A traditional small-group plan is one option, and in Pennsylvania it needs at least two enrolled employees and usually a minimum participation rate. It’s also gotten expensive: small group rates rose 12.7% for 2026 with another 11.5% proposed for 2027. The average family premium on an employer plan is now almost $27,000 a year.
Tell me how many people, roughly what they earn, whether you want to contribute a fixed dollar amount or a percentage, and whether you and your family are on the same plan. That’s enough to sketch two or three structures with real numbers.
I’m Nathan Baughman, owner of BIG Benefits for Small Business. When the big carriers say “small business” they usually mean 50 or more employees. I mean you. The shop, the crew, the office with four desks.
Small-group plan through the major carriers, once you have the headcount and participation. Guaranteed issue, employer contribution, brought in with my group partner.
QSEHRA or ICHRA reimbursement: you set a monthly allowance, employees buy their own plan (marketplace or private), you reimburse tax-free. Ninety-day notice rules apply; I’ll walk you through them.
Level-funded plan for healthy groups that have enough enrolled lives (most carriers want five to ten): fixed monthly cost, potential refund of unused claims. Worth a look at the upper end of “small.
“Private, underwritten plans for the owner, the family, and any employee who qualifies and prefers it.
Group isn’t the only way. Reimbursement (QSEHRA/ICHRA) is built for you. Ask about joining a larger group. Don’t leave the owner on the worst plan.
“Nathan is so helpful! A great resource for small business owners!” — Rich H., WI
Not knowing about reimbursement. A QSEHRA lets a business with fewer than 50 employees and no group plan give each employee tax-free money toward their own individual plan, up to $6,450 single / $13,100 family for 2026. An ICHRA does the same with no cap and can vary by employee class. The employee picks their own plan; you write a check with rules around it.
Not enough bodies for a group. Did you know you can sometimes enroll your business into a larger group if you don’t have enough participating members? It depends on the carrier and the situation, and it’s one of the questions worth 20 minutes.
Leaving the owner uncovered. Owners often build the plan for the team and put themselves on the worst option. If you’re healthy, a private underwritten plan for you and your family, alongside reimbursement for the team, is often the most efficient structure.
1. Is there a maximum out-of-pocket? 2. Is it an unlimited contract? 3. Is it guaranteed renewable? If a plan uses words like “deductible” and “PPO network,” that doesn’t automatically make it actual health insurance. These three questions do.
Send me an age and a zip code and I’ll send back a general idea of what’s available in your area. Twenty minutes, no charge, no pressure. Happy to answer any and all questions so you can make the most informed decision for you, your family, or your business.
