Pennsylvania Small Business Health Insurance Options


Pennsylvania Small Business Health Insurance
The HSA for America Complete Guide to Pennsylvania Small Business Health Insurance is here. This guide is aimed at companies in Pennsylvania with fewer than 30 employees. 

This document was created to assist small business owners and freelancers in providing the most cost-effective employee health benefits. You can still be competitive while offering the compensation and benefits you need to keep the best talent on your team.

Pennsylvania Small Business Health Insurance Benefit Options

There are many options available to small businesses in Pennsylvania when it comes time to provide health benefits for their employees. 

The most popular, but also the most costly option is to implement the traditional group health plan.

Prices vary depending on age. However, according to from the Kaiser Family Foundation the average cost of group health insurance sponsored by an employer for a worker or family in 2022 will be $21,531, which is about $150 higher than the average.

Pennsylvania employees contribute an average of $6,650 towards their health insurance, nearly $500 higher than the national average.

Pennsylvania businesses have other options that can reduce costs. They include:

  • Health Savings Accounts (HSAs).
  • Health reimbursement arrangements (HRAs).
  • Direct primary care memberships
  • Health Sharing Programs 

Your small business’s best strategy depends on a number of factors, including the size of your company, your budget and your employees’ age and medical needs.

Read on the go, download our Complete Guide To Small Business Healthcare Plans.

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Pennsylvania Small Business Health Insurance: Geographical Considerations

Pennsylvania has a unique healthcare system that includes not only the busy cities of Philadelphia, Harrisburg, and Scranton but also more rural areas like St. Mary, and Egg Harbor City.

This is why Pennsylvania business owners need to carefully consider how they distribute their workforce throughout the state. Executives in Scranton who are based at the company’s headquarters may choose to use an HMO which restricts their workers and their family to only seeing doctors in their network, but many of their employees live and work far away from this network.

Pennsylvania Small Business Group Health Insurance

Most Pennsylvania employers prefer the traditional health insurance plan.

This is also one of the most expensive.

Here’s how the system works:

An employer will contract with an insurance company to provide a health insurance plan for its employees, and if they wish for their family members.

According to the Affordable Care act, employers with 50 or fewer employees are required by law to provide ACA qualified health insurance for all employees that work more than thirty hours per week.

The health insurer must offer the 10 Minimum Essential Coverages required by Affordable Care Act. These include:

  • Ambulatory care (outpatient medical services that are provided without the need to be admitted in a hospital).
  • Emergency services
  • Hospitalization (including overnight stays, surgery and hospitalization)
  • Pregnancy, maternity, and newborn (both before & after birth) care
  • Services in mental health and substance use disorders, including behavioral health treatment.
  • Prescription drugs
  • Rehabilitative, habilitative, and assistive services and devices (services, devices, and other devices to help individuals with injuries, disabilities, and chronic conditions recover mental, physical, and cognitive skills)
  • Laboratory services
  • Preventive services, wellness programs and chronic disease management
  • The coverage of pediatric services includes oral and visual care, but adult dental and optical care are not considered essential health benefits.

ACA mandates that all health insurance plans cover both birth control and breast-feeding.

It is true that traditional health care insurance is expensive but there are benefits.

When a worker enrolls for insurance during their initial enrollment phase, during an enrollment period that is triggered after a qualifying event in life, or at the beginning of the annual general enrollment period on November 1, the insurance company will not be able to deny or charge them a higher rate because of medical history.

Pennsylvania Small Businesses Can Opt Out of Health Insurance

In accordance with the Affordable Care Act employers who have fewer than fifty workers are not obliged to provide health insurance.

Pennsylvania law doesn’t have any requirement either. If you have fewer 50 employees, then you do not need to offer health coverage.

No penalty will be charged.

But it is a good idea for all companies to offer health care benefits.

Pennsylvania in particular is an area where there is little unemployment and fierce competition between employers to attract talent.

Pennsylvania employers can save a lot by offering employees a medical cost-sharing plan.

The HRA Alternative to Pennsylvania Small Business Health Insurance

Alternatively, offer your employees an approved small employer health reimbursement agreement (QSEHRA) and assist them in paying for their personal health insurance on a taxable basis.

QSEHRAs offer the following benefits to employers:

1.)No contribution minimum

QSEHRAs don’t require a minimum amount of contributions every year like pension plans. As an employer, it is up to you to decide how much money will be allocated for HRA benefits. This budget can change each year depending on your cash flow. 

A QSEHRA allows you to control the budget of your health insurance.

2.) Flexibility

You can offer a different amount to employees based on the marital or familial status. If you want to discriminate, then give a larger benefit to employees that have families and less to singles with no dependents. This reflects the actual cost of health insurance to their families.

3.) Employers and employees both enjoy tax-free treatment.

Your employer contributions can be deducted as a compensation expense. Unlike cash compensation, employees do not pay taxes on their QSEHRA benefit if they have a health plan that includes 10 essential coverages as specified by the Affordable Care Act. 

It is for this reason that a QSEHRA will be more beneficial than a simple health insurance stipend, which employees can use towards health insurance and other expenses.

4.) QSEHRAs Support Employee’s Choice

There are too many traditional group insurance plans that force employees with vastly different situations to choose between just one or two options for health insurance.

The HR department and the company management select these items, which are often expensive and not appropriate for employees. 

A QSEHRA offers workers and their family members a wide range of options and gives them the power to select a health plan that is right for them.

Pennsylvania Taxed Employer Health Insuranc Coverage

Under federal and Pennsylvania law, the premiums for health insurance you pay as an employee are fully deductible as a business cost. These premiums are not taxable for the employee.

The overall cost of healthsharing plans is lower. Employees can deduct the monthly cost of these plans from their taxes. Employer assistance to pay health-sharing costs is taxable for the employee.

Pennsylvania Small Business Health Insurance Has Its Disadvantages

The traditional group health insurance for employers has many disadvantages, both to them and their employees.

  • The Cost
    As we mentioned above, the cost of health insurance is often crippling.Overkill is a major factor in the high cost of traditional health insurance. Washington and Harrisburg regulators have piled on coverages and requirements for health insurance that are not necessary to most workers.

    For example, traditional insurance carriers must include mental health benefits, drug and alcohol addiction coverage, as well as maternity coverage that many workers are not interested in.

    The result is that they are much less effective and cost-effective than necessary.

  • Inflexibility

    Many group health insurance programs are a one size fits all strategy. This may not be able to adequately meet the budgets and needs of certain employees. Group health insurance plans sponsored by employers are usually limited to one or a few options, which may not suit the needs of specific employees.

    Some workers may find it more cost-effective to purchase their own health insurance plan through the individual market. They could also benefit from subsidies under the Affordable Care Act.

    A less expensive health-sharing plan may be a better option for them. These innovative, affordable alternatives to insurance can be an excellent solution for employees who are healthy and have no pre-existing medical conditions.

    The following sections will discuss in detail health sharing plans.

  • Administrative burden
  • Administrative costs can be high for a health insurance plan. The administrative costs of managing a full-fledged health benefit are substantial. These tasks are crucial to the smooth and effective operation of a health insurance plan within an organization.

    However, they are a significant burden for small employers that don’t have enough staff to operate the plan.

    Businesses can use other strategies, such as Health Care Stipends and Health Reimbursement Arrangements.

    The Affordable Care Act offers alternative ways to encourage workers. The workers may benefit from the available subsidies. The employer is also removed from the entire process, which reduces overhead and administrative expenses.

Health Sharing Plans in Pennsylvania

Health sharing plans for small business in Pennsylvania are a viable alternative to costly health insurance.

Pennsylvania’s businesses are turning to medical cost sharing as an alternative to traditional health insurance. By switching to health sharing plans, businesses can often save up 50% on premiums in comparison to their old group health plans. 

Pennsylvania small companies could save upwards of $10,000 annually per employee, for a family plan, and over $3,500 per person per year, for a single policy.

These programs provide a cutting-edge way for companies to finance healthcare. This allows them to provide high-quality health care to their employees while limiting costs. Health sharing programs operate on the principle of sharing resources across a group.

Health sharing programs involve participants paying an amount of money predetermined per year, instead of traditional health insurance which requires payment of premiums to insurance providers.

Health Sharing Plans vs. Health Insurance

Health sharing plans do not mean health insurance.

Instead, healthsharing organisations are voluntary associations where members agree to share their medical expenses with other members. Health sharing ministries are not for profit organizations, unlike most health insurance companies.

Mandated Coverages

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 for minimum essential coverage.

A medical cost-sharing plan is not required to pay for addiction treatment, such as for those who have never used drugs. They also don’t cover the costs of injuries resulting from the drunken driving of members.

Conditions that Exist

Unlike traditional insurance plans, some healthsharing plans impose waiting periods for them to share the costs related to treating preexisting illnesses. 

In addition, they often have waiting periods before allowing surgery. This is excepted for accidents or injuries that could not possibly be anticipated at the time of enrollment.

These waiting periods reduce adverse selection to a great extent and allow health-sharing organizations to offer a comprehensive set of health benefits at a fractional price of a standard ACA-qualified health insurance group policy, or one bought via Pennie.

Note: Plans that are part of a healthsharing program do not qualify as subsidies under the Affordable care Act. Although the cost savings can be so substantial, it is still worth switching to healthsharing even if one qualifies for a government subsidy.

Because small-group health insurance plans aren’t eligible for a premium tax subsidy under ACA rules, switching to a health sharing plan is a better option.

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Pennsylvania Has Restrictions on Health Sharing and Network Access

Health sharing plans provide more options when choosing healthcare providers. They are different from traditional managed-care plans such as PPOs and HMOs, which by far are the most commonly sponsored group health plans.

In Pennsylvania, most healthsharing organizations do not restrict their members to using providers who are part of a network. Members of the health-sharing plans are allowed to choose any doctor they like. Giving people the choice of doctors.

What Is the Right Health Sharing Program for Your Pennsylvania Small Business Health Plan?

Every business differs. It is important to do some research before deciding on the right plan. 

Business owners in Pennsylvania can get a full analysis of their case and a recommendation that is specific to them and their employees.

To begin the process, simply click on this link to set up an appointment with us. 

Prepare a list of employees.

In many cases, switching employees to health insurance could save them thousands of pounds per covered employee. It may not be a good idea to use health sharing if you are dealing with employees who have pre-existing conditions.

Consultations and analyses will always be free.

Small Businesses in Pennsylvania May Be Eligible for Health Reimbursement Arrangements

Health Reimbursement Arrangements or HRAs are employer-funded benefits which reimburse employees of their individual healthcare costs tax-free.

Oft, Pennsylvania’s small businesses will simply stop offering the group health benefit. Instead, small businesses in Pennsylvania establish an HRA. This HRA allows employees to purchase health insurance for themselves on the private market using pre-tax dollars.

It also allows the worker to take advantage the subsidies available, which further reduces the cost of the company. 

Workers who have any HRA left over can use the money to cover out-of-pocket expenses, including prescriptions and durable equipment, as well as co-pays. HRA benefits to employees are also tax-free. 

An HRA is a great alternative to formal group health plans. It allows your employees the flexibility to select health insurance that meets their individual needs.

Click here to learn more about HRAs.

QSEHRAs (The HRA for Small Businesses)

QSEHRA can be used to reimburse small employers for health care costs.

This benefit applies to companies that employ fewer than 50 employees full-time, or an equivalent number of people.

Businesses can determine their own QSEHRA contribution maximums. There are some limitations. Pennsylvania employers have the option to pay up $5,850 (up $487.50 per monthly employee) for individuals and up $11,800 (up $983.33 for family employees) by 2023.

Employees use this money to purchase their insurance either through an Personal benefits manager or online via the health insurance exchange. It also preserves their ability to get a subsidy under a group plan that is paid by an employer. 

As an employer, you have the option to reimburse both your employee’s premiums for health insurance and their additional medical costs.

QSEHRAs (Qualified Special Enrollment Health Reimbursement Accounts) and Special Enrollment Days

Employees will be eligible for Special Enrollment Period if you cancel your insurance plan and replace with HRA. During this 60-day window, your employees will be able to buy their own ACA insurance plan that is guaranteed issue and does not require medical underwriting. 

This can help to ensure your employees won’t be affected by a gap in coverage if you decide to replace your current group health plan entirely with a QSEHRA.

HRA Advantages to Pennsylvania Small Business Health Insurance

Health Reimbursement Arrangements, or HRAs, have a number of advantages.

Tax-deductible for you and tax-free for your employees, the money you spend to provide HRA benefits to your staff is a great investment.

HRA money does not become yours until you actually pay it to the workers. It remains as a source of operating capital. You don’t need to give it to anyone else.

The HRA program is designed with a lot of flexibility by the employer, which includes what expenses are covered. 

Workers are not deprived of their health insurance if the leave or convert to contractor status. The QSEHRA system allows workers to own and control their health insurance. Not the employers. 

HRA Disadvantages to Pennsylvania Small Business Health Insurance

Not all employees want the burden of choosing and researching their own health care plan. Some workers need extra support to navigate through the transition. 

You can get help from your HSA for America personal benefits manager if this happens. So that no worker is left out. 

You can also call 800-913-0172 to schedule an appointment.

Click on to find out more about the alternatives to employer-sponsored insurance in Pennsylvania for small businesses.

Direct Primary Care Benefits

Direct Primary Care plans, or DPCs, are an alternative healthcare system that has been gaining in popularity both in Pennsylvania and throughout the United States. This is a membership model. In exchange for a monthly flat fee that’s affordable, just like a gym, your employees get as many visits as needed, in person or through telehealth.

DPC’s monthly membership fees start at just $80 and are a viable option for people to prioritize their health, without having to pay copays or insurance co-payments.

DPC Plans provide unlimited access to primary care, preventive and chronic care services.

Some of the services that are commonly provided by direct primary health care practices include

Direct Primary care doctors provide many medical services.

  • Preventive care. DPC doctors are committed to preventive medicine. They offer services such as routine checks, immunizations and screenings.
  • DPC doctors offer acute care to patients with minor injuries, infections, colds and flu, and other illnesses.
  • Chronic disease management. DPC doctors assist patients in managing chronic conditions, such as diabetes and hypertension. They also help with asthma, arthritis, and other diseases. They offer continuous care, monitoring and can adjust treatment plans if necessary.
  • Comprehensive physical exams. DPC doctors perform thorough physical examinations in order to determine overall health, identify risks and make personalized recommendations.
  • Urgent care. DPC doctors often offer same-day and next-day urgent treatment.
  • The appointment system allows patients to get prompt attention on non-emergency health issues.
  • Diagnostic and laboratory testing. DPC physicians may coordinate or offer a wide range of laboratory services, including blood tests, urine analyses and imaging studies, (X-rays, Ultrasounds) as well as electrocardiograms.
  • Medication Management DPC physicians can prescribe medications. They also monitor their effectiveness. They can also educate and counsel patients on how to use medications.
  • Mental Health Services Mental health is often part of the comprehensive care provided by many DPCs. DPC physicians may offer counseling, therapy or referrals to mental specialists as needed.
  • Minor procedures. Some DPC doctors are trained to perform minor procedures in their office, such as suturing lacerations, removing moles or skin lesions, joint injections, and others.
  • Care coordination and referrals. DPC doctors act as patient advocates and coordinate care with specialists, hospitals, and other healthcare providers when referrals are necessary.

Meanwhile, since there’s no insurance company involved, there are no co-pays, co-insurance, or deductibles to worry about. The monthly subscription covers everything. This means cash-strapped workers can seek the care they need right away. They never need to put off seeing the doctor because they can’t afford the deductible or co-pay.

If patients need additional coverage, they can opt for supplemental plans like accident insurance, high-deductible health plans and health sharing plans. DPC members are entitled to routine health care. Patients can choose more cost effective coverage options like healthsharing, rather than traditional health insurers.

Health Savings Accounts

HSAs are a great way to manage your medical expenses, and also to lower the premiums on workplace health insurance.

Pennsylvania residents and businesses are in desperate need of any tax break. The good news: employer contributions to employee Health Savings Accounts can be fully deducted from Pennsylvania Corporate Income Tax as a compensation expense.

HSAs enable individuals to put money aside for future medical needs before they pay taxes. HSAs allow both employees and their employers to contribute, up to a certain annual limit. This is updated by Congress each year to reflect changes in the cost of life.

HSAs allow for tax-deferred investment growth and withdrawals that are used to pay qualified healthcare costs.

HSA Eligibility 

Employees who want to enroll in an High Deductible Health Plan (HDHP) or benefit from employer pretax contributions must do so. 

In 2023, an IRS-defined high-deductible health care plan is any plan with at least a $1,500 deductible for individuals or $3,000 deductible for families.

A HDHP can only have a maximum of $7,500 in annual out-of pocket expenses. This includes deductibles as well as copayments and insurance. (This limitation does not apply for out-of network services. ).

Can I Combine HSAs & Health Sharing? 

There is only one major health plan that allows employees to contribute pre-tax money into their health savings accounts: the HSA SECURE Plan. It’s available through HSA America.

HSA SECURE Plan allows you to combine the tax-saving and healthcare benefits that come with a Health Savings Account (HSA) with the cost savings of healthsharing.

To enroll in the plan, however, your employees MUST have at least some form of self-employment or small business ownership or income.

HSA SECURE cannot be used by employees who are W-2. HSA SECURE could be an excellent option if you or your employee have a side business, freelance or other work and are in good physical health. 

As a small business, you may find that the HSA-SECURE Plan is a fantastic way to save money.

Your employees must enroll in HSA SECURE by themselves. If they’ve already enrolled and created an HSA you can make pretax contributions in their name, up until the annual limit Congress determines every year. 

HSA SECURE is available by clicking on the link below.

Click here to learn more about HSA SECURE.

How is Pennsylvania Small Business Health Insurance Taxed

This table explains the tax implications of each alternative strategy available to small companies in addition traditional health insurance.

Plan TypeEmployerWorkers
Traditional health insurance premiumsTax deductible. May qualify for a tax credit (see below)Non-taxable
HSA contributionsTax deductible
Pre-tax, up to certain limits. No income limitations.
Health sharing costsTax deductible as a compensation expenseTaxable as ordinary W-2 income
Health reimbursement arrangementsTax deductibleBenefits are non-taxable to the employee
HSA withdrawalsN/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 expenseTaxable to the employee

Incorporate All Levels Of The Pennsylvania Small Business Health Insurance Pyramid

Employee Health Benefits should be designed to cover the entire Employee Healthcare Pyramid. From routine prevention, to accessing primary care and early detection for health problems through to catastrophic accidents.

Pennsylvania Small Business Health Insurance Pyramid

The left side of this page lists the common solutions that are based on insurance and address the different levels of the Care Pyramid.

The right side of this page lists a few alternative and more affordable ways to protect employees on each of the Pyramid levels.

Employees can find affordable solutions for each level of the plan with a well-designed plan. It is important that there are no employees who have to go without or delay treatment because they cannot afford the premiums, co-insurance or copay.

The Personal Benefits Coordinator can create for you a unique plan which provides solutions to each of the levels of the Care Pyramid. Most often, this is at a fractional cost to an employer compared with a standard group plan.

Pennsylvania Small Business Health Insurance Tax Credit

Small Business Health Care Tax Credit, passed with the ACA allows certain small businesses claim a federal credit up to 50% on their employees’ health insurance costs.

This program is designed for small business owners who have 25 or less employees and tend to hire workers at lower wages.

Businesses that are for-profit or non-profit can claim the tax credit.

*  Employ fewer than 25 people and pay an average salary of $53,000 (excluding all owner salaries). Owners are generally not considered when calculating the average salary and number of employees for a business. The number of employees are also based on the “full-time equals”. Two half-time workers would be equal to one full-time worker.

 Paying at least 50% of employee premiums;

* In Pennsylvania, this means offering coverage that meets the requirements of the Affordable Care Act on the Pennie website.

Once an employer has 25, employees, or if the average salary is $53,000 or more

What is the process for claiming credit?

This tax credit can be claimed on your income tax returns with IRS Form 8941 attached (tax-exempt businesses are required to submit a Form990-T to make a claim even though they do not have to).

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 my business hasn’t paid any taxes this year?

Yes.

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.

Combining Your Pennsylvania Small Business Health Insurance Plan Strategies

Combining programs to increase your insurance coverage can be smart.

Many employers find that by combining several healthcare packages, they can control their healthcare costs as well as provide full coverage to all of their employees.

One cost-effective approach is to combine a Direct Primary Care plan (DPC) that provides normal primary health care with an affordable health sharing plan covering catastrophic events.

Comparing this to the conventional health care insurance for groups, it can save money for you, your employees or both.

Giving employees the opportunity to select between an HDHP HDSA plan and a health-sharing plan as well as the ability to contribute money into a Health Savings Account can provide them with more freedom, while potentially lowering costs.

What To Do Now

The best course of action is to put together an employee census and contact us for a free, complementary business health plan analysis and recommendation.

You’ll be connected with 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.

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.

Pennsylvania Small Business Health Insurance FAQs

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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 Pennsylvania?

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 Pennsylvania?

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

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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 Pennsylvania?

Maternity benefits are commonly included in health insurance policies and healthsharing plans in Pennsylvania, 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 Pennsylvania?

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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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 Pennsylvania?

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 Pennsylvania?

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 Pennsylvania?

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 Pennsylvania?

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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