Health Insurance for Small Business Owners
Health insurance for small business owners starts with one question: are you covering yourself, or a team? Group plans are built for corporations. You move different, think different and work different — your coverage can be just as independent.
The short answer
A small business owner can get health insurance three ways: a plan in your own name, a group plan through the business, or a mix of the two. If the business is only you, or you and a spouse, a group plan is usually off the table — so a plan you own yourself is the route.
- No employees needed
- Nationwide PPO networks
- Enroll any time of year
Health Insurance Options for Small Business Owners
There isn’t one right setup. It depends on who works in the business and how they are paid. These are the four we build most often.
A Plan for You, the Owner
An individual private PPO in your own name. It isn’t tied to the business, so it stays with you if you restructure, sell, or start the next company. For a solo owner, a single-member LLC or an owner-only S-corp, this is usually where the conversation starts and ends.
Coverage for Key Employees
A custom benefits package for the people you can’t afford to lose. Not every business is ready to cover everyone on day one, and you don’t have to choose between everyone and no one.
A Mix for W-2 Staff and Contractors
Full-time employees and 1099 contractors rarely fit under one policy. We set up a mix: one route for the people on payroll, and individual PPO plans that travel across state lines for the people who aren’t.
A Small-Group Plan
When you have employees on payroll and want one plan for the whole team, a small-group or association plan can make sense. It comes with rules about who has to join and what the business contributes, which we walk through before you commit.
Whichever setup fits, the plan underneath it is usually the same kind: a nationwide PPO plan with no referrals and no network that ends at the state line. Private plans are medically underwritten, so they are not the right fit for everyone — when one isn’t, we say so and show you the alternatives.
Group Plan vs. Individual Private PPO
Neither is better. They are built for different businesses, and plenty of owners end up using both.
| Small-group plan | Individual private PPO | |
|---|---|---|
| Who it is built for | A business with employees on payroll | One person or one family — an owner, a contractor, a key employee |
| If the business is only you | Generally not available. An owner, or an owner and spouse, usually doesn’t count as a group. Rules vary by state. | Available. No employees needed. |
| Who owns the policy | The business | The person covered |
| How the price is set | On the group — mainly ages, location and the plan chosen | On the applicant’s health, through a short questionnaire. Some conditions can be excluded, or an application declined. |
| When someone leaves | Their coverage ends with the job, or continues for a while at their own cost | Nothing changes. The plan goes with them. |
| When you can start | A group can usually start any month; the carrier’s participation rules apply | Any time of year. There is no open-enrollment window. |
| Paperwork for the owner | Ongoing: enrollments, terminations, contributions, renewals | Very little. Each person holds their own plan. |
This table describes how these two kinds of coverage generally work, not the terms of any particular plan. Eligibility, participation and contribution rules vary by carrier and by state. Benefits and eligibility vary.
When the Business Is You: Locum CRNAs and Physicians With an LLC
Going from W-2 to 1099 is essentially starting a small business, and there is no playbook. If you take locum contracts through an LLC or an S-corp, you are a business owner — with one employee at most, and that employee is you.
1099, no S-corp election
Sole proprietor or single-member LLC
There is no group to insure, so the plan is an individual PPO in your own name. It follows you from contract to contract and from state to state, and it doesn’t care which agency or facility is paying you this month.
You pay yourself a salary
LLC or corporation taxed as an S-corp
The coverage is the same individual PPO. What changes is the paperwork: how the premium is paid and reported matters at tax time, and this is the setup where it goes wrong most often. Sort it out with your CPA before the first premium is paid, not after.
Start with health insurance for 1099 and locum CRNAs, and take our guide to the self-employed health insurance deduction to your CPA. If you have just left a hospital job, read the alternatives to COBRA before the 60-day window closes. Norwood does not give tax, legal or accounting advice.
What Self-Employed Clients Say About Working With Jake
These are Google reviews from people who came to Jake as business owners or newly self-employed.
“Helped me find a great plan that fit my needs. If you’re a business owner or going into locum practice, Jake is your guy.”
Alex C. · Google review
“Finding a good plan when you are self employed can be challenging, but Jake made it very easy.”
Bridget · Google review
“He worked with me patiently to find a policy that would work for my husband and I as I transitioned from W-2 to self-employed.”
Angie S. · Google review
Jake Norwood is a licensed health insurance agent based in Fort Worth, Texas — Texas resident license 3361009, National Producer Number 21649072. A consultation is a fit review, not a sales pitch: if a private plan isn’t the right answer for you or your team, we will say so.
Questions Business Owners Ask About Health Insurance
Can I get health insurance as a business owner with no employees?
Yes. You buy a plan in your own name rather than through the business. A group plan generally needs at least one employee who isn’t the owner or the owner’s spouse, so a one-person business usually can’t get one — but you don’t need one.
Your choices are an individual private PPO, a Marketplace plan, or a spouse’s employer plan if one is available. Which is best depends on your health, your income and how much you travel.
How does health insurance for LLC owners work?
An LLC doesn’t change what you can buy. It changes how the premium is handled at tax time. A single-member LLC owner buys an individual plan exactly as any self-employed person does.
If the LLC is taxed as an S-corp, or has more than one member, there are extra steps in how the premium is paid and reported. Our tax and HSA guide lays out the questions to take to your CPA. Norwood does not give tax, legal or accounting advice.
Is a group plan or an individual plan cheaper for a small business?
It depends on who is being covered. A group plan is priced on the group as a whole. An individual private PPO is priced on one applicant’s health, so a healthy owner often sees a different number than the group rate would give them — and someone with a significant health history may see the opposite, or not qualify.
That is why we look at both. The comparison above shows how the two differ in everything other than price.
Does a small business have to offer health insurance?
Under federal law, not below 50 full-time-equivalent employees. The Affordable Care Act’s employer requirement applies to businesses at or above that size. Some states and cities have rules of their own, so check locally.
Most small businesses that offer coverage do it to hire and keep good people, not because they have to.
Can my business reimburse employees for their own health insurance?
Yes, if it is set up as a formal health reimbursement arrangement. Paying employees back informally can cause tax and compliance problems. The arrangements written for this have rules about which businesses can use them and which plans an employee must hold to qualify.
Not every plan qualifies, so settle the arrangement and the plan together, with your CPA or benefits attorney involved. We can tell you whether the coverage you are considering fits.
I’m a locum CRNA or physician with an LLC. Do I need a business plan or an individual one?
An individual one. With no employees besides yourself there is no group to insure, and an individual PPO that you own is what follows you between contracts, agencies and states.
The LLC matters for how you handle the premium, not for which plan you buy. More on that above, and on the page for 1099 and locum CRNAs.
Will the plan work if my team or my work is in more than one state?
With a nationwide PPO network, yes. In-network care isn’t limited to the state where the plan was bought, which matters for owners who travel, for remote teams and for clinicians who contract in several states a year.
See how nationwide PPO health insurance works, or the FAQ page for the plan terms behind it.
Built for Business Owners
At Norwood Health, we help business owners protect what they’ve built.
Our private plans restore peace of mind and show your team you take care of your own.