assistance to help them navigate through the change.
We can help if you are in this situation. There is no one left behind.
Simply have your workers select this link and make an appointment or call 800-913-0172.
Click Here to learn more about alternatives to employer-sponsored health insurance for Nevada small businesses
Direct Primary Care Benefit
Direct Primary Care plans present a healthcare alternative that’s growing in Nevada as well as across the nation.
The model is membership-based. For an affordable monthly membership fee (similar to that of a gym), your employees get as many visits they need in person, or through telehealth.
DPC’s monthly membership fees start at just $80 and are a viable option for people to take care of their health, without having to pay copays.
DPC plans offer members unlimited access for routine primary, chronic, and preventive care.
The following are some examples of direct primary healthcare services offered by doctors who practice Direct Primary care include:
- Preventive care. DPC doctors stress preventive medicine. Services include routine check-ups with immunizations or screenings of various diseases.
- DPC doctors offer acute care to patients with minor injuries or illnesses such as infection, colds and influenza.
- Manage chronic disease. DPC doctor help you manage chronic conditions, such as arthritis, diabetes and hypertension. They offer continuous monitoring and make adjustments to treatment plans if necessary.
- Comprehensive physical exams. DPC offers comprehensive physical examinations by DPC doctors to identify and assess risks as well as provide personalized advice on health.
- Urgent care. DPC Doctors are usually available the same or next day for urgent care. To ensure that patients receive timely attention, they can make appointments for any non-emergency health issues.
- Diagnostic services and Laboratory Services. DPCs may perform or arrange a range of lab tests including bloodwork, urine testing, imaging (X-rays) and ECGs.
- Medication Management DPC doctors prescribe medications. They can monitor the effectiveness of those drugs and make necessary adjustments. These doctors can also educate and counsel patients on how to use medications.
- Mental health services DPCs provide mental health treatment as part of their overall care. DPC practitioners may refer to mental health professionals for counseling or therapy.
- Minor procedures. DPC physicians are sometimes trained to do minor procedures right in the office. These include suturing lacerations and removing skin lesions or moles. They can also perform joint injections.
- Care coordination and referrals. DPC doctors are patient advocates who coordinate care and refer patients to specialists, hospitals, or other providers of healthcare when needed.
As there is no insurer involved, no copayments, no coinsurance and no deductibles are required. All costs are covered in the subscription fee. Cash-strapped people can get immediate access to the health care they deserve. No longer will they have to wait until later because the co-pay or deductible is too high.
For services not covered by DPC, patients can purchase supplemental insurance plans. These include accident plans, high-deductible health plans and health sharing plans. DPC covers routine medical care. Therefore, members are free to opt for more cost-effective options such as healthsharing or traditional insurance.
HSAs (Health Savings Accounts)
It is possible to lower the cost of health insurance by using HSAs.
Nevada’s residents and companies need to take advantage of every possible tax incentive. Nevada corporations can deduct employer contributions towards employees’ Health Savings Accounts.
HSAs enable individuals to pre-tax funds for future medical needs. HSAs can be funded by employees as well as employers. However, the annual contribution limit is set annually by Congress in order to adjust it to inflation.
HSAs allow for tax-deferred investment growth and tax-free withdrawals.
HSA Qualification
To be eligible for employer pretax contributions or to open a HSA, the employee must sign up with a high-deductible health plan.
IRS definition of a High Deductible Health Plan for 2023 is any plan having a deductible at least $1,000 for an individual, or $3,000 family.
A HDHP can only have a maximum of $7,500 in annual out-of-pocket expenditures (including deductibles. copayments. and coinsurance). This limit is for individuals. For families, the total amount cannot be higher than $15,000. It does not include out-of network services. ).
What if I Want To Combine HSAs or Health Shares?
At present, there is only one plan that allows employees to contribute pre-tax money into a Health Savings Account: the HSA Secure Plan. It’s available via HSA For America.
HSA SECURE Plan provides a way for you to enjoy the advantages that come from a healthcare savings account and the advantages of cost-savings through healthsharing.
However, to be eligible, you must own or run a business, or earn income as a self-employed person.
HSA SECURE will not be available for straight W-2 workers. HSA-SECURE may work for you if the employee has a side business, small freelance company, or unpaid job and is in excellent health.
HSA SECURE Plans are also an excellent way for small business owners to save on expenses.
You would need to have your employees enroll themselves in HSA SECURE. Once they have enrolled in an HSA and set it up, you may make contributions pre-tax on their behalf.
Click here to learn more about HSA Secure.
Nevada Small Business Health Insurance Taxation of Health Benefits
This table explains the taxation of each alternative strategy available to small companies in addition traditional health insurance. HSA accounts grow tax-deferred and withdrawing money to pay for qualifying healthcare expenses is free of tax.
Plan Type Employer Workers
Traditional health insurance premiums Tax deductible. May qualify for a tax credit (see below) Non-taxable
HSA contributions Tax deductible
Pre-tax, up to certain limits. No income limitations.
Health sharing costs Tax deductible as a compensation expense Taxable as ordinary W-2 income
Health reimbursement arrangements Tax deductible Benefits are non-taxable to the employee
HSA withdrawals N/A
Withdrawals for qualified medical expenses are tax-free. Otherwise taxable as ordinary income.
A 20% penalty for non-qualified withdrawals applies up until age 65.
Direct primary care costs
Tax deductible as a compensation expense Taxable to the employee
Nevada Small Business Health Insurance Care Pyramid
Employee Health Benefits should be designed to cover the entire Employee Healthcare Pyramid. From routine prevention, primary healthcare access and early detection, to catastrophic accidents, it must include everything from the Employee Healthcare Pyramid.
We list the most common insurance solutions for each of the levels in the Care Pyramid on the left.
We list on the right a variety of alternatives, which are more cost-effective, to provide meaningful protection for the employees in each level of the Pyramid.
Good plan designs provide employees with affordable solutions at each of these levels. So that no employee needs to delay or go without care because they can’t afford a premium, coinsurance, or copay…
You can design a personalized plan with the help of your personal benefits manager. These plans can be designed for employees at different levels in the Care Pyramid and are often priced at fractions of what traditional group insurance would cost.
Nevada Small Business Health Insurance Tax Credit
Small Business Health Care Tax Credit passed together with the ACA permits some small companies to claim a Federal Tax Credit of up 50% of their employee’s health insurance expenses.
The program was designed for businesses that have 25 employees or fewer, and hire workers who are paid lower wages.
Both for-profits and non-profits can generally claim this credit.
*Has fewer then 25 employees. Average salaries are around $53,000. It is not common to include owners when calculating employee numbers and salaries. Also, it is calculated based upon “full-time employees” (FTEs). The two-half-time employees will equal one-full-time employee.
* Employees must be paid at least half as much in premiums.
* Offer Affordable Care Act-qualified coverage available on the state exchange, in Nevada’s case, on Nevada Health Link.
Tax credits will no longer be available to employers who have 25 or more employees, or when the average annual wage is at least $53,000.
What is the process for claiming credit?
This tax credit can be claimed on your income tax returns with IRS Form 8941 attached (tax-exempt businesses are required to submit a Form990-T to make a claim even though they do not have to).
Contributions to health insurance for your employees do not attract tax.
My business has not paid any taxes for this year. Is it possible to claim the credit even if my business hasn’t paid any taxes this year?
Yes. You can carry back the tax credit to use it to offset the income tax liability for the year before or you can carry forward the tax credit to offset the liability over the following 20 years.
You can get a refund if your company is not taxed.
To learn all about the Small Business Health Care Tax Credit consult your tax professional.
Combine Nevada Small Business Health Insurance Plan Strategies
When it comes to maximizing your coverage, combining different programs is a wise move.
Combining a variety of health care packages allows employers to reduce healthcare costs and provide complete coverage for their employees.
Combining a Direct Primary Care Plan (DPC), which covers normal primary care, with a low cost health sharing program that includes catastrophic events is one way to achieve cost savings.
Comparing it to traditional group health insurance can make this option more affordable, either for the company or for employees.
Giving employees the opportunity to select between signing up for a health sharing plan or purchasing an individual health insurance plan, as well as the ability to contribute money into a Health Savings Account for those that choose an HAS-qualified HDHP plan, which can provide them with more freedom, while potentially lowering costs.
How to proceed?
The best way to proceed is by putting together a business health plan and contacting us.
Your HSA for America Personal Benefits Manager will review your family and work situation with you. They’ll also discuss your budget, needs and employees’ contribution ability.
Many of the PBMs we work with are also successful entrepreneurs. These PBMs are business owners themselves and have a deep understanding of your requirements as an entrepreneur.
Can I provide both Health Insurance and Health Sharing at the same?
If you offer both, employees can choose the one that suits them best.
Please not that you may fall short of the required minimum rate of participation if you have too few employees participating in a health plan. HRAs can be used to reimburse employees for their individual health coverage, which is close to that cost.
Nevada Small Business Health Insurance FAQ
What is the Difference Between Health Insurance and health sharing for Small Businesses?
A health sharing plan involves members pooling their funds together to cover medical costs.
Nevada: Can employees contribute to their HSAs?
The annual contribution limits established by Congress apply to employers who wish to contribute to HSAs for their employees.
Nevada allows employers to deduct their contributions toward HSAs when calculating state income tax.
Yes. Nevada allows employers to deduct their contributions for employee HSAs as compensation expenses from state income taxes.
Is it possible for a small business to still receive the Small Business Health Care Tax Credit in Nevada even though they do not owe tax?
You can carry the Small Business Health Care Tax Credit backwards to offset your income tax liabilities from previous years or forward for up 20 years.
In Nevada, are maternity benefits included in health-sharing plans?
Nevadans are accustomed to having maternity care covered by their health insurance, as well as healthsharing plans. This includes care during pregnancy, delivery, and after birth. However, certain health sharing plans have limitations on the costs-sharing benefits that are available for children who were not born to a married couple
HRAs are they compatible with health-sharing plans, individual insurance plans and other types of coverage?
HRAs may be combined with other options of coverage. HRAs are used by some small companies to reimburse their employees for the premiums of individual health policies. HRA money can’t be used for reimbursement of employees’ health share plan costs.
How do I know which health insurance options and cost-sharing plans are best for my Nevada business?
It’s not worth it to go at it alone. Talk to an Employee Benefits Manager. He or she can perform a free assessment and provide recommendations, based on specific requirements, your budget, the employee population, and other factors. You can work with them to design the best plan possible that maximizes value for employees and helps you stay competitive.
Does health sharing have a waiting period on conditions pre-existing?
Certain health sharing plans have waiting times for preexisting conditions. Review the plan’s guidelines for specific information or talk to your Personal Benefits Manager.
Health Savings Accounts can be used to help employees with medical costs in Nevada.
HSAs let individuals set money aside for future medical bills before tax. Contributions from both employers and employees may provide tax savings and help reduce healthcare expenses.
Offer Direct Primary Care Plan (DPC) along with other cover options for Nevada Small Businesses?
Combining DPC plans with lower-cost health coverage, like Health Share Plans, provides comprehensive and affordable healthcare solutions for both small businesses and their staff.
What are the requirements for claiming the Small Business Health Care Tax Credits?
Businesses that earn a profit can claim a tax credit by filing IRS Form 8941 on their income tax return, whereas small businesses who are not taxed must file a Form Form 990T.
HSA for America cannot provide you with tax advice. Employers can consult their own tax advisors to get full information about how they claim the credit.
What is a Health Reimbursement Agreement (HRA)?
HRAs reimburse employees’ qualified medical expenses that are not covered under their health insurance plans. The employer determines which expenses are covered and how much money they will contribute.
Are there restrictions on how large a small business can be to qualify for the Nevada Small Business Programs?
QSEHRAs are only open to employers that have fewer 50 employees. You can still get HRAs if you are an employer with more than 50% of employees.
You’ll also be subject to an ACA mandate that you provide a qualified plan of health insurance for employees. If not, you may have to pay a fee. You should speak to your Personal Benefits Coordinator if your company is about to or plans on hiring its 50th full time worker, or equivalent, in the next few months. Your plan could be affected..
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