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New Health Insurance Options for PA Small Businesses

New Health Insurance Options for PA Small Businesses
A light at the end of the tunnel

Finally, after 6 years of the Affordable Care Act (ACA), new health insurance options for PA small businesses are starting to pop up. And just in time too, since our local insurance market was beginning to look quite grim.

Why PA Needs New Health Insurance Choices

For most small employers, premiums have gone up a lot in the past few years. Yet the plans keep getting worse at each renewal. There seems to be no end in site to this dreadful cycle. While there are many factors involved, let’s take a look at two of the main reasons we are in this mess.

First, stronger regulations have forced small health insurers out of business. Hence less competition, which has lead to higher rates and lower quality plans. Next, under the ACA, health insurers can not base their prices on the health of your employees. Rather they must use age banded, standardized rates. So even if you had no claims, your rates would still go up like everyone else’s.

New Health Insurance options Reward healthy businesses

Seeing this as a chance to get new healthy customers, insurers began to craft a different type of policy. And as a result there is now a handful of new plans in PA that reward healthy businesses with lower rates. Here are some of the features:

    • This could add up to thousands of dollars, even for small employers.Rates are typically 15% – 25% less than comparable ACA plans.
  • The new plans use tiered rates instead of age banded ones.
    • Hence, employee prices are based on their coverage tier, like single, husband and wife, or family, not their age.
  • Employers can potentially receive a refund if they have a good claims year.

It’s not all roses though as there are a few hoops to jump through. First, the plans are typically only available if you have five or more employees. Next, you must health qualify. So get ready to fill out those invasive medical history questionnaires! Well, maybe not. With some insurers, they just check your Rx claims behind the scenes. Finally, you might have to file 1095 tax forms for your workers under these plans. But it’s only once a year.


While filling out forms is a pain in the neck, it may be well worth the effort. For the first time in years, these new plans give you the chance to save money without sacrificing benefits. Plus you truly get what you pay for, as refunds are given when your claims are less than predicted. So why not get a quote at your next renewal, or sooner? The only thing you have to lose are the high prices!

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