One renewal quote changed everything. Learn about this small business health insurance case study:
Small Business Health Insurance Case Study
A 60-person manufacturing company was staring down a 24% premium increase that pushed its annual group health insurance spend past $1.1 million.
Instead of accepting it, they called HSA for America. Within one plan year, they cut costs by $180,000 — without reducing employee access to care.
This small business health insurance case study breaks down exactly how they did it.
Key Takeaways
- A 60-person company saved $180,000 in one year by replacing traditional group insurance with a hybrid ICHRA model.
- Employees kept access to quality care — no corners were cut.
- Small business health insurance savings this significant are achievable with the right strategy and advisor.
- Most small business owners overpay simply because they don’t know better alternatives exist.
The Problem: Premiums That No Longer Made Business Sense
The company had been on a fully-insured group plan for six years.
Each year brought another increase. But the 2025 renewal — a 24% jump to $17,700 per employee annually — finally forced a real conversation.
Employees weren’t happy either. High deductibles and a narrow network meant they were paying significant monthly contributions for a plan they felt they couldn’t afford to use.
The Solution: A Hybrid ICHRA Model
HSA for America’s advisors recommended replacing the group plan with an Individual Coverage Health Reimbursement Arrangement (ICHRA).
Instead of locking everyone into one carrier’s plan, the company provided a defined monthly reimbursement allowance — $650 for individuals, $1,400 for families. Employees then chose their own health plan:
- 60% enrolled in HSA-qualified high-deductible health plans and opened Health Savings Accounts (HSAs). The employer seeded each HSA with $500.
- 40% — mostly younger, healthier employees — joined vetted health sharing plans, where monthly contributions ran significantly below what the old group plan cost.
Compare Pricing on the Best HealthShare Plans Available
The Results: $180,000 in Small Business Health Insurance Savings
The numbers tell the story.
Old plan employer cost: ~$858,000/year New ICHRA total cost: ~$678,000/year First-year savings: $180,000 (21% reduction)
Employee participation held at 89%. Employees in health sharing plans saw their monthly contributions drop by an average of $210. The CFO projected ongoing savings of $150,000–$180,000 annually going forward.
Frequently Asked Questions
Is an ICHRA legal for small businesses?
Yes. ICHRAs have been federally authorized since 2020 and are available to businesses of any size.
Can employees keep their doctors?
Usually yes. Most employees choosing ACA-qualified plans or health sharing programs with broad networks retain their existing providers.
How long does the switch take?
Most transitions take 60–90 days, timed to your plan’s renewal date.
Will employees be upset about the change?
Usually not. Most employees welcome lower personal costs and more plan choice. Clear communication and guided enrollment support make the transition smooth.
Does this work for businesses with fewer than 20 employees?
Yes. ICHRAs and health sharing plans are available to businesses of any size, including sole proprietors with just a handful of staff.
Your next renewal doesn’t have to look like the last one. See how much your business could save — schedule a free small business health insurance consultation with a Personal Benefits Manager at HSA for America. Call 800-913-0172.
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