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TL; DR
According to federal law, all businesses with at least 50 full-time or full-time equivalent employees have to offer health care coverage
Over 11% of Georgia residents don’t have access to a healthcare plan
Remaining compliant with relevant small business health insurance rules helps protect your business
Offering your employees a healthcare plan as part of your employee benefits package is a great way to attract top talent and retain loyal workers while helping them live healthier and happier lives. What a savvy business move.
If you work in benefits administration and your business operates out of The Peach State, this is what you need to know about health insurance in Georgia.
What is small business health insurance?
Small business health insurance allows businesses to provide their employees with healthcare coverage. The Healthcare.gov search engine is a great way for a small business in Georgia to learn more about its health insurance plan options.
Health insurance basics in Georgia
As of 2022, Georgia was home to 1.2 million small businesses, and small businesses comprised the majority (99.6%) of all businesses in Georgia at that time. These small businesses majorly impact and employ 1.7 million people, accounting for 42.5% of the state's workforce. (U.S. Small Business Administration Office of Advocacy). This means over a million Georgia workers rely on their small business employers for access to healthcare, or else they have to procure it through other avenues such as buying it themselves or enrolling under a spouse’s workplace plan.
Georgia employers must follow federal regulations to determine whether they are required to offer health insurance to their employees. Currently, small businesses in Georgia (like in all states due to the Affordable Care Act) with fewer than 50 full-time employees or full-time equivalents are not obligated to provide a health insurance plan.
Some small business owners in Georgia are taking new approaches to ensuring their employees receive healthcare access—with mixed reviews from the public. JenChan's, a restaurant in Atlanta, has added a 4% health insurance surcharge to customer bills to help cover the rising cost of healthcare for its employees. The decision has sparked mixed reactions, with some social media backlash from people outside Georgia but strong local support (customers can remove the surcharge if they wish), but the owners aim to raise awareness about the true costs of running a small restaurant (11Alive).
Finding the right small business health insurance plan
Choosing the right health insurance plan for your small business may feel intimidating, but with some careful consideration, you can find the right fit. These are some factors you will want to keep top of mind during your search for a new plan:
Deductible options
Premium options
Network size
Employee needs
Copay options
When it comes to your budget, you can get some money back on your healthcare spending if your business qualifies for the Small Business Health Care Tax Credit.
If you’re looking to save on your health insurance spending, you can see if you are eligible for the Small Business Health Care Tax Credit. If your business is eligible for this tax credit, you could receive up to 50% tax savings (with a maximum of 35% for non-profit employers).
To qualify for this tax credit, you must enroll in a Small Business Health Options Program (SHOP) plan, have fewer than 25 full-time equivalent (FTE) employees, and ensure the average annual salary of your employees is $56,000 or less. You must also cover at least half the premium costs for your full-time employees and offer SHOP coverage to all full-time staff. There's no requirement to include dependents or part-time employees (those working fewer than 30 hours a week) for tax credit eligibility.
How to enroll in small business health insurance
To enroll in a small business health insurance plan, it can be helpful to work with a SHOP-registered agent or broker. These professionals can help you find the right health insurance companies in Georgia that fit your company’s needs.
It’s important to note that your business can’t have more than 50 employees and still qualify for a small business health insurance plan. If your business qualifies, the good news is you can start shopping for coverage right now. If you purchase SHOP insurance, your employees don’t need to wait for Open Enrollment to enroll in coverage.
Federal health insurance regulations
All Georgia businesses must adhere to federal health insurance regulations under the Affordable Care Act. On a state level, Georgia business owners should also be aware of local rules, such as:
Insurance requirements: Ensure compliance with health insurance assignment systems, as outlined in Rule 120-2-81. Participation in systems like the Georgia Health Insurance Assignment System (GHIAS) may be necessary for businesses offering health insurance benefits.
Insurance coverage standards: Employers providing group health plans must follow standards for eligibility and benefits under state and federal laws, including the Health Insurance Portability and Accountability Act (HIPAA) and COBRA(GA R&R - GAC 1)(GA R&R - GAC). (Rules and Regulations of the State of Georgia).
Legal obligations of small business owners
It’s important that you do your research and are aware of how to keep your Georgia small business compliant with all health insurance legal requirements. For example—federal rules require that employers with more than 50 full-time or full-time equivalent employees in the prior calendar year provide affordable care for 95% of their employees and dependents. If they don’t, they may be required to make an Employer Shared Responsibility (ESRP) payment to the federal government.
Managing small business health insurance
Small businesses typically face two main challenges when offering a health insurance plan as part of their employee benefits package—compliance and education.
Compliance: To simplify managing your small business health insurance plan, establish a routine for keeping up with state laws and regulations regarding small business health coverage. Staying compliant with these rules can help you prevent potential challenges in the future.
Education: The last thing any small business wants is to invest in a healthcare plan and wind up with it being underutilized by employees. To make managing your small business health insurance easier, consider setting up a regular process to stay informed about state laws and regulations related to health coverage. This is especially important if you manage employees in many different states besides Georgia, such as Texas or Florida.
Resources and support
According to the United States Census Bureau, 11.4% of Georgians lack access to healthcare. Offering health benefits through your small business could make a big difference for your employees. However, the process of selecting the right healthcare provider and plan may feel overwhelming. If you want to learn more about the best health insurance options for small businesses in Georgia, consider these resources:
Thatch: Book a free demo with Thatch to see how you can save an average of $1,620 per employee annually.
Healthcare.gov: Explore your coverage options in the Georgia health insurance marketplace under the Small Business Health Options Program (SHOP).
Jacqueline DeMarco is a freelance writer who lives in the Bay Area and tackles a wide variety of healthcare and wellness topics. She writes for healthcare publications such as Hoag Hospital Foundation, Whisper, Outcomes4Me, USA Today, Newsweek, and more.
Connect with JacquelineThis article is for general educational purposes and is not legal advice. The opinions shared here belong to the author and are not official statements from Thatch. For legal and tax questions, please feel free to consult with a qualified professional.
