Connecticut Small Business Health Insurance Options
Welcome to the HSA for America Complete Guide to Connecticut Small Business Health Insurance. This guide is for Connecticut-based companies that have 30 or fewer employees.
This guide is designed to provide small business, freelancers, and independent professionals with the best health care benefits at the lowest possible cost. It is possible to stay competitive without sacrificing the overall benefits package and compensation you offer.
Connecticut Small Business Health Insurance Benefits
Connecticut has many choices for small businesses when it comes time to provide health benefits for employees.
It is the most affordable option, but also the one that’s most prevalent, to have a standard group health care plan.
Prices can vary depending on your age. However, according to statistics from the Kaiser Family Foundation in 2022, an employee’s and his family would pay $24,018, or nearly $3,000 over the national average.
Connecticut’s employees pay an average of more than 6 005 dollars per year towards health insurance.
Connecticut business owners have several other options available to them that they can use to reduce their expenses. The following are some of the options available to Connecticut businesses:
- Health savings Accounts (HSA)
- HRAs are health reimbursement plans.
- Direct Primary Care (DPC), memberships
- Programs for health sharing
- The right strategy for small businesses is dependent on many factors. These include the size of your firm, budget available, as well as age, medical needs, and other requirements, of both your staff and those of their families.
Connecticut Small Business Health Insurance and Geographical Issues
Connecticut’s unique healthcare landscape is also important to consider. This includes not only the busy city areas of Bridgeport, Hartford, Waterbury but also more rural places around Warren, Ellsworth, etc.
Connecticut business owners need to be careful about the distribution of their staff. For example, executives at the Waterbury headquarters of a business may not want to use an HMO with a network that limits their employees to in-network physicians when they have many workers in Oxford who live and work far from this plan.
Connecticut Small Business Group Health Insurance
In Connecticut, most employers opt for traditional group health plans.
The price is high.
The following is how the system works:
Third-party health insurers, which are usually for-profit corporations, provide benefits to employees as well as their families if they so desire.
The Affordable Care Act requires that employers who have 50 employees or more offer a health plan approved by the ACA to employees working more than 30 hour per week. Otherwise, they will be penalized.
Health insurance plans must include the 10 minimum essential coverages required by the Affordable Care Act. The ten essential coverages (MEC) are as follows:
- Patients can receive ambulatory services without needing to go into hospital.
- Emergency services
- Hospitalization can include overnight hospitalizations and surgery.
- The care of newborns, pregnant women, and mothers (both before and afterwards)
- Treatment for substance abuse disorders, mental illness and behavioral problems (including counseling and therapy)
- Prescription drugs
- Rehabilitative devices and services (devices that assist those who have disabilities or are injured to gain mental or physical skills)
- Laboratory services
- Prevention and Wellness Services and Chronic Disease Management
- Dental and Vision coverage for children (adults are not covered by essential health benefits).
For example, the ACA mandates that insurance policies cover both birth control and nursing.
Traditional health insurance for business is expensive, but it has the benefit of guaranteed enrollment.
In the event the worker does not enroll during an initial period, when they are first eligible for coverage, or during a special open enrollment that begins November 1st, each year or after a qualifying life experience, then the insurance company is prohibited from refusing to cover them or charging a higher rate due to their medical records.
Small Businesses Can Opt Out of Health Insurance in Connecticut
According to the Affordable Care Act (ACA), employers who have fewer than fifty employees are not required by law to offer any health coverage.
Connecticut also has no such requirement. It is not required to provide any health coverage if your company has fewer 50 employees.
The penalty is not applicable to you.
But it is a good idea to offer competitive benefits to all companies, including small businesses. Without them it could be very difficult to find and keep quality employees.
Connecticut is one of the states with the lowest unemployment rates and where employers compete fiercely for top talent.
Connecticut employers could save money by providing a health-sharing plan or medical cost-sharing program (see below for more information) and paying some of or all the employee’s costs.
Read on the go, download our Complete Guide To Small Business Healthcare Plans.
Connecticut Small Business Health Insurance HRA Alternative
You can also offer your employees a QSEHRA (Qualified Small Employer Health Reimbursement Arrangement) that allows them to pay their individual health insurance tax free.
QSEHRAs offer the following advantages to employers:
1.) There are no minimum contributions.
QSEHRAs do not require you to make a certain minimum amount every year like pension plans. Employers can choose their own HRA budget, which they may change each year depending on cash flow.
A QSEHRA allows you to control the budget of your medical benefits.
2.) Flexibility.
If you want to discriminate, then offer a higher or lower amount depending on the marital status of your employees. If you want to discriminate, then give a larger benefit to single employees or employees without children if they have families. This reflects the actual costs of buying health insurance.
3.) Both employers and employees are eligible for tax-free treatment.
Contributions by employers are tax-deductible. Your employees won’t pay tax on the QSEHRA benefits, unlike those paid in cash.
This is why offering QSEHRAs to employees who can then use them for health insurance purchases or other expenses, are usually more beneficial than offering an insurance subsidy.
4.) QSEHRAs Promote Employee Choice
There are too many group health plans that limit employees to just two or three options for health coverage.
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.
Is Connecticut Employer Health Insurance Taxed?
As an employer, you can deduct all the costs associated with health insurance as part of your business expenses under federal and Connecticut laws. Also, they are not taxed to employees.
Costs of the health-sharing plan are lower. These plans’ monthly fees are tax-deductible for employees. However, employer assistance for paying health sharing costs is taxable to the employee.
Connecticut Employer Group Medical Insurance: The Disadvantages
There are some disadvantages of traditional health care for employees and employers.
- Cost. We have already mentioned that the cost to provide health insurance is high. This can be especially true for industries with high labor costs.
The government regulators of Washington and Hartford have crammed health insurance policies full of mandatory coverages that are not practical for most workers.Traditional health insurance, for example, requires that carriers include coverage of drug and alcohol abuse, mental health, and maternity, which many workers do not need or desire.
Consequently, they become much less economical and effective.
- Inflexibility. Most group insurance programs offer an all-encompassing strategy which does not necessarily meet specific needs and budgets of employees. Group health insurance sponsored by an employer is usually a one-size-fits all strategy that does not address the specific needs of employees.
The Affordable Care Act may offer subsidies to workers who purchase individual plans.
A less costly health-sharing plan may suit them better. The innovative, affordable, and flexible alternatives to traditional health insurance are a good solution for employees who do not have pre-existing health conditions.
The following sections will discuss in detail health sharing plans.
- Administrative burden. Administrative costs are high when managing a comprehensive health plan. It involves managing documents and compliance, auditing the plans to make sure employees are not enrolling non-qualified individuals into the plan and answering questions from staff. This is essential for a health insurance plan to run smoothly within an organization.
They are a burden for very small companies who do not have enough employees to support a full time HR team to manage the plan.
Business owners may also use strategies like Health Reimbursement Arrangements or health care stipends.
The Affordable Care Act offers alternative ways to encourage people to get their own health insurance. The workers may benefit from the available subsidies. The employer is also removed from the whole process.
Health Sharing Plans in Connecticut
Health sharing plans are a viable and economical alternative to overpriced health insurance coverage for small businesses in Connecticut.
Businesses in Connecticut are increasingly utilizing medical cost sharing plans as a budget-friendly substitute for traditional group health insurance plans. By switching from health insurance to health sharing, companies can frequently save up to 50% on premiums compared to their old traditional group health plans.
That means Connecticut small businesses could potentially save more than $10,000 per year per employee for family coverage, and more than $3,500 per employee per year for single coverage.
These programs represent a revolutionary method of financing healthcare. This allows companies to afford high-quality healthcare for their staff while also controlling expenditures. A health sharing program is a way to pool resources across several individuals and organizations.
The participants of health sharing programs make a certain amount of money each year, instead of the usual insurance premiums that are paid to insurance providers.
Health Sharing Plans vs. Health Insurance
Health sharing plans are not the same thing as health insurance.
In contrast, health sharing 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, health sharing ministries are nonprofit.
Mandated Coverages
While federal and state laws require traditional health insurance policies to include coverage for many things that many people don’t want or need, health insurance plans have no such requirements. The Ten Minimum Essential Coverage requirements don’t apply to health sharing organizations.
Medical cost-sharing plans are not required to cover the cost of addictions treatment for people who never use drugs, for example. And they don’t need to cover the cost of treating injuries because of the members’ drunk driving.
There are pre-existing conditions
Most health sharing plans impose waiting period before sharing costs to treat pre-existing condition.
They may also require waiting periods prior to surgery for all but accidents or injury that was not anticipated at the time of enrollment.
Health sharing companies can provide a range of excellent benefits that are a fraction as expensive as a policy purchased through Access Health CT or an ACA-qualified, unsubsidized group health insurance.
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, regardless of whether they are eligible for a subsidy or not.
Connecticut employers can benefit from health sharing even more because they don’t receive a premium subsidy.
Health Sharing and Network Restrictions in Connecticut
Unlike traditional managed care plans such as HMOs and PPOs, which are by far the most common employer-sponsored group health insurance plans, health sharing plans often offer more choice when it comes to choosing healthcare providers.
Most health sharing organizations Connecticut don’t restrict their patients to providers in the network. Health sharing members can choose any doctor they want. Choosing the doctor of your choice is a right that people should have.
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Do You Need Connecticut Small Business Health Insurance for Your Employees?
Every company is unique. The best plan to use, be it a health sharing system or traditional group insurance, requires careful evaluation.
You can get full analysis and specific recommendations for your company and staff in Connecticut.
You can make an online appointment by simply Clicking Here.
Prepare a list of employees.
In many cases, switching over to health care insurance saves thousands of dollars for each employee. It may not make sense to share health insurance with workers who already have preexisting conditions.
You can always consult with us and get an analysis for free.
Small Businesses in Connecticut Can Take Advantage of Health Reimbursement Arrangements
HRAs are tax-free benefits funded by employers that reimburse employees for their individual health care costs.
Small businesses in Connecticut often drop group health benefits altogether. They instead establish an HRA and provide the money to their employees to purchase individual health insurance on the market with dollars pre-taxed.
So, workers can take advantage and reduce the costs to both employer and worker.
Employees can also use their HRA to pay other expenses, including prescriptions and durable equipment. HRA benefits, once again, are not taxed to employees.
When you offer an HRA as opposed to a group health insurance policy, employees have the option of choosing the plan they prefer.
Click here to learn more about HRAs for small businesses.
QSEHRAs (HRAs for Small Businesses)
QSEHRA or the Qualified small employer health reimbursement arrangement (pronounced “Cue Sarah”) is available to businesses of all sizes.
This benefit is intended for businesses with less than or equal to 50 full-time staff members, who are not offering a standard group health insurance.
Business owners can set the maximum QSEHRA amount they wish to contribute, as long as it is within certain parameters. Connecticut employers are allowed to make contributions up until 2023 of up $5,850 (maximum $487.50 monthly) for individuals and up $11,800 (maximum $983.33 monthly) for families.
They can then use that money to get their own individual or family health insurance by using the Access Health CT exchange web site, or a broker. In this way, employees can keep their subsidy eligibility.
The employer can decide to pay the employee’s premiums for health insurance only or also reimburse them for any extra medical expenses.
QSEHRAs (Qualified Special Enrollment Health Savings Accounts) and Special Periods of Enrollment
Your employees are eligible for the Special Enrollment period when you replace your existing health plan with an HRA. During this 60-day period, your employees can buy their own ACA qualified insurance plan without having to go through medical underwriting.
The QSEHRA will ensure that you don’t have to worry about your employees’ losing coverage after your QSEHRA replaces your current group health insurance.
Advantages of HRAs
Health Reimbursement Arrangements offer many advantages.
The money you spend for HRA benefits is tax deductible by you and tax free to your employees.
HRA funds are yours until they’re actually paid out to employees. You can use it as working capital. It is not required to be deposited with a third party.
HRA benefits can be tailored to suit the needs of employers, with many options available. This includes how much you will pay for certain expenses.
When workers change status from employee to contractor, their coverage of health insurance isn’t affected. With QSEHRA’s approach, each worker is the owner of his or her own insurance policy and can control it. It’s not up to the employer.
Disadvantages of HRAs
It is not the desire of all employees to have to choose and research their own plan. Some workers will need additional help navigating through the change.
We can help if you are in this situation. There is no one left behind.
Have your workers simply click on this link or call 800-913-0172, for an appointment to receive personalized service.
Click here to learn more about alternatives to employer-sponsored health insurance for Connecticut small businesses
Direct Primary Healthcare Advantages
Direct Primary Care plans have become a popular alternative healthcare option in Connecticut, and across the US.
This is a model based on membership: Your employees can receive as many consultations as they require, whether in-person or through telehealth, for an affordable flat monthly fee.
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 offers members access to all routine, primary, preventive, and chronic health care services.
The following are some examples of direct primary healthcare services:
Some of the most common medical services offered by doctors who practice Direct Primary care include:
- Preventive care. DPC doctors stress preventive medicine. Services include routine checkups, vaccines, screening for conditions, and other services
- DPC doctors offer acute care to patients with minor injuries or illnesses
- Manage chronic disease. DPC doctor help you manage chronic conditions, such as arthritis, diabetes, and hypertension. It includes ongoing monitoring of patients and adjusting treatment plans as necessary
- Comprehensive physical exams. DPC offers comprehensive physicals examinations by DPC doctors to determine overall health status, identify possible risks, and offer personalized health recommendations.
- 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.
- Lab and diagnostic services. DPC doctors can offer or coordinate laboratory testing, such as bloodwork, urine analysis and imaging tests (X rays, ultra-sounds, ECGs).
- Medicine management. DPC physicians can prescribe medications and monitor their efficacy, adjusting as required. Also, they provide counseling and education about medication use.
- Mental health services Mental health is often included in DPC care. DPC doctors can provide therapy, counseling and even refer you to mental specialists if necessary.
- Minor Procedures. DPC doctors can perform some minor procedures at their offices, including suturing wounds, skin lesion removal, injections of joints, etc.
- Referrals, coordination of services and care. DPC doctors are patient advocates who coordinate care and refer patients to specialists, hospitals, or other providers of healthcare when needed.
There are also no deductibles or co-pays because there isn’t an insurance company. Monthly subscriptions cover everything. It allows workers who are strapped for cash to receive the medical care they need immediately. Patients no longer need to postpone their doctor’s appointments because of a high deductible or copay.
Accounts for Health Savings (HSAs)
The HSA (Health Savings accounts) is a powerful tool that can assist workers in managing their health care costs as well as help to keep the premiums of workplace health insurance lower.
Connecticut’s residents and business owners need any tax relief they can receive. Employer contributions to Health Savings Accounts for employees are fully deductible from Connecticut Corporate Income Tax as a compensation cost.
HSAs let individuals set aside money before taxes to help pay future medical bills. HSAs allow both employees and their employers to contribute, up to the limit of an annual amount set by Congress each year.
The money in an HSA grows tax deferred, and any withdrawals made to cover qualified medical expenses are tax-free
Qualifications for HSAs
For an employee to receive pretax employer contributions towards a HSA (or to make a contribution to one), they must first enroll in a High Deductible Health Plan.
In 2023, an IRS-defined high-deductible health care plan will be any plan which has a deductible that is at least $3,000/$1,500 for families and individuals respectively.
A HDHP can only have a maximum of $7,500 in annual out-of-pocket expenditures (including deductibles copayments and coinsurance). This limit is higher for families. It does not include out-of-network services. ).
Can I Combine HSAs With Health Sharing?
Currently, only one major health sharing plan preserves an employee’s eligibility for pre-tax contributions to a health savings account: The HSA SECURE Plan, which is available through 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 that come from health sharing.
To enroll in the plan, however, you must be a self-employed person or own a small business.
HSA SECURE will not be available for straight W-2 workers. HSA-SECURE may work for you if the employee has a side business, is self-employed, does freelance or other part time work and is in excellent health.
HSA SECURE Plans are also an excellent way for small business owners to save on expenses.
HSA SECURE is only available to employees who enroll on their own. If they already have an HSA established, then you can still make pretax contributions on their behalf up to the limit Congress sets each year.
HSA SECURE is available by clicking on this link.
How Are Connecticut Small Business Health Insurance Benefits Taxed?
Now that you know a bit about each of the alternative strategies available to small employers in addition to traditional health insurance, here is a brief table explaining how each of these benefits are taxed.
| 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 |
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Address All Levels of the Care Pyramid
A good employee health benefits package should address all levels of the Employee Healthcare Pyramid – from routine preventive care, through primary care access for maintenance and early detection of health problems, all the way through catastrophic incidents, as shown below:
On the left we have listed the traditional solutions that are based on insurance and address each level of care pyramid.
To the right we provide a range of affordable and alternative ways of providing protection to employees of each pyramid level.
Plan design that is good will offer employees affordable options on each of these levels. The plan should ensure that none of the employees are forced to postpone or skip care simply because they don’t want to pay a higher premium or coinsurance.
It is possible to design a personalized plan with the help of your personal benefits manager. Your plan can provide solutions for every stage of the Care Pyramid, and at a fractional cost compared to a typical group plan.
Connecticut Small Business Health Insurance Tax Credit
Small Business Health Care Tax Credit passed together with ACA permits certain small companies to claim a Federal Tax Credit of up 50% of employee healthcare costs.
This is for businesses who employ fewer than 25 people and are more likely to use lower-paid workers.
Both for-profits and non-profits can generally claim this credit.
* Less than 25 employees with an average annual salary around $53,000, excluding salaries for all the owners. The average number of employees is calculated without including the owners. Also, employees are counted as “full time equivalents” or FTEs. This means that two employees working half time would be equivalent to one employee who works full time.
* You must pay at least half the premiums of your employees.
The state exchange website (Access Health CT in Connecticut) will offer Affordable care Act coverage.
If an employer has more than 25 employees, or when the average annual wage exceeds $53,000.
How can I get credit for my purchase?
Tax-exempt small business must submit Form 990T for tax purposes, even if they are not required to do so.
Contributions to health insurance for your employees do not attract tax.
My business has not paid any taxes for this year. Can I claim my tax credit even though I don’t owe any taxes this year?
Yes. It is possible to carry this tax credit back to offset tax liabilities from the previous years or forward to offset tax obligations over the next twenty years.
The credit can be refunded if you are a business that is exempt from taxes.
For more information on the Small Business Health Care Tax Credit, consult your tax advisor.
Credits are refundable if your business is tax exempt.
You can consult with your tax adviser to get the full details of the Small Business Health Care Tax Credit.
Combine Connecticut Small Business Health Insurance 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.
As a cost-effective option, consider combining Direct Primary Care plans (DPCs) for primary care and a health-sharing plan with low costs that cover catastrophic events.
Compared to conventional group health insurance, this strategy can be more affordable for your company, for your employees, or both.
Offering employees, the choice between signing up for a health sharing plan or purchasing an individual health insurance plan, as well as giving them the chance to fund a Health Savings Account (HSA) for those who choose an HSA-qualified HDHP plan, can give them more flexibility and possibly lower costs.
What Should You Do?
The most effective course of action would be to create an employee list and get in touch with us so that we can provide a complementary, complimentary business health plan assessment and recommendation.
You’ll relate to an experienced HSA for America Persona Benefits Manager who will go over your work force and families with you, your budget and needs, your employees’ ability to contribute, and any preexisting conditions you may be aware of who need to be considered when designing a new plan.
Many of our PBMs have been successful business owners and entrepreneurs in their own rights. They have been in your shoes, and understand your needs as a business owner, and what it takes to recruit and retain the best possible talent to help you remain competitive.
How can I combine health insurance with health sharing?
Both options can be offered side-by side. This allows employees to pick the plan that best fits their needs.
It is important to note that if too many workers opt out of group health insurance, your participation rates could drop below the minimum required for maintaining a collective plan. HRAs are a great way to reimburse your employees’ individual insurance costs, as they will come close.
Connecticut Small Business Health Insurance: FAQs
What is the Difference Between Health Insurance and Health Sharing for Small Businesses?
A health sharing plan involves members pooling their funds together to pay each other’s medical bills.
What are the rules for Connecticut employers contributing to employee HSAs?
You can make contributions into your employees’ HSAs. However, there are limits imposed by Congress on the amount you can pay.
Connecticut: Can contributions by employers towards HSAs qualify as state tax deductions?
Yes. Employer contributions towards employee HSAs are fully deductible from state income tax as a compensation expense in Connecticut.
How do I apply for the Small Business Health Care Tax Credit?
Small businesses with a tax exemption must use Form 990 for their tax return. The credit is claimed by filing IRS Form 8941 on your annual tax return.
HSA for America doesn’t provide tax advice. To get the full details on how to claim this credit, employers are advised to consult with their tax advisor.
Are maternity benefits covered by health sharing plans in Connecticut?
Maternity benefits are commonly included in health insurance policies and health sharing plans in Connecticut, covering prenatal care, labor, and postnatal care. However, some health sharing plans may have restrictions on cost-sharing benefits for children conceived outside of marriage.
HRAs are they compatible with health-sharing plans, individual insurance plans or health-sharing plans?
Yes, 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.
What is the best combination of cost-sharing and health insurance for a small business?
Don’t do this alone. Speak to a Personal Benefits manager. They can provide a complimentary analysis based on the specific needs of your company, including budget and employee count, as well as any existing conditions. The Personal Benefits Manager can design a plan to maximize value while controlling cost and keeping you competitive.
Are there waiting periods for pre-existing conditions with health sharing plans?
Yes, some health sharing plans may have waiting periods for pre-existing conditions before coverage begins. It’s important to review the plan guidelines or consult with a Personal Benefits Manager for more information on specific plans.
Health Savings Accounts (HSAs) can help employees manage their medical expenses in Connecticut?
HSAs enable individuals to pre-tax save money for future medical bills. Employers and employees both can contribute. This provides tax benefits as well as potential savings in healthcare expenses.
Does offering a Direct Primary Care (DPC) plan alongside other coverage options make sense for small businesses in Connecticut?
Combining DPC coverage with other low-cost plans, such as Health Sharing Plans, can offer comprehensive and cost-effective healthcare solutions to small businesses.
Does a small business that does not have any Connecticut taxes owe be able to claim the Small Business Health Care Tax Credit at all?
Yes, even if a business doesn’t owe taxes in a particular year, the Small Business Health Care Tax Credit can be carried back to offset income tax liability from the previous year or carried forward for up to 20 years.
What is an HRA (Health Reimbursement Arrangement) and how does it work?
An HRA is an employer-funded account that reimburses employees for qualified medical expenses not covered by their insurance plan. Employers determine what expenses are eligible and contribute funds accordingly.
What is the maximum size small business that can qualify for this program in Connecticut?
The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is only available to employers who have fewer than 50 employees. However, if you have more than 50 employees, or your company grows to have more than 50, there are other types of HRAs available to you.
You’ll also be required by the ACA to offer a health plan that is qualified for your workers, otherwise you will have to pay a fine. Speak to your Personal Benefits manager if you plan on hiring your 50th employee or the equivalent soon. This could have an impact on your plans.
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