How to Think About "Best"
If you search for the best small business health insurance in Pennsylvania, you will find plenty of lists. The honest answer is that the best plan depends on who is on your team. A plan that works well for a ten-person office where everyone lives nearby may be a poor fit for a team that is spread across several counties, or for a business with a few employees who each want something different.
So instead of ranking plans, this page walks through how to find the one that fits. It starts with what to figure out about your own team, then covers what is different about buying coverage in Pennsylvania, and then the main options on the table. If you are choosing between a traditional group plan and an ICHRA, our comparison of ICHRA vs. group health insurance puts them side by side.
In one sentence
The best plan is the one that fits your team, your budget, and the doctors your employees actually use.
How to Choose Coverage That Fits
Four questions will get you most of the way to the right plan, whether you work through them on your own or with an advisor.
Step 1
Know your team
Start with who works for you: how many people, where they live, and whether they are full-time or part-time. A team that lives in different counties or states has different needs than one that works side by side, and that shapes which plans make sense.
Step 2
Set your budget
Decide how much the business can put toward coverage each month, and how much you expect employees to cover. Knowing both numbers early keeps you from falling for a plan you cannot sustain.
Step 3
Compare the plan types
A traditional group plan gives everyone the same coverage. An ICHRA lets employees choose their own plan with an amount you set. The SHOP marketplace is another path for small employers. Each fits a different kind of team.
Step 4
Plan for support
The plan is only part of the picture. Decide who will answer employee questions, handle enrollment, and review your coverage at renewal, whether that is you, a staff member, or an advisor.
What Is Different in Pennsylvania
Federal rules apply in every state, but Pennsylvania adds a few pieces of its own, including its own marketplace and its own continuation law. Knowing them helps you shop with fewer surprises.
Marketplace
Pennie, the state marketplace
Pennie is Pennsylvania's official health insurance marketplace. It is where individuals and families shop for their own coverage, which matters if you are considering an ICHRA, since employees on an ICHRA choose individual plans.
Continuation coverage
Pennsylvania's mini-COBRA law
Pennsylvania has its own continuation law, 40 P.S. § 764j, that lets employees keep group coverage after certain events, such as leaving a job. Which continuation rules apply to you depends on your plan and your business, and your advisor can confirm.
Small group
What counts as a small employer
Under federal rules, a small employer is one that averaged up to 50 employees in the prior year, although a state may choose 100 instead. Small group coverage is built for employers in that range, and your advisor can confirm where your business falls.
Federal rules
The 50-employee line
Employers with 50 or more full-time employees, including full-time equivalents, face additional ACA requirements, in Pennsylvania or anywhere else. Your headcount decides which rules apply to you.
These are general points, not advice for your situation. Wondering whether you have to offer coverage at all? Read our guide to whether you have to offer health insurance in Pennsylvania. Based in the northeastern part of the state? See how we help employers across Northeastern Pennsylvania.
Your Options in Pennsylvania
Pennsylvania employers can go several ways. Here are the main paths, with a guide to each.
Small Group Health Insurance
One plan, or a few, offered to your whole team. A good fit when you want everyone on the same coverage and the same doctors.
Learn moreICHRA for Pennsylvania Businesses
You set an amount and employees pick their own individual plan. A good fit when your team's needs vary or you want a cost you set in advance.
Learn moreSHOP Marketplace vs. ICHRA
A side-by-side look at the SHOP marketplace and an ICHRA on cost, control, and paperwork.
Learn moreBenefits Administration in Pennsylvania
Help with enrollment, new hires, and the ongoing paperwork that comes with offering coverage.
Learn moreCommon Questions About Small Business Health Insurance in Pennsylvania
How do I choose the best small business health insurance in Pennsylvania?
Start with your own team. Look at how many employees you have, where they live, and what each person needs, then set a budget for what the business can contribute. From there, compare the main paths, such as a group plan, an ICHRA, or the SHOP marketplace, and decide who will handle questions and enrollment. The best choice is the one that fits those answers, not a plan that tops someone's list.
What is the difference between a group plan and an ICHRA?
With a group plan, you choose the plan or plans and your team enrolls in what you offer. With an ICHRA, you set a monthly amount and each employee picks an individual plan, and you reimburse them up to that amount. An employer generally cannot offer an ICHRA and a traditional group plan to the same class of employees.
Is there a Pennsylvania marketplace for small businesses?
Pennie is Pennsylvania's official health insurance marketplace, and it is where individuals and families shop for their own coverage, which is the route employees take with an ICHRA. For small employers, the SHOP marketplace is a separate option that HealthCare.gov lists on its small business pages. What is available to your business depends on your situation, so ask an advisor to confirm before you plan around it.
What counts as a small employer?
Under federal rules, a small employer is one that averaged between 1 and 50 employees in the prior year, though a state may choose 100 instead. Small group coverage is designed for employers in that range. If your headcount is near the line, an advisor can confirm which rules apply to you.
Do I have to offer health insurance in Pennsylvania?
Under federal law, employers with 50 or more full-time employees, including full-time equivalents, face ACA requirements about offering coverage, and smaller employers are generally not subject to that rule. Our guide to whether you have to offer health insurance in Pennsylvania goes through it in more detail.
What happens to coverage when an employee leaves?
Pennsylvania has its own continuation law, 40 P.S. § 764j, that lets employees keep group coverage after certain events, and federal COBRA may apply as well depending on your size. Which rules cover your business depends on your plan, and your advisor can confirm and walk you through the notices.
Can I get help comparing options?
Yes. Our advisors are licensed in Pennsylvania, New Jersey, and Delaware and can compare group plans, an ICHRA, and other options with you in one conversation. If you are weighing whether to work with an advisor or broker at all, our guide on whether you need a broker can help.
This FAQ is general information, not legal, tax, or insurance advice. Rules can change and every situation is different, so talk with a licensed advisor about yours.
Meet Our Small Group and ICHRA Advisors
Ready to Find the Right Fit?
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Disclosures
We are compensated by the insurance carriers for policies you choose through us. There is no direct cost to you. Compensation may vary by carrier and product. Information on this page is for educational purposes and does not constitute legal, tax, or accounting advice. Please consult your professional advisors about your specific situation. We are licensed to advise clients in Pennsylvania, New Jersey, and Delaware. Contact us to confirm availability in other states.
