Running a small business comes with plenty of challenges—and choosing the right health insurance for your team can be one of them.
The good news? You’re not alone. Capital Blue Cross is here to help.
Whether you're exploring health insurance for the first time or reassessing your current benefits package, this guide is designed to help small business owners in Pennsylvania understand how small group coverage works, how you qualify, and why it’s worth it.
Get step-by-step help applying for coverage—at no cost to you.
Schedule an appointment or call 855.505.2583 for personalized support.
Let’s Start with the Basics
Small group health insurance coverage is designed for businesses with between 1 to 50 Full-Time Equivalent (FTE) employees. If you have a mix of part-time and full-time staff, Capital Blue Cross can help you calculate eligibility based on the number of FTE employees.
Why Offer Health Insurance?
Providing health coverage is more than just a nice-to-have benefit – it’s a competitive advantage. Employers often list health insurance as the top benefit for their workforce, even higher than a retirement savings plan.
Offering small group coverage can help your business:
Recruit smarter: A solid benefits package can attract higher-quality candidates.
Retain employees: Employees are more likely to stay with a company that looks after their well-being.
Boost productivity: Healthier employees take fewer sick days and are more engaged in the job.
Enhance credibility: Offering insurance adds legitimacy and shows you’re invested in your team.
Save on taxes: There can be tax benefits for having an employee health plan depending on the type of business you run. It’s best to talk with a tax advisor for answers to your specific questions.
Types of Small Group Insurance Plans
Choosing the right health plan for your employees is one of the most important decisions you’ll make as a small business owner. Each type of plan offers different levels of flexibility, cost, and coverage.
The most common types of plans available to small group employers include:
Preferred Provider Organization (PPO): Employees can visit any doctor or specialist without a referral and are rewarded with lower costs when using in-network providers.
Health Maintenance Organization (HMO): Employees must choose a primary care physician who coordinates all care and referrals. Except for emergency services, HMOs generally do not cover out-of-network services.
Qualified High Deductible Health Plan (QHDHP): Employees pay lower monthly premiums but face higher out-of-pocket costs before insurance coverage begins. These plans are often paired with Health Savings Accounts (HSAs) for tax-free savings on medical expenses.
Important Terms to Understand Employer Health Coverage
It’s easy to feel intimidated by all the terms used when discussing health insurance. Here are key definitions for small business owners to know:
Premium: The amount paid monthly for each employee’s insurance coverage.
Deductible: The annual amount paid out-of-pocket for covered healthcare services before the insurance plan begins to pay.
Coinsurance: The percentage of the cost paid out-of-pocket for covered healthcare services after the deductible is met.
Copay: A fixed amount your employee pays out-of-pocket at the time of service for covered healthcare services.
Out-of-pocket maximum: The most an employee will pay on deductibles, copayments and coinsurance in a plan year for covered services. After reaching this limit, insurance covers 100%.
Full-Time Equivalent (FTE): A way to measure how many full-time employees a business has, even if some workers are part-time. Since one FTE works at least 30 hours per week for more than 120 days in a year, two part-time workers may count as one FTE depending on the hours they work.
Fully insured plans: A type of insurance plan in which the employer pays a fixed amount to the insurance company, which assumes the financial risk of employee claims – it’s a common arrangement for small businesses that seek more predictable costs.
Health Savings Account (HSA): A tax-advantaged savings account that helps employees pay for deductibles and other qualified medical expenses. Employees may only contribute to an HSA if they have a QHDHP.
How to Get a Quote for Small Group Health Insurance
Capital Blue Cross aims to act as an extension of your team, readily available to help you with any of your insurance needs.
Here’s what we need to get started:
Basic employee info: First name, sex, date of birth, and ZIP code.
Whether family members will be covered.
Your business name, industry classification, and address.
Within 48 hours, you’ll receive a proposal that includes:
Rate information: Age-based pricing sheets to help estimate costs.
Plan details: Easy-to-understand summaries of benefits, terms, and conditions.
Next steps: Instructions for moving forward, including a link to our Capital Blue Cross site for employers and small groups.
You’ll also get details on valuable resources available to your employees with a Capital Blue Cross plan, such as:
Healthy Blue Rewards: Earn rewards for healthy actions.
MyCareFinder: Tools to help find and compare care options.
MyCare Rewards: Incentives for choosing high-quality, cost-effective care.
Wellness Programs: Support for employee health and well-being.
Employee Assistance Program (EAP): A confidential, voluntary program that provides employees free short-term counseling, referrals, and support for personal and work-related challenges.
You’ll be able to choose up to two Capital Blue Cross insurance plans that are fair and equitable for all employees.
Ready to Learn More?
Call 855.505.2583 or schedule an appointment to speak with a licensed representative today.
Get personalized guidance tailored to your industry and staff size.
Receive help choosing plans that fit your budget and meet your employees’ needs.
Understand the paperwork, requirements, and benefits. No guesswork needed.
Let Capital Blue Cross help you build a stronger, healthier workplace starting with your benefit package.