Complete Guide to Oklahoma Small Business Health Insurance

Oklahoma Small Business Health Insurance

Introduction: Targeted at Oklahoma-based small businesses with 30 or fewer employees, this guide helps provide effective, cost-efficient health benefits to maintain competitiveness and attract top talent.

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Options for Health Insurance:

  • Traditional Group Health Insurance: Most common but costly, with annual costs around $20,108, employees contribute about $7,200.
  • Alternative Options:

Geographic Considerations:

 The guide emphasizes considering Oklahoma’s diverse healthcare landscape, from urban areas like Tulsa and Oklahoma City to rural regions. Businesses should consider network accessibility for all employees across the state.

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Details on Traditional Insurance:

  • Requires ACA-compliant coverage for companies with 50+ employees.
  • Includes essential benefits like emergency services, hospitalization, maternity care, prescription drugs, and more.
  • Guarantees coverage acceptance during enrollment periods.

Insurance is Optional for Smaller Businesses:

Businesses under 50 employees are not mandated by the ACA to provide health insurance, with no penalties for non-provision.

Taxation of Health Coverage:

Premiums paid by employers are tax-deductible and not taxable to the employee. Contributions towards health-sharing plans are deductible but taxed to the employee when employer-paid.

Taxation of Health Coverage:

Disadvantages of Traditional Health Insurance:

  • High costs and inflexibility may not meet all employee needs.
  • Administrative challenges can be significant for small employers, who may opt for simpler, cost-effective strategies like HRAs or health sharing plans.

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Health Sharing Plans:

  • Cost-effective alternative to traditional insurance.
  • Participants share medical costs within a community, often leading to substantial savings.
  • Offers more flexibility in provider choice.

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HRA Options and Benefits:

  • HRAs allow employers to reimburse employees for insurance on a tax-free basis.
  • Provides flexibility and control over health benefit expenses.
  • Supports employees in choosing insurance that best fits their needs.

Guidance for Implementation:

  • Employers should conduct thorough analyses of employee needs and business capabilities.
  • Consulting with a Personal Benefits Manager is recommended to tailor health plans that suit company and employee needs effectively.

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Summary:

This guide is designed to assist small business owners in navigating the complex landscape of health benefits, providing various options and strategies to manage costs while ensuring comprehensive coverage for employees.

Frequently Asked Questions

About Small Business Health Insurance Oklahoma: Plans & Strategies

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Can I Offer Health Insurance and Health sharing at the same time?

Yes, you can offer both options side by side, allowing employees to choose which plan suits their needs best.

Note if too many employees opt out of a group health insurance plan, you could fall below the minimum participation rate required to maintain a group plan. However, you can always use an HRA to reimburse the employees for individual health insurance, which will be close to the same cost. 

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Are there waiting periods for pre-existing conditions with health sharing plans?

Yes, some healthsharing 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.

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Can employers contribute to their employees’ HSAs in Oklahoma?

Yes, employers are allowed to make contributions to their employees’ HSAs, subject to annual limits set by Congress.

 

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Does offering a Direct Primary Care (DPC) plan alongside other coverage options make sense for small businesses in Oklahoma?

Combining DPC with low-cost coverage options like health sharing plans can provide comprehensive and cost-effective healthcare solutions for small businesses and their employees.

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Can a business still claim the Small Business Health Care Tax Credit if they don’t owe taxes in Oklahoma?

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.

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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.

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Is there any limitation on the size of small businesses eligible for these programs in Oklahoma?

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 will also have an ACA requirement to provide a qualified health insurance plan for your employees, or pay a penalty. If you are on the cusp, or planning to hire your 50th full-time worker or equivalent in the near future, speak with your Personal Benefits Manager, as that could affect your plan design.

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What is the difference between health insurance and healthsharing for small businesses?

Health insurance is a traditional coverage plan offered by insurance companies, while healthsharing involves members contributing to a pool of funds to cover each other’s medical expenses.

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    How can Health Savings Accounts HSAs help manage medical costs for employees in Oklahoma?

    HSAs allow individuals to set aside pre-tax money to save for future medical costs. Both employers and employees can contribute, providing tax advantages and potential savings on healthcare expenses.

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    Can employer contributions towards HSAs be deducted from state income tax in Oklahoma?

    Yes. Employer contributions towards employee HSAs are fully deductible from state income tax as a compensation expense in Oklahoma.

     

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    How do I claim the Small Business Health Care Tax Credit?

    The tax credit can be claimed on the annual income tax return with IRS Form 8941 for for-profit businesses, while tax-exempt small businesses must file a Form 990-T tax return.

    HSA for America does not provide tax advice. Employers should consult their tax advisor for full information on claiming the credit.

     

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    Are maternity benefits covered by health sharing plans in Oklahoma?

    Maternity benefits are commonly included in health insurance policies and healthsharing plans in Oklahoma 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.

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    Can HRAs be used alongside other coverage options like health sharing plans or individual health insurance plans?

    Yes, HRAs can be used alongside other coverage options. Some small businesses choose to cancel group health insurance altogether and use HRAs to reimburse employees’ premiums for individual policies. However, HRA money cannot be used to reimburse employees directly for health sharing plan costs.

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    How can I determine which combination of health insurance and cost-sharing options is best for my small business in Oklahoma?

    Don’t go it alone. Contact a Personal Benefits Manager who can conduct a free analysis and recommendation based on your specific needs, budget, employee census, and any pre-existing conditions that need to be considered. They can help design an optimal plan that maximizes the value for your employees while controlling costs and helping you remain competitive. 

     
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