Maryland Small Business Health Insurance – 2025 Guide

Maryland Small Business Health Insurance Options

HSA for America presents a detailed guide to Maryland small business health insurance options for 30 or fewer employees, aiming to streamline their health benefits approach while maintaining a competitive edge in talent acquisition and retention.

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Maryland Small Business Health Insurance Options

Maryland small businesses have several health insurance options:

  • Traditional Group Insurance: Although cost-effective for many, the average annual cost of a family plan is about $21,648.
  • Alternative Health Plans:

ACA Compliance

  • Businesses with 50 or more employees must provide ACA-compliant health plans or face penalties.
  • Health plans are required to cover a range of essential services, from hospitalization and prescription drugs to mental health services and maternity care.

Geographic Considerations

Given Maryland’s diverse regions, from urban areas like Baltimore and Annapolis to rural locales like Taneytown, business owners should tailor health plans considering the geographic distribution of their workforce.

Maryland Small Business Health Insurance Geographic Considerations

The Cost of Providing Maryland Small Business Health Insurance

  • The high cost of traditional health insurance is a challenge, with Maryland’s premiums slightly higher than the national average.
  • Employers can explore cost-sharing strategies, which can significantly lower expenses.

The Cost of Providing Insurance

Challenges of Traditional Maryland Small Business Health Insurance

  • Cost: Traditional plans can be prohibitively expensive, particularly in industries with high labor costs.
  • Inflexibility: Standard plans may not meet all employees’ needs, making personal market plans or health-sharing more appealing.

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Benefits of HRAs

  • Flexibility: QSEHRAs do not require minimum contributions and can be adjusted annually.
  • Tax Advantages: Contributions are tax-deductible for employers and tax-free for employees if used for qualifying health expenses.
  • Promotes Employee Choice: Health Reimbursement Accounts allow employees to choose their health coverage, potentially increasing satisfaction.

Maryland Small Business Health Insurance Guide 2025

Contact an HSA for America Personal Benefits Manager for a free analysis and recommendation tailored to your Maryland business.

Administrative Burdens

  • Managing traditional health benefits involves significant administrative overhead.
  • Employers can reduce these burdens through streamlined approaches like HRAs or stipends.

burden administrative

Advantages of Health Sharing Plans

  • Cost Savings: Health sharing plans can offer substantial savings over traditional insurance.
  • Flexibility in Provider Choice: Unlike HMOs or PPOs, health sharing plans often allow members to choose any provider, enhancing accessibility and satisfaction.

Direct Primary Care (DPC) Advantage

  • Affordability and Access: DPC offers unlimited access to primary care services for a flat monthly fee, removing typical barriers like copays and deductibles.
  • Comprehensive Care: Includes everything from preventive care and urgent care to chronic disease management.

Health Savings Accounts (HSAs)

  • Tax Benefits: Contributions are tax-deductible, and funds grow tax-free, usable for qualified medical expenses.
  • Eligibility: Available to employees enrolled in high deductible health plans, enhancing their healthcare financial management.

Taxation of Maryland Small Business Health Insurance Benefits

  • Contributions to health plans and HRAs by employers are tax-deductible, and health benefits received by employees are generally tax-free.
  • Health sharing plan costs are deductible for the employer but taxable for the employee.
Taxation of Maryland Small Business Health Insurance Benefits

Strategic Considerations

Employers are encouraged to consider combining different health strategies to optimize benefits while controlling costs, such as integrating DPC plans with health sharing programs for a balanced approach to healthcare coverage.

Maryland Small Business Health Insurance: Common Questions 

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What is the Difference Between Health Insurance and Healthsharing for Small Businesses?

A health sharing plan involves insurance members pooling their funds together to pay each other’s medical bills.

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Are employers allowed to contribute towards their employee’s HSAs?

You can make contributions into your employees’ HSAs. However, there are limits that Congress sets annually.

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Do small Maryland businesses make any sense by offering Direct Primary Care plans alongside other insurance options?

Health sharing plans and DPC can be combined to provide small business owners and employees with comprehensive healthcare coverage at a low cost.

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If a Maryland business does not owe any taxes, can it still claim the Small Business Health Care Tax Credit?

The Small Business Health Care Tax Credit may be used to reduce income taxes owed in the prior year. It can also be carried forward up to 20-years.

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Does Maryland have a limit on the size of small business eligible to receive these programs?

Only employers with fewer than fifty employees are eligible for the Qualified Small Employee Health Reimbursement Arrangement. If you employ more than fifty employees or your business grows beyond 50, you can choose from other HRAs. 
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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What is the best combination of cost-sharing and health insurance for my small Maryland business?

Get some assistance with this. Speak to a Personal Benefits manager. They can provide a complimentary analysis and recommendations 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.

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Can you tell me about the waiting period for health plans that cover pre-existing conditions?

It is possible that some plans require a certain waiting period before beginning coverage for conditions already present. If you want more information about a particular plan, review the plan’s guidelines or talk to a Personal benefits manager.

Health Savings Accounts can be used to help Marylanders manage the medical costs of their employees.

HSAs let individuals set money aside for future medical expenses before tax. Contributions from both employers and employees may provide tax savings and help reduce healthcare costs.

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Maryland: can contributions from employers to HSAs deductible?

Yes. Maryland allows employers to deduct their contributions for employee HSAs from state income taxes as compensation expenses.

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How can I get the Small Business Health Care Tax Credit (SBHCTC)?

Tax credit claims can be made on Form 8941 of the IRS for businesses that make a profit, while small tax-exempt businesses are required to file Form 990-T.

HSA for America is not a tax advisor. For more information, employers should contact their tax advisor.

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How does an HRA work?

HRAs are employer-funded accounts that reimburse employees for medical costs not covered by insurance. Employers decide what medical expenses qualify and then contribute money accordingly.

HRAs can be combined with other options for coverage, such as health sharing plans and individual health insurance policies.

HRAs are compatible with other insurance options. HRAs can be used to reimburse employee premiums on individual policies. HRA funds cannot be used directly to reimburse employees for the costs of health sharing plans.

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Do health-sharing plans cover maternity benefits in Maryland?

Maryland health plans and insurance companies offer maternity benefits that cover prenatal, postnatal, and labor care. Some healthsharing plans restrict the cost-sharing benefit for children born outside marriage.

 
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