Oregon Small Business Health Insurance Options
The Complete Oregon Small Business Health Insurance Guide (2025 Edition)
HSA for America: Complete Guide for Oregon Small Businesses. This guide is for small businesses in Oregon that have 30 employees or less.
This document is meant to help independent professionals and entrepreneurs provide the best possible health insurance for employees at the lowest cost. So, you can be more competitive without sacrificing the benefits or compensation package that will keep your best employees on the job.
Oregon Small Business Health Insurance Benefits
Oregon has many options available to small business owners when it comes time to offer health benefits.
The traditional group insurance plan is by far the most cost-effective option.
Prices are dependent on the age of the employee, but based on data provided by the Kaiser Family Foundation, the cost per worker and family for group health coverage sponsored by their employer in 2021 will be $20,918.
Oregon employees on average contribute $5,943 to their health coverage costs.
Oregon businesses are also able to reduce their cost by using a range of options. These include the following:
- Health Savings accounts (HSAs)
- Health reimbursement plans (HRAs)
- Direct primary care (DPC memberships)
- Health sharing programs
The best strategy for small businesses is determined by a variety of factors including your budget, the size of the business and age and medical needs of employees and dependents.
Read on the go, download our Complete Guide To Small Business Healthcare Plans.
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Oregon Small Business Health Insurance – Geographic Considerations
Oregon’s healthcare system is unique, with both the more urbanized areas, such as Portland and Hillsboro, and the rural, less populated areas, like Roseburg or La Pine.
Oregon business owners are advised to consider the location of their workers in order to ensure that they can provide the best service. It’s not a good idea for the executives of a company headquartered in Hillsboro, to choose an HMO limiting workers and their dependents to in-network doctors if 80% of their employees are located in Yamhill.
Oregon Small Business Group Health Insurance
Most Oregon employers opt for traditional group health plans.
It is also the most costly.
Here’s what it looks like:
Employers contract with third-party providers of insurance, typically a for profit corporation, in order to offer a range of health benefits for their workers and – if they so desire – for their family members as well.
Employers with 50 or greater employees are required to offer ACA qualified health insurance for all employees working more than 30 hours a work week. If they do not, then the employer will have to pay a fine.
The health plan must cover the ten Minimum Essential Coverages (MECs), as required by Affordable Care Act. They are:
- Ambulatory patient service (outpatient treatment you receive without needing to be admitted to a medical facility)
- Emergency Services
- Hospitalization is a term used to describe a hospital stay (including overnight stays and surgery)
- Pregnancy care, maternity care and newborns (both before and afterwards)
- Treatment for mental disorders and substance abuse, including counseling and therapy
- Prescription drugs
- Rehabilitative or habilitative services or devices (services or devices that assist people with disabilities, chronic conditions, or injuries to gain mental or physical skills)
- Laboratory services
- Prevention and wellness services for chronic diseases management
- Dental and vision services for adults are not included in essential health coverage
The ACA also mandates that all health insurance plans cover contraception, breastfeeding and other aspects of pregnancy.
Although traditional health insurance is most expensive, it offers the benefit of guaranteed enrollment.
In the event that the worker enrolls before the end of his initial enrollment, during an enrollment period caused by a qualifying event in life, or at the beginning of the general open enrollment, starting November 1st, each year, then the insurance company is not allowed to reject them or charge higher premiums because of their past medical history.
Small Businesses in Oregon Are Not Required To Provide Health Insurance
According to the Affordable Care Act (ACA), employers with less than fifty employees are not required at all to offer health coverage.
Oregon state law has no requirements either. If you only have 50 or fewer employees, then you do not have to offer any type of health insurance.
You won’t have to pay a fine.
Employers of all sizes should consider offering health benefits. Even very small companies can benefit from this, because it is much harder to hire and retain employees with a health plan that is competitive.
Oregon is an excellent example, with its low unemployment and intense competition between employers to find the best talent.
Oregon employers are able to save money on medical costs by offering a cost sharing plan.
Oregon Small Business Health Insurance HRA Alternative
You can help employees pay for individual health coverage on a tax free basis by offering a QSEHRA, which is a qualified small-employer health reimbursement arrangement.
QSEHRAs can provide the following benefits to employers
1.) No minimum contribution limits
QSEHRAs are not tied to an annual minimum contribution like pension plans. As an HRA employer, you have the freedom to determine your own budget and alter it annually based on cash flow.
With a QSEHRA you can manage your health budget.
2.) Flexibility
Employees can be offered a higher or lower amount depending on their marital and family status. You could discriminate by giving a bigger benefit to employees who have children than those who don’t.
3.) Employers and their employees can both benefit from tax-free treatment
Your employer contributions will be fully deductible for tax purposes as a compensation cost. But unlike cash compensation your employees will not be taxed on their QSEHRA if they maintain an insurance plan which includes the 10 minimum coverages specified under the Affordable Care Act.
A QSEHRA offers a more attractive alternative to a simple health insurance stipend, as employees can use it for purchasing health insurance or other expenses.
4.) QSEHRAs Encourage Employee Choice
Too many group health plans restrict employees to a small number of health insurance choices.
These are often too expensive and unsuitable because they’re selected by HR and company managers, not by employees themselves.
QSEHRAs offer workers and their loved ones a vastly increased number of choices, allowing for a more personalized health care plan.
Oregon Small Business Health Insurance Taxation
As an employer, you can deduct all of your health insurance premiums as a legitimate business expense. This is true for both the federal government and Oregon’s state law. Additionally, the premiums paid by employers are not taxed.
Healthsharing plans offer lower overall costs. They are tax-deductible for employees. However, the employee will be taxed for employer assistance in paying health sharing expenses.
Employer-Sponsored Health Insurance: Oregon’s Disadvantages
Traditional group health plans for employers have many disadvantages that can be detrimental to both the employer and employee.
- Cost
We have mentioned that the cost to provide health insurance on a monthly basis can be staggering.
Some of the reasons why traditional health insurance is so expensive are due to overkill. Government regulators at Washington and Salem have packed health insurance plans with coverages and requirements, which don’t make sense for most workers.
Traditional health insurance includes coverage for drug and/or alcohol addictions, mental illness, and maternity care that many employees don’t require or want.
This reduces their efficiency and costs.
- Inflexibility
Group health plans are often a one size fits all approach that does not address the specific needs and budgets for employees. Group health plans sponsored by an employer tend to be one-size-fits all and may not meet the specific needs of employees.
Workers could benefit by buying their own individual plan, possibly taking advantage a subsidy offered under the Affordable Care Act.
These workers may also benefit from a cheaper health sharing plan. These affordable, innovative alternatives to traditional health insurance may be the best solution for people in good physical health and without any pre-existing health conditions.
More information on health sharing programs is discussed below.
- Administrative burden
This includes maintaining documentation and compliance. Auditing plan enrollments to ensure non-qualified employees are not enrolled in the plan. And answering questions from employees. This is essential for ensuring the smooth running of an organization’s insurance program.
The plans can be a major burden for small businesses that do not have the staffing to support a fulltime HR department.
You can also employ strategies like Health reimbursement arrangements and health care stipends.
These alternative methods encourage workers buy their own health insurance via the Affordable care Act. This could help workers to benefit from subsidies. It takes the employer completely out of the equation, reducing overheads and administrative costs.
Health Sharing Plans in Oregon
Health sharing is a viable, affordable alternative for small businesses to costly health insurance.
Oregon companies are increasingly using medical cost share plans to save money on traditional group insurance plans. By switching to health sharing plans, businesses can often save up 50% on their existing group health plans.
Oregon small companies could potentially save over $10,000 per annum per employee with family coverage. And more than $3500 per annum per employee with single coverage.
These programs provide a cutting-edge way for companies to finance healthcare. This allows them to offer their employees access to high-quality health care, while still controlling costs. Health sharing programs operate on the principle of sharing resources across a group.
Health sharing programs allow participants to pay a set amount per annum in lieu of traditional health insurance. Typical insurance requires that premiums be paid to insurance providers.
Health Sharing Plans vs. Health Insurance
Health sharing plans is not the exact same thing as insurance.
Healthsharing associations are instead voluntary associations of likeminded people who agree on a voluntary basis to share the medical costs of their members. Health sharing ministries are not for profit organizations, unlike most health insurance companies.
Oregon Small Business Health Insurance Mandatory Coverage
Health insurance plans, however, do not require coverage of many things that people may not need or want. Health sharing organizations don’t have to meet the requirements of the Ten Minimum Coverage.
People who do not take drugs are exempt from the requirement to pay for addiction treatment. It is not required to cover the costs of injuries caused by a drunk driver.
Oregon Small Business Health Insurance Pre-Existing Conditions
Contrary to traditional health plans, healthsharing plans might impose a waiting period for them to share the cost of treating preexisting conditions.
The waiting period for surgery is often longer, except for accidents and injuries which could not have possibly been predicted prior to the enrollment of the member.
These waiting periods reduce adverse selection to a great extent and enable health sharing organizations (HSOs) to offer a wide range of benefits at a fraction, or even a small fraction, of the cost compared with a standard ACA group health policy.
Note: Under the Affordable Health Care Act, healthsharing plans will not be eligible for subsidies. Although the cost savings can be so substantial, it is still worth switching to healthsharing even if you do not qualify for a government subsidy.
Oregon employers can benefit from health sharing even more because under ACA small group insurance plans are not eligible for a tax credit.
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Health Sharing and Network Restrictions in Oregon
Health sharing plans are often more flexible when it comes down to selecting healthcare providers.
In Oregon, the majority of healthsharing organizations don’t limit their patients to network providers. Instead, healthsharing plan members are free to choose any doctor they like. By allowing people to choose their own doctors.
What Is the Right Health Sharing Program for Your Company?
Every business differs. To choose the right plan, you need to do some research, regardless of whether it is a traditional group insurance plan or a healthsharing program.
You can get a detailed case analysis in Oregon that is tailored to your company and workforce.
You can make an online appointment by clicking here.
Prepare a list of employees.
Most often, switching to a health insurance plan will save employees thousands of pounds per year. It may not be a good idea to use health sharing if you are dealing with employees who have pre-existing conditions.
Small Businesses in Oregon Can Get Health Reimbursements
HRAs are tax-free benefits funded by employers that reimburse employees for their individual healthcare expenses.
Small businesses in Oregon often drop group health insurance benefits altogether. They instead establish an HRA and provide the money to their employees to purchase individual health insurance on the market with pre-tax dollars.
The company can also benefit from the available subsidies, thereby lowering the overall cost to the employee and the company.
After paying for the premiums, workers may use any remaining HRA funds to cover other costs, such as prescriptions, deductibles, copays and durable medical equipment. HRA benefits remain tax-free for the employee.
By offering an HRA instead of a formal health insurance plan for your group, you empower your employees to select the plans that meet their preferences and needs.
Please click here to learn more about HRAs for your business.
QSEHRAs: The HRA for Small Businesses
QSEHRA, or the Qualified small employer health reimbursement arrangement (pronounced “Cue Sarah”) is a type of HRA that can be used by small businesses.
This benefit is for companies that have fewer than fifty full-time workers or the equivalent and do not offer any traditional group health insurance.
Businesses can set their own QSEHRA maximum allowances within certain limits. Oregon employers will be able to contribute up to $5.850 per employee (upto $487.50 monthly) as of 2023.
The employees use this money to buy their own health insurance through the online exchange or a Personal benefits manager on the individual and family market. The employee retains the right to a subsidy that they wouldn’t get under a group health plan paid by their employer.
You can choose to reimburse employees’ health insurance premiums only or their premiums and any additional medical costs.
QSEHRAs & Special Enrollment Periods
Your employees are eligible for a Special Registration Period when you replace your health insurance with an HRA. This 60-day period allows your employees to purchase their own ACA qualified insurance plan without having to go through medical underwriting.
It will help ensure that your employees are not left without coverage if you decide to replace your existing group health plan with a QSEHRA.
Oregon Small Business Health Insurance HRA Advantages
Health Reimbursement Arrangements are a great way to save money.
The money you spend on HRAs for your employees can be deducted from your taxes and is tax-free for them.
HRA money is yours until it’s paid out to employees. You can use it as working capital. It is not required to be deposited with a third party.
The HRA benefit can be designed by employers in a way that suits their needs, and includes what expenses they are willing to cover.
The workers’ health insurance is not affected if they change their status to contractors or leave the company. The QSEHRA allows the employee to control and own their insurance policy. Not the employer.
Oregon Small Business Health Insurance HRA Disadvantages
Some workers may not want to be responsible for researching and choosing their own health plan. Some workers might need help to navigate the transition.
Your HSA for America Personal Benefits manager is ready to assist you. No worker will be left behind.
To schedule an appointment, have your workers Click this Link or call 800-913-0172.
Click here for more information about alternative health insurance options for small businesses in Oregon.
Direct Primary Healthcare Advantage
Direct Primary Plans (DPCs) are an alternative model of healthcare that is becoming increasingly popular in Oregon, and all across the US.
A membership-based approach is used: Your employees pay a flat and affordable monthly fee.
DPC is a great option for individuals who are looking to prioritize their own health. Membership costs start as low as $80.00 per month.
DPC plans allow members to access routine primary care, preventive care and chronic health services.
Examples of direct primary care services provided include:
Direct Primary Care Doctors provide many medical services.
- Preventive care. DPC doctors stress preventive medicine. Services include routine check-ups and immunizations as well as screenings for a variety of conditions.
- DPC physicians treat acute illnesses, such as infections and minor injuries.
- Chronic disease management. DPC physicians help patients manage chronic illnesses like diabetes, high blood pressure, asthma, arthritic, and more. They provide ongoing monitoring, as well as adjustments to treatment plans when necessary.
- Comprehensive physical exams. DPC Doctors offer comprehensive physical exams that help assess your overall health.
- Urgent care. DPC’s doctors are usually available for urgent care on the same or next day.
- To ensure that patients receive prompt care for non-emergency problems, they can make appointments.
- Lab and diagnostic services. DPC doctors are able to offer or coordinate various laboratory tests. These include blood work, urine testing and analysis, imaging (X-rays or ultrasounds) studies, as well electrocardiograms.
- Mental health service. As part of their comprehensive services, many DPCs offer mental health treatment. DPC practitioners may refer to mental specialists, provide counseling or therapy when necessary, and even refer their patients.
- Minor procedures. Some DPCs are trained to do minor procedures at their offices. This includes suturing lacerations and removing moles.
- Referrals and care coordination. DPC doctors coordinate and advocate for patients and work with other healthcare providers, including hospitals and specialists.
No insurance company is involved so there are no copayments, coinsurances, or deductibles. The monthly subscription includes everything. So, workers who are strapped for cash can receive the medical care they need. Never again will workers have to wait until they are financially able to see a doctor, because of a high deductible or copay.
For services that are not covered by DPC membership, patients can purchase supplemental plans. These include high-deductible plans, health-sharing plans, and accident insurance. DPC offers routine health care as part of membership. However, many patients choose healthsharing over traditional health insurance because it is more affordable.
But good news: with a little research and some guidance from a health insurance expert, you can usually prevent these kinds of mistakes before they happen.
A smart move is to talk about what you need and what choices you have with an HSA for America Personal Benefits Manager.
This won’t cost you anything.
And they know a lot about saving you money.
That said, as professional health insurance experts, here are some of the biggest mistakes and misconceptions about health insurance we run into all the time.
Health Savings Accounts
Health Savings Plans (HSAs) can provide a very powerful tool for workers to help them manage their medical bills and also to keep the premiums down on workplace health insurance.
Oregon businesses, as well as residents of the state, need every tax incentive they can receive. Good news! Employer contributions into employees’ Health Savings Accounts(HSAs), are fully deductible from Oregon Corporate Income Tax as a compensation cost.
HSAs let individuals set aside money pre-tax to help pay for future healthcare costs. HSAs may be contributed to by employees as well as employers. However, the annual contribution limit will change every year in accordance with inflation.
HSA funds grow tax-deferred and withdrawals made to pay for medical expenses that qualify are tax-free.
Oregon Small Business Health Insurance HSA Eligibility
Employees that want to participate in a HSA or benefit from employer pretax contributions will need to enroll in a qualified high deductible health care plan.
The IRS defines high-deductible plans for 2023 as those with a minimum $1,500 individual deductible or $3,000 family deductible.
Total annual HDHP expenses (including copayments), deductibles and coinsurance, cannot exceed $7500 or $15,000 for individuals. This limit does apply to in-network and out-of network services. ).
Can I combine HSAs (Health Savings Accounts) with Health Sharing?
HSA for America offers the HSA-SECURE plan, which is one of the major health sharing plans that preserves employee eligibility to contribute before tax towards a health account.
HSA SECURE Plan provides a way to combine both the tax and health benefits of an HSA with the cost-savings advantages of Healthsharing.
To enroll in the plan, however, your employee MUST have a self-employed income or be a business owner.
HSA SECURE will not be available to employees with a straight W-2. HSA-SECURE may be right for you if your employee has a side business, freelance or small business of their own and is in good health.
HSA SECURE Plans are also an excellent way for small business owners to save on expenses.
Your employees would be required to enroll in HSA SECURE independently. After they’ve set up and enrolled an HSA for themselves, you may make contributions pre-tax on their behalf.
HSA secure is explained in detail by clicking the link.
How Oregon Small Business Health Insurance is Taxed
This table explains the taxation on each alternative strategy available to small employers, in addition traditional health coverage.
| 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 |
The Care Pyramid for Oregon Small Business Health Insurance
The best employee healthcare packages should take into account all levels, including the Employee Healthcare Pyramid. These include routine preventive measures, access to primary health care for maintenance and early diagnosis of health problems as well as catastrophic incidents.
On the left we have listed the traditional solutions based upon insurance which 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 solutions 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, a copay or if coinsurance.
Your personal Benefits Manager will help you design a plan specifically for your workforce that offers a solution to each of the levels in the Care Pyramid. Often, this is at a fractional cost of an employer’s traditional group insurance plan.
Oregon Small Business Health Insurance Tax Credit
Small Business Health Care Tax Credit enacted along with ACA, allows for some small businesses claim a credit federal of up 50% of the costs of health insurance.
It is for smaller businesses who employ fewer than 25 people and have a tendency to pay lower wages.
For-profit as well as non-profit organizations can both claim 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. The “full-time employees” are also used in calculating the total number of staff. The two-half-time employees will equal the one-full-time employee.
Employees must be paid at least the half-cost of insurance premiums.
Oregon Health Insurance Marketplace.
Tax credits are eliminated when employers reach 25 employees and/or the average wage is at least $53,000.
How do I claim my credit?
If you are a small business that is tax exempt, then the IRS Forms 990-T must be filed to receive this credit.
Taxes on your contributions to employee health care aren’t applicable.
If I owe taxes for my company this year. Can I still claim a tax credit?
Yes. It is possible to carry this tax credit back to offset tax owed in the preceding year.
This credit is refundable for businesses that are exempted from paying taxes.
To learn all about the Small Business Health Care Tax Credit consult your tax professional.
Combining Oregon Small Business Health Insurance Plan Strategies
Combining multiple programs to maximize coverage is a smart idea.
Combining several health care packages can help employers control healthcare costs without compromising coverage.
Consider combining Direct Primary Care plans for normal primary healthcare with low-cost health-sharing plans that cover catastrophic occurrences. This could be a cost-effective solution.
This strategy could be cheaper for your company or employees.
It is possible to offer employees more flexibility by giving them the option of choosing between a Health Sharing Plan or a HDHP plan which qualifies as an HSA.
What To Do Next
Contact Us For a Free, Complementary Business Health Plan Analysis and Recommendation
The HSA for America Persona Benefits manager will talk to you about your staff and their families. They’ll also go over budget and requirements, employee contribution abilities, and other preexisting health conditions.
Many of our PBMs themselves are successful entrepreneurs. They understand the needs of business owners and know how to retain and recruit top talent.
Can I combine health insurance with health sharing?
Yes, you can give both options, so employees can pick the one that suits them best.
Please note that if you allow too many employees to opt out, the minimum participation required to keep a group insurance plan could be violated. HRAs allow you to reimburse employees who purchase individual health coverage, which is close to the cost of group insurance.
FAQs About Oregon Small Business Health Insurance Plans
What is the difference between Health Insurance and Healthsharing for Small Businesses?
Healthsharing is an alternative to traditional health insurance, which is offered by insurance companies. Members contribute to a pool to cover one another’s medical costs.
Do health sharing plans have waiting periods for pre-existing diseases?
Some healthsharing plans do have waiting periods before they cover pre-existing medical conditions. For more information, it’s best to consult a Personal Benefits manager or review the plan guidelines.
How can I claim the Small Business Health Care Tax Credit (SBHCTC)?
For-profit small businesses can claim the tax credit on their annual income tax returns with IRS Forms 8941, while those that are tax-exempt must file Form 990T.
HSA for America is not a tax advisor. Employers are advised to consult with their tax advisors for complete information about claiming the credit.
Is it a good idea for Oregon small businesses to offer a Direct Primary Care plan (DPC) alongside other options?
Combining DPC and low-cost options such as health sharing plans, can provide comprehensive healthcare solutions at a cost-effective price for small businesses and employees.
What is a Health Reimbursement Agreement (HRA) and how does this work?
IHRAs are employer-funded accounts that reimburse employees for medical expenses they incur but which are not covered by insurance. Employers decide what expenses qualify and then contribute money accordingly.
Does Oregon have a limit on the size of the small business eligible for these programs?
Only employers with fewer than fifty employees are eligible for the Qualified Small Employee Health Reimbursement Arrangement. If you have over 50 employees or if your company expands to more than 50 people, you can choose from other HRAs.
You’ll also be required by the ACA to offer a qualified health plan for your workers, or you will have to pay a fine. Speak to your Personal Benefits manager if you plan on hiring your 50th full time worker in the near term. This could have an impact on your plan.
How can Health Savings Accounts (HSAs) help employees manage their medical costs in Oregon?
HSAs are a way for individuals to save money before taxes to pay future medical expenses. Employees and employers can both contribute to HSAs, allowing for tax benefits and savings on healthcare costs.
In Oregon, can employers contribute to the HSAs of their employees?
Employers can contribute to HSAs of their employees, but only up to the annual limit set by Congress.
In Oregon, can employer contributions to HSAs be deducted when calculating state income tax?
Yes. In Oregon, employer contributions to employee HSAs can be deducted from the state income tax.
Can a small business claim the Small Business Health Care Tax Credit even if it does not owe any taxes in Oregon?
The Small Business Health Care Tax Credit may be used to offset the income tax liability for the previous year. It can also be carried forward up to 20-years.
Do health sharing plans cover maternity benefits in Oregon?
In Oregon, maternity benefits, including prenatal, labor and postnatal care, are included in many health insurance plans and healthsharing plans. Some healthsharing plans restrict the cost-sharing benefits of children born outside marriage.
Can HRAs work with other options for coverage, such as health sharing plans and individual health insurance plans?
Yes, HRAs are compatible with other insurance options. HRAs can be used to reimburse employees for premiums on individual policies. HRA funds cannot be used directly to reimburse employees for the costs of health sharing plans.
What is the best combination of health insurance options and cost-sharing for my small business?
Don’t do it alone Contact a personal benefits manager They can provide a free assessment and recommendations based on the specific needs of your company, budget, employee count, and other pre-existing conditions. They can design an optimal plan to maximize the value of your employees, while controlling costs and ensuring you remain competitive.
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