Ohio Small Business
Health Insurance Plans 2022

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OH Small Business Health Insurance Plans

Ohio Small Business Health Insurance Plans

Ohio Small Business Health Insurance Plans 2022. The following is an overview of the rules that govern small group health insurance plans in the State of Ohio.

The information that is discussed below includes the laws that have been mandated by the Affordable Care Act (ACA or "Obamacare"), as well as the laws that are required by Ohio State government.

If you own and operate a OH small business and you already offer small group health insurance or you're thinking about offering small group health insurance - this guide can help you better understand the regulations, requirements and available Ohio small business health insurance plans available.

Learn how to get Ohio small business health insurance plans for 1 to 50 employees. The best small business health insurance providers in OH offer affordable rates, flexible coverage options and access to a large network of medical providers.

Below are some answers to commonly asked OH small business health insurance plan questions:


How Much Does Ohio Small Business Health Insurance Cost?

The average price of a standard Ohio small business health insurance policy ranges from around $583 to over $1706 per employee per month based on; single or family, location, coverages offered, deductibles and more.

What Are The Small Business Health Insurance Regulations In Ohio?

Ohio Small Business Health Insurance Plans

The State of Ohio has fewer small business health insurance regulations than most states. Nevertheless, if you're a small business owner, it's important to understand these regulations so that you can make the right decisions for yourself and your employees.

While there is no state law that requires employers to offer group health insurance to their employers in the State of Ohio, the majority of employers do offer their employees this benefit.

All health insurance companies are required to follow the guidelines that have been established by the Federal government under the Affordable Care Act, as well as the state of Ohio.

Health insurance companies that are based in Ohio are required to sell small group health insurance policies to all small business owners.

Furthermore, there are two Ohio small business health insurance plans that have been standardized by the state that all health insurance companies must offer.

If you qualify, your business must meet the minimum participation requirements that have been set forth by your Ohio health insurance company. If you don't meet the minimum level of participation that your health insurance company requires, your policy could be terminated.

In Ohio, health insurance companies can charge higher premiums for small business health insurance policies due to the age, family size, and geographic location of the group; however, higher premiums cannot be charged as a result of the health status of the group.

Lastly, like individual health insurance plans, illness cannot be used as a ground for terminating small business health insurance policies.

Does Ohio Participate In The Affordable Care Act?

Affordable Care Act Ohio

In 2010, the Affordable Care Act (ACA or "ObamaCare") was passed by the United States Congress and was signed into law by Obama. Following its passage, provisions of the law have continued to be phased in, and as of January 1, 2014, the majority of American citizens and legal residents of the United States are required, by law, to have qualifying health care coverage.

If they fail to have coverage, they are responsible for paying an annual tax penalty for each month they aren't insured, which is known as the "individual mandate".

The cost of the penalty for failure to have qualifying coverage is $95 per adult and $47.50 per child, or 1% of your total taxable income; whichever amount is higher - as much as $285 per family. In 2017, the penalty increased, and has continued to increase thereafter.

Qualifying Exemptions For The Individual Mandate

Individuals who meet one of the following are exempt from the individual mandate and the associated tax penalties in OH:

  • Illegal aliens
  • Jailed individuals
  • Religious objections
  • The cost of health insurance coverage is higher than 8% of your household income
  • Those who aren't covered for less than three months during the calendar year
  • Those who have hardship waivers
  • Your income level is blow the 100% poverty level

What Are The Affordable Care Act Requirements For Ohio Small Businesses?

Ohio Small Business Health Insurance Plans Claim Form

If you're a small business owner in Ohio, you must provide your employees with insurance. This is a requirement that was put into place by the Affordable Care Act.

Referred to as the Employer Shared Responsibility provision, all employers must offer their employees at least one of the ACA-compliant Ohio small business health insurance plans, otherwise then can face fines of up to $2,000 per employee.

Ohio small business owners can purchase coverage for their employees through the state's Small Health Option Program (SHOP) exchange, or from a private insurance agent or broker.

Affordable Care Act Standardized Essential Health Benefits

As per the ACA, all qualifying health insurance plans must offer 10 standardized essential benefits.

Depending on the state, additional benefits may also be required. The 10 ACA standardized essential benefits are as follows:

  1. Ambulatory patient services (medical care that is offered without being admitted to a hospital)
  2. Emergency services
  3. Hospitalizations, such as overnight stays and surgical procedures
  4. Lab services
  5. Mental health and substance abuse disorder services, including behavioral health treatments, such as psychotherapy and counseling
  6. Pediatric health care services, including vision and oral care; however, adult vision and dental coverage aren't essential health benefits under ACA
  7. Pregnancy, maternity, and newborn care, including before and after birth
  8. Prescription pharmaceuticals
  9. Preventative and wellness services, as well as management for chronic diseases
  10. Rehabilitative and habilitative services and devices, including services and devices for injuries, disabilities, and chronic health conditions

Additional Health Benefits Mandated In Ohio

In addition to the above-mentioned standardized essential health benefits that have been established by the Affordable Care Act, health insurance policies in Ohio must also include the following benefits, which have been mandated by the state government:

  • Emergency transportation - ambulance services
  • Off-label prescription pharmaceutical drugs

Standardized Ohio Small Business Health Insurance Plans
ACA Metal Levels

In order to make it easier to compare costs and benefits, the Affordable Care Act has designated all qualifying Ohio small business health insurance plans to be one of four metal colors, including Bronze, Silver, Gold, and Platinum.

Each of these designations is based on the average amount of health care costs that the plan will cover, which is illustrates at percentages of how much the insurance company will cover for health care, as well as the amount the insured will have to pay out-of-pocket.

All insurance companies that are participating in the federal or state health care exchange program must offer at least the Silver and Gold Ohio small business health insurance plans.

All four of the metal plans have a shared maximum out-of-pocked amount that the insured can be charged during any calendar year. The following table illustrates this information:

Metal Plan Insurer Pays / Insured Pays
Bronze60% / 40%
Silver70% / 30%
Gold80% / 20%
Platinum90% / 10%


Guaranteed Issue

As per the ACA, individuals cannot be denied coverage or charged higher premiums because of their past health history, or their gender.

Additionally, look-back and waiting periods cannot be imposed. Additionally, policies are effective when they are issued and all coverage is renewable if the individual chooses to renew the policy.

However, plans can be canceled if the individual fails to pay their premiums or commits fraud.

How Are OH Health Insurance Premiums Determined?

A premium is the amount the insured must pay out-of-pocket in order to maintain their health insurance policy. The premiums that are charged for any of the qualifying metal plans can be based on the following:

  • Age of the individual
  • Whether or not the individual uses tobacco
  • Where the individual lives, based on a rating area
  • The number of family members who will be enrolling

What Types Of Health Insurance Plans Are Available For Ohio Small Businesses?

Health Insurance Plan Types

While there are several types of health insurance plans to choose from, the following plans are the most popular among OH small business owners:

Health Maintenance Organization - Simply known as an "HMO", this type of plan offers a variety of health-related services via a network of health care providers and hospitals that exclusively contract with the HMO, or who agree to offer their services to members of the HMO. Employees who participate in this type of plan usually have to choose a primary care physician (PCP), and receive most of their care from this physician. If a specialist is needed, the PCP will recommend one that is affiliated with the HMO.

Preferred Provider Organization - More commonly referred to simply as "PPO", this type of health insurance plan is the most common among Ohio small business owners. The insurance company provides a preferred list of health care providers, and employees must receive their medical care from the doctors and hospitals on that list for their claims to be paid at the highest level possible - but they also have the flexibility to see any other provider anywhere in or out of state.

Point-of-Service Plan - Known as a (POS), this type of health insurance plan provides access to health care services at a lower overall cost, but with fewer choices. Members can access care from in-network or out-of-network providers and facilities, but coverage is better when you stay in-network. POS plans may vary, but generally, plans are considered a blend of HMO and PPO plans - offering more flexibility than HMOs, but less than PPOs.

Health Savings Account - A health savings account (HSA) is a special type of bank account that allows participants in the insurance plan to save money that can be used specifically for the medical care they require in the future. HSA-qualified health insurance plans are usually PPO plans that are specifically designed to be used with an HSA.

Indemnity Health Insurance - This type of health insurance plan allows members to control their own health care and to visit any doctor or hospital they choose. The insurance company would then pay a pre-determined percentage of the total charges for the services that were rendered. Employees may have to pay for some types of services up-front and then they can submit a request for reimbursement with the insurance company.

Ohio Small Business Health Insurance Plans - The Bottom Line

We strongly advise business owners to speak with a CPA and a OH health insurance broker before jumping in and getting any type of the Ohio small business health insurance plans available.

Make sure that you know exactly what each option can do for your company and the potential drawbacks associated with it.

Ohio Economic Data, Regulations & Commercial Insurance Minimum Requirements

Made In Ohio

If you're an entrepreneur, you know how important it is to research the location where you plan on setting up shop. No matter how how-quality and valuable the products and/or services your business offers may be, if you're situated in an area that isn't suitable for your operation (the wrong target demographic, a poor market, etc.), you just aren't going to achieve the success that you're hoping for.

If you're considering Ohio for your headquarters or for a new branch of your business, you definitely want to take the time to research the area before you set up shop. Below, we'll take a look at the economic trends of the Buckeye State, including employment rates and key industries that are thriving in the area. We'll also highlight some of the key forms of commercial insurance business owners need to carry when operating in Ohio.

Economic Trends for Business Owners In Ohio

The Buckeye State has seen a marked increase in job growth, which is indicated by the record low unemployment rate. According to the Ohio Department of Job and Family Services, as of April, 2022, the rate of unemployment was 4.3 percent; the lowest it's been in more than 18 years. In April the previous year, the rate was 4.6 percent, a difference of .03 percent in 1 year; however, and more notably, the rate has dropped .01 percent in just one month, as it was 4.4 percent in March, 2022. July, 2001 was the last time Ohio saw such a low level of unemployment, when the rate was 4.2 percent.

In January, 2010, the rate was an astounding 11.1 percent, so it's safe to say that there has been a definite decrease in the number of jobless people in the Buckeye State, which is a strong indication of the overall economy of the state.

The greater Cincinnati area is one of the best places for businesses in Ohio, where smaller cities are seeing the largest growth. Examples include Blue Ash, Beachwood, Independence, Sharonville, and Springdale. Industries that are thriving in Ohio include:

  • Advanced Energy and Environmental Technologies
  • Aerospace and Aviation
  • Automotive
  • Bioscience
  • Information Technology
  • Logistics and Distribution
  • Manufacturing
  • Oil and Gas
Business Insurance Regulations In OH

The Ohio Department of Insurance regulates insurance in Ohio. Certain policies are mandated in Ohio, meaning business owners must carry specific types of coverage. Business owners can protect themselves, the customers they serve, the vendors they work with, and their workers from various risks by investing in the right type of insurance coverage. Coverages that are required include:

Workers Compensation - Most Ohio businesses with employees are required to pay for workers comp. If your OH business has just one employee, you're probably required to carry workers' compensation insurance. In Ohio, workers' compensation insurance is provided through the state - rather than through private insurance companies.

Other forms of insurance that business owners may be required by contract or municipality. The amount of coverage business owners need to carry for each policy vary and depend on a variety of factors, including the size of the operation, the number of employees, and the nature of operations.

Request a free Ohio small business health insurance plans quote in these other OH cities: Adel, Algona, Altoona, Ames, Anamosa, Ankeny, Asbury, Atlantic, Bettendorf, Akron, Alliance, Ashland, Ashtabula, Athens, Austintown, Avon, Avon Lake, Barberton, Beavercreek, Berea, Boardman, Bowling Green, Broadview Heights, Brook Park, Brunswick, Canton, Centerville city, Chillicothe, Cincinnati, Cleveland, Cleveland Heights, Columbus, Cuyahoga Falls, Dayton, Delaware, Dublin, East Cleveland, Eastlake, Elyria, Euclid, Fairborn, Fairfield, Findlay, Forest Park, Gahanna, Garfield Heights, Green, Grove City, Hamilton, Hilliard, Huber Heights, Hudson, Kent, Kettering, Lakewood, Lancaster, Lebanon, Lima, Lorain, Mansfield, Maple Heights, Marion, Marysville, Mason, Massillon, Mayfield Heights, Medina, Mentor, Miamisburg, Middletown, New Philadelphia, Newark, Niles, North Canton, North Olmsted, North Ridgeville, North Royalton, Norwood, Oregon, Oxford, Painesville, Parma, Parma Heights, Perrysburg, Pickerington, Piqua, Portsmouth, Reynoldsburg, Riverside, Rocky River, Sandusky, Shaker Heights, Sidney, Solon, South Euclid, Springboro, Springfield, Steubenville, Stow, Strongsville, Sylvania, Tallmadge, Tiffin, Toledo, Trotwood, Troy, Twinsburg, Upper Arlington, Wadsworth, Warren, Westerville, Westlake, White Oak, Whitehall, Willoughby, Wooster, Xenia, Youngstown, Zanesville and all other OH cities & Ohio counties near me in The Buckeye State.

Also find OH local small businesses by General Liability Class Code and learn about Ohio small business insurance requirements for general liability, business property, commercial auto & workers compensation including OH business insurance costs. Call us (614) 407-1774.

Small Business Health Insurance Plans By State

You can find more state specific small business health insurance information including requirments and coverage by clicking on the state below:


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