Frequently Asked Questions
Q & A
Q: Do small businesses in Ohio have to offer health insurance to employees?
A: No. Businesses with fewer than 50 full-time equivalent employees (FTEs) are not required by the Affordable Care Act (ACA) to provide health insurance. Offering coverage is optional but can help attract and retain talent. Businesses with 50+ FTEs must offer affordable coverage or face penalties.
Q: How many employees do I need to qualify for group health insurance?
A: Most carriers offer small group plans for businesses with 1-50 employees (some include the owner as an employee). You generally need at least one common-law employee (not just owners or spouses) working 20+ hours/week.
Q: What are the main options for providing health benefits?
A: Common choices include:
- Traditional group health plans (fully insured or self-funded)
- High-deductible plans with HSAs
- Health Reimbursement Arrangements (HRAs) like ICHRA (reimburses individual plans) or QSEHRA (for businesses under 50 employees without a group plan)
- Ancillary benefits (dental, vision, life insurance), HRAs are increasingly popular for cost control and employee choice.
Q: How much does group health insurance cost for a small business in Ohio?
A: Costs vary widely based on employee ages, location, plan type, and coverage level. In 2026, expect average premiums to rise 9-20% due to medical inflation and subsidy changes. Employers often cover 50-80% of premiums. HRAs offer fixed monthly allowances for more predictable budgeting.
Q: Can I get tax credits for offering health insurance?
A: Yes. The federal Small Business Health Care Tax Credit can cover up to 50% of premiums paid if you have fewer than 25 FTEs, average wages under ~$56,000, and contribute at least 50% of employee-only premiums. Ohio may offer additional incentives for ICHRAs (e.g., potential $400/employee credit—verify current status). Use IRS tools or a tax advisor to check eligibility.
Q: What’s the difference between group health insurance and an ICHRA?
A: Group plans provide one employer-selected policy for all eligible employees. ICHRA reimburses employees tax-free for their own individual ACA-compliant plans. ICHRA offers more employee choice, fixed employer costs, and portability, but requires administration for verification and compliance.
Q: Do I have to cover part-time employees or dependents?
A: Not necessarily. Plans typically cover full-time employees (30+ hours/week) and can include dependents. You decide eligibility rules, but coverage must be uniform within employee classes to comply with ACA and state rules.
Q: How do I choose the right plan for my business?
A: Assess your budget, employee needs (e.g., family coverage, preventive care), and workforce (e.g., remote vs. on-site). Compare options through a licensed Ohio broker or agent, or on platforms like SHOP (via HealthCare.gov) for small groups. Consider carriers like Medical Mutual, Anthem, or UnitedHealthcare, or HRA administrators for flexibility.
Q: What are the key compliance requirements in 2026?
A: Limit waiting periods to 90 days max. Provide a Summary of Benefits and Coverage (SBC). For applicable large employers (50+ FTEs), ensure affordability (employee share ≤ 9.96% of income for the lowest silver plan equivalent). File ACA forms (1094-C/1095-C) as required. Ohio mandates equivalent telehealth coverage.
Q: Where can I get help finding and enrolling in a plan?
A: Work with a licensed insurance broker or agent in Ohio. Resources include the Ohio Department of Insurance, HealthCare.gov (for SHOP), or specialized firms like Take Command Health (for HRAs). Brokers can compare multiple carriers and help with quotes.
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