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Best Health Insurance Companies for Small Businesses for 2024

Blue Cross Blue Shield is our top pick for its availability and wellness programs

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Blue Cross Blue Shield stands out as the best health insurance company for small businesses because of its range of coverage options. The company offers a nationwide preferred provider organization (PPO) network and extra benefits for employees, including an extensive discount program. 

Depending on your state, you may have a few options for finding health coverage for your employees, including through the Small Business Health Insurance Options Program (SHOP)—a government marketplace for small business health plans—and by purchasing a traditional group health plan from a broker or directly from an insurer. 

To choose the best health insurance companies for small businesses, we evaluated major health insurance carriers based on financial strength, customer satisfaction, coverage options, telehealth and wellness benefits, digital tools, and more. These are our top picks. 

  • Best Overall: Blue Cross Blue Shield
  • Best for Customer Satisfaction: Kaiser Permanente
  • Best for Part-Time and Seasonal Workers: UnitedHealthcare
  • Best for Self-Funded Plans: Aetna
  • Our Top Picks

Blue Cross Blue Shield

Kaiser Permanente

UnitedHealthcare

  • See More (1)

The Bottom Line

Small business insurance options.

  • Frequently Asked Questions (FAQs)
  • Methodology

Best Overall : Blue Cross Blue Shield

Blue Cross Blue Shield (BCBS) offers flexible options to small business owners, including the option to access the nation’s leading PPO network. In many states, BCBS employee plans come packed with extra benefits, and most plans include an extensive discount program.

Nationwide availability

Health and wellness discounts

Workplace wellness programs in many states

Poor J.D. Power ranking in some regions

Blue Cross Blue Shield, which is also our pick for the best health insurance company overall, offers employers many options. Among them are plans that include access to the BlueCard PPO network, which gives employees coverage when traveling nationwide. In some states, BCBS offers fully insured, level-funded, and self-funded plans. Blue Cross Blue Shield is a group of companies, so benefits and plans vary by region, but many member companies offer extra benefits. 

For example, the member company Anthem provides an employee assistance program at no extra cost to help members manage stressful events, from legal issues to the search for care. In many states, BCBS plans also come with 24/7 telehealth and access to mobile app plan management. Most members also get access to Blue365, an extensive discount program that also offers a $25 gym membership in some states. 

BCBS and Anthem companies had a combined average of 3.5 stars out of 5 stars from the National Committee for Quality Assurance (NCQA), an independent body that judges insurance plans on the quality of their providers, as well as customer satisfaction. But customer satisfaction ratings vary by region. Check the 2023 J.D. Power U.S. Commercial Member Health Plan Study to see how BCBS fared in your region. While rankings are poor in many regions, BCBS was top-ranked in Florida. 

BCBS companies also have an A or A- financial strength rating from AM Best . 

Best for Customer Satisfaction : Kaiser Permanente

Kaiser Permanente has top customer satisfaction ratings from the NCQA and J.D. Power, along with an award-winning app and a suite of virtual care options.

4.2-star average NCQA rating

Top-ranked by J.D. Power in most regions where available

Administers HRAs, HSAs, and FSAs

Robust support for chronic conditions

Only available in eight states and D.C.

Kaiser Permanente has better customer satisfaction ratings than any of the major health insurance providers we reviewed, with a 4.2-star average NCQA rating and top J.D. Power rankings in four regions. The company offers employers many options. While Kaiser is known for its health maintenance organization (HMO) plans , it also offers preferred provider organization (PPO) plans . Employees can pair some plans with a Kaiser-administered health reimbursement arrangement (HRA) , health savings account (HSA) , or flexible spending account (FSA) . Members can even submit HRA and FSA claims using their mobile phone cameras. 

Free wellness coaching is included at no cost. Members who are at risk for chronic conditions are automatically enrolled in a disease management program with comprehensive support and remote patient monitoring. And Kaiser offers several additional employee benefits, including dental, vision, acupuncture, and chiropractic. Kaiser is also our top pick for the best digital tools, with an award-winning app, 24/7 virtual care, mental health apps, and online physical therapy. 

The main drawback is that Kaiser Permanente isn’t available everywhere. The company only offers plans in eight states and the District of Columbia. Kaiser does offer a SHOP (Small Business Health Options Program) plan in Georgia and Virginia.

Best for Part-Time and Seasonal Workers : UnitedHealthcare

UnitedHealthcare offers small business plans nationwide, including a unique coverage solution for contractors, part-time workers, and seasonal employees.

Offers a unique program for non-benefit-eligible workers

Offers wellness resources and incentives

A+ financial strength rating from AM Best

J.D. Power ratings vary by region

UnitedHealthcare is our top pick for small businesses with several types of employees and contractors, including part-time and seasonal workers. Its FlexWork program offers coverage for non-benefit-eligible employees nationwide. The program provides group-premium-equivalent rates for three plan types designed for different types of workers, and you can add extra benefits like $0 telehealth, dental, and vision. 

UnitedHealthcare also offers members access to Self Care (a wellness app), fitness incentives, an online weight loss program, a smoking cessation program, and more. Plus, UnitedHealthcare offers a large provider network of more than 1.3 million healthcare providers. 

UnitedHealthcare also boasts an A+ financial strength rating from AM Best and a 3.5-star average NCQA rating. Though J.D. Power ratings vary by region, UnitedHealthcare was the top-scoring company in Texas and Virginia. The company also offers SHOP plans in Maryland, Massachusetts, New York, and D.C.

Best for Self-Funded Plans : Aetna

Aetna is one of the few health insurance companies to offer self-insured plans tailored to small businesses. We also like that it offers virtual primary care and a CVS allowance.

Offers self-funded plans for up to 25% upfront savings

Offers a variety of health expense funds

Optional robust behavioral health benefits

Members of some plans can access affordable care at MinuteClinic locations

Fully insured group plans in some states don’t include MinuteClinic benefits

Self-funded plans from Aetna offer up to 25% savings upfront, plus stop-loss insurance if your claims for a particular month go over your maximum claims amount. When you renew your plan, Aetna will refund 50% of any surplus funding to you. 

Members get access to CVS Health virtual primary care plus up to a $100 allowance for health and wellness products at CVS. The company also offers HRAs, HSAs, FSAs, and retirement reimbursement arrangements (RRAs) in most states. In addition, you have the option of adding behavioral health benefits that include virtual counseling, mental health tools, and an employee assistance program. Many plans offer MinuteClinic benefits as well, but fully insured plans in some states are excluded. 

Aetna has a 3.5-star average NCQA rating and a financial strength rating of A with AM Best. The company also came out on top in the East South Central, Northwest, and Southwest regions in the 2023 J.D. Power U.S. Commercial Health Plan Study, but ratings vary by region. Aetna offers SHOP plans in Maryland and D.C.

Blue Cross Blue Shield offers the most options for employers, with many plans providing access to the BlueCard PPO network and 24/7 telehealth, along with a variety of funding options in some states. If you’re looking for a self-funded plan, Aetna offers the best option tailored to small businesses in many states, as well as CVS benefits and optional robust behavioral health benefits. Kaiser Permanente takes the cake for customer satisfaction, with high third-party ratings and great digital tools, while UnitedHealthcare’s unique FlexWork program makes it our top pick for nontraditional employees. 

When choosing small business health insurance, you have a few options, according to Robert Slayton, an employee benefits consultant. 

Small Group Health Insurance

One option is to purchase a small group plan directly from a commercial health insurance company that serves small businesses or through a broker. “It gives the employer control over which plans to offer and [assurance] that people will remain covered while employed,” said Slayton. However, you may also need to offer COBRA or mini-COBRA plans. Mini-COBRA plans are required by some states for companies with fewer than 20 employees.

Self-Funded Plan

You may be able to save money by taking on the responsibility of paying out employee health claims yourself. This is known as a self-funded or self-insured plan, which typically relies on a commercial health insurer to administer the provider network and provide assistance with enrollment and claims processing. 

Health Reimbursement Arrangement (HRA) 

Another option is for the employer to offer a health reimbursement arrangement (HRA), which is an employer-funded group plan that pays employees back for qualified health expenses up to a certain dollar amount each year. Expenses may include premiums for an employer-sponsored plan, as well as copays and coinsurance. There are several types of HRAs, including a qualified small employer HRA (QSEHRA) for companies with fewer than 50 full-time employees. Another type is an individual coverage HRA (ICHRA), which lets employees use the funds to buy their own health insurance with pretax dollars. Funds can also be used for copays and deductibles. “[Employers] choose an amount to give each employee so that the employee can purchase coverage on their own,” said Slayton. “Employees who claim this reimbursement must have an underlying individual plan or Medicare.” 

SHOP Plan 

The Small Business Health Insurance Options Program allows you to compare small business plans offered on the ACA Marketplace and offer one or multiple options to your employees. These plans are typically the only route to the Small Business Health Care Tax Credit. However, they’re only offered on the federal marketplace in eight states and on state-run exchanges in 13 states. 

Frequently Asked Questions

Do small businesses have to provide health insurance.

If you employ fewer than 50 people full-time, you are not required to offer health insurance to your employees. But more than half of firms that size do offer it, according to the National Federation of Independent Business. A 2022 U.S. Chamber of Commerce survey found that 88% of employees rank health insurance as the most important employer-provided benefit. If you have 50 or more employees and choose not to offer coverage that meets federal standards, you’ll be required to pay a penalty called a Shared Responsibility Payment instead.

How Much Does Small Business Health Insurance Cost?

Costs vary by location and the network and coverage you choose, but on average, small businesses contributed $7,349 per single covered employee in 2023. Experts recommend keeping your total employee benefit costs between 10% to 20% of your overall revenue.

What Is a Self-Insured Health Plan?

A self-insured health plan is a type of group health insurance in which the employer collects premiums and is responsible for paying claims when employees need care. These plans can be self-administered, or the business may work with an insurance provider to get stop-loss coverage (which puts a ceiling on your risk) and administrative support. 

There are several benefits to self-funded plans. Employers can keep surplus premiums (or receive a portion returned by the stop-loss carrier), plans can be customized to a greater degree, and certain ACA provisions that lead to high costs can be avoided. Increasingly, small businesses are opting for self-funded coverage. But self-insured plans aren’t right for every business.

Can an S Corp Pay for Health Insurance?

Yes. An S corp can provide health insurance for its employees. However, most health insurance companies require you to have at least two employees to get a group plan, so if you are an S corp owner and don’t have employees, you’ll need to get individual health insurance from the ACA Marketplace. Additionally, you can’t provide an HRA to anyone with a greater than 2% stake in your company.

How We Chose the Best Health Insurance Companies for Small Businesses

We chose the best health insurance companies for small businesses by looking at our research for our list of the overall best health insurance companies and then investigating what options these insurers offer for small businesses looking to buy plans for their employees. 

To identify which health insurance companies to review for our overall winners list, we analyzed business and market insight databases, considered health insurance company market share, and researched user-generated data from Google to determine public interest and trends in health insurance companies and plans. 

We collected data from the National Committee for Quality Assurance (NCQA), an independent organization that rates healthcare plans on quality and patient satisfaction. We also gathered data from state and federal government insurance marketplace websites and databases, and directly from companies via websites, media contacts, and existing partnerships. The data collection process took place between Sept. 29 and Oct. 23, 2023.

We then developed a quantitative model that scores each health insurance provider based on 27 criteria that fall into four major categories and are crucial in evaluating the company’s offerings and benefits. We weighted the four categories as follows for this article:

  • Plan Quality & Customer Satisfaction : 20%
  • Plan Features : 40%
  • Availability : 15%

Read our full methodology for reviewing health insurance companies.

J.D. Power. “ Commercial Health Plan Member Satisfaction Declines in Key Areas, J.D. Power Finds. ”

The Commonwealth of Massachusetts. " MiniCobra Continuation of Coverage Benefits Guide ."

Healthcare.gov. " What's An Individual Coverage Health Reimbursement Arrangement (HRA)? "

Healthcare.gov. “ SHOP Marketplace Basics for Employers .”

U.S. Department of Health and Human Services. “ As a Small Business Owner, Am I Required to Offer Health Insurance to My Employees? ”

KFF. " 2023 Employer Health Benefits Survey (Section 6) ."

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Small Group Health Insurance Options

More Value. More Choice. All Blue Cross and Blue Shield of Texas (BCBSTX) fully-funded standard small group Qualified Health Plans (QHP) for 2-50 employees offer features and benefits designed with members’ health and wellbeing in mind.

Popular Plans for Small Businesses

Blue choice ppo sm.

Blue Choice PPO gives you flexible benefit design options at a price you can afford while giving your employees a wide range of benefits and the freedom to visit any doctor they choose, with benefits paid at a higher level when the doctor is within the network.

Blue Advantage HMO SM

This cost-effective health plan is designed to provide affordable quality health care services to the uninsured and underinsured whenever they access care through a participating Blue Advantage HMO network provider.

Ask your agent or broker to get a quote for a BCBSTX standard small group qualified health plan.

  • Download the 2023 Small Group Plans Brochure

Full-Service Quoting, Enrolling and Management Solutions

For agents and brokers.

Bentegro for Small Business (1-50) is a comprehensive sales, enrollment and benefits management platform built for agents and brokers. Tell your agent or broker to talk to us about Bentegro.

For Employer Groups (2-10)

Groups too small for an agent, a broker or an in-house benefits manager can opt for a self-service employer enrollment and management solution when choosing a standard fully-funded plan. (Average group size is 5.)

BCBSTX Supports Your Business

Health care benefits are a crucial part of recruiting new employees and retaining your existing workforce. That’s why BCBSTX provides you with the tools, resources, and professional health care expertise you need to maintain the health, productivity, and satisfaction of the employees who help your business thrive.

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business health insurance reddit

Looking for solutions based on the size of your business? Select the page most relevant to your business case.

Looking for solutions based on the product your business offers? Select the page that corresponds best to the audience your business targets.

See how Reddit can help you ace your client’s campaign with our resources tailored toward marketing agencies. Look here for case studies, brand safety guidelines, and more.  

People in communities across Reddit are looking for products from small businesses like yours. See example campaigns and learn how to strategize for your first ad.

Insurance Advertising

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Insurance can look confusing from the consumer perspective.

Given the heavy regulation each insurance company is under, policies get complex. Simplify yours for consumers with Reddit’s advertising solutions and insights.

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Insurance Industry Trends

There are so many coverage options out there to choose from for everything from life insurance to health insurance. The overwhelm has led people to search for an easier path to purchase than shopping around with several insurance agents. Instead, they come to Reddit.

The average number of pages a consumer has to go through to read an insurance policy. 1

Insurance companies across the U.S. 2

Of Americans say too much content makes it hard to choose what to engage with. 3

Of social media users say they prefer to get insurance advice and recommendations from ordinary people. 4

Insurance consumers turn to Reddit to break through the noise

Reddit is a one-stop-shop for both broad and deep insurance conversations related to everything from purchasing life insurance to generic questions like “what does renter’s insurance cover?” The ability to seek honest reviews from any fellow insurance consumer coupled with the vast depth of knowledge not found on other social platforms or sites makes the search for an insurance policy a lot less overwhelming.

I've been approved for an apartment and I've been going over the lease. In the email they sent they mentioned:

Please note that we will need you to provide us with renters insurance should you choose not to use the liability insurance that the property offers!

The liability section of the lease is hard to make heads or tails of. Should I just look into getting private renters insurance? What should I look for if I do? The lease mentions a minimum coverage amount I need. Should I just find a renter's insurance policy that meets the lease's requirements? Or should I just sign the lease and opt into their "liability insurance"?

Communities home to insurance conversations in 2022. 5

Redditors looking to buy insurance say that Reddit is the #1 platform for honest reviews when switching insurers. 6

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Insurance Industry Trends and Insights

Insurance marketing is tough without knowing where customers are looking for information related to any specific policy—but we know Redditors are actively shopping around for insurance.

Car Insurance

Consumers are coming to Reddit for advice on purchasing auto insurance. Whether they’re looking for new car coverage, shopping for a cheaper policy, or finding the best customer services, your potential customers are here.

Why is car insurance so expensive for young people?

Home Insurance

We’ve recently seen tremendous growth in our r/FirstTimeBuyer community. Those in the market for both homeowners and renters insurance are active, whether buying through an insurance agency or speaking directly with insurers.

We are buying our first house in Seattle area, and before we close we need homeowners insurance. Our broker told us to get quotes from our car insurance company, which is Geico. There is also the question of what coverage to choose, and max payout if rebuilding the whole house is necessary. We are buying the house for $575k. The problem is that I didn't grow up in US, and so have no idea what so ever about anything homeowners insurance related.

Could someone please recommend homeowners insurance companies, and give me tips on coverage.

Life Insurance

Our r/LifeInsurance community has been poppin’ with consumers looking for advice on their next purchase from someone other than an insurance agent. These types of communities are a great tool for marketers to reach leads with their next ad campaign.

business health insurance reddit

I am currently thinking of purchasing life insurance, just a reasonable policy, something for the wife to have in case something happens, we just had a daughter and bought a house, took on some debt, and I want to make sure there is something there if something happens. My broker is pushing this “whole life” policy... he is talking up how great it is. I don’t really understand it, and I’ve heard from friends in the business that it’s a rip off. Can someone explain this to me in layman’s?

Redditors purchase policies based on the recommendations they find on the platform.

Insurance businesses should be a part of the conversation on Reddit. Our communities are where marketers can connect their brands directly with consumers—whether through an organic conversation or an advertisement—with their next campaign.

Of insurance shoppers on Reddit say they would purchase an insurance policy if they saw another user on Reddit had recommended it. 19

Of U.S. redditors have purchased an insurance policy based on information they found on Reddit. 20

Consideration

#1 Reading in-depth discussions about the best insurance companies.

#1 Accessing honest reviews of companies when switching insurers.

#1 Learning tips and tricks on discounts, savings, and bundling.

#1 Browsing trustworthy testimonials from existing customers.

#1 Asking for guidance in resolving insurance-related questions.

Insurance brands are welcomed by Reddit communities

Redditors aren’t going to be allergic to your digital marketing campaign or insurance ad—as long as you keep it real, they want to connect with insurance providers in our communities.

Of U.S. redditors say financial ads on Reddit are more relevant to them than on other sites. 21

Insurance shoppers on Reddit say they are interested in seeing insurance brands share helpful information on Reddit. 22

Insurance shoppers on Reddit say they would purchase insurance if they saw an ad about it on Reddit. 23

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Insurance Marketing Examples

Get inspired to test new, creative ways to optimize your ad spend. These insurance campaigns hit their goals out of the park.

Aviva went big selling their small business insurance product on Reddit with video ads that felt like commercials, and a variety of other ad types.

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Insurance Advertising Toolkit

Reddit is the number one platform insurance shoppers use when seeking out the best insurance companies, honest reviews, discounts, bundles, and expert guidance. 24

Get your brand in front of redditors with these tools.

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Get the most out of your advertising budget by optimizing your creatives for success on Reddit, with things like longer headlines and a conversational tone.

A 3D orange-red toolbox icon.

We’ve got a variety of ad types to fuel your marketing efforts, from unique formats like AMAs and Megathreads to tried and true videos and promoted posts.

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Ensure you reach your target audience by targeting communities like r/FirstTimeHomebuyer and r/LifeInsurance.

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Prove your ad spending is moving the needle with our tools for optimization and reporting.

1-3 Forbes, Petro Zinkovetsky, attorney insurance specialist

4 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023

5 Brandwatch, Global, 2022

6 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023

7 GWI, USA, Q3 2022

8 Brandwatch, Global, Jan - Dec 2022

9 Reddit Internal Data, Feb 2023

10 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023

11 Reddit Internal Data, YoY Growth, Jan-Dec 2022

12 Brandwatch, Global, Jan - Dec 2022

13 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023

14 GWI Core, US, 2022

15 Reddit Internal Data, YoY Growth, Jan-Dec 2022

16 Brandwatch, Global, Jan - Dec 2022

17 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023

18 GWI Core, US, 2022

19-20 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023 

21 Reddit Internal Data via Suzy, U.S., 2022

22-24 Reddit Internal Data via Attest, U.S., n=1000, 18+, Monthly Reddit Users, Feb 2023 

business health insurance reddit

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