A wide range of options — and
the guidance to help you choose
the right one for your business.

Small Business Health Insurance | Commercial Health Insurance | ADPIA

Business Health Insurance

Business health insurance can help protect your employees and their families against mounting debt due to illness or accidents.

Business Health Insurance:
The Right Care for You & Your Employees

Business health insurance often includes prescription drug benefits, giving employees affordable access to the medications necessary to address an immediate health concern or manage a chronic condition. These days, many prescription plans also cover mail orders, allowing prescriptions to be filled and delivered directly to an employee’s home.

In addition, some commercial health insurance plans cover preventive care. Carriers may also offer wellness programs to encourage healthy behaviors and identify medical conditions when they first develop.

Choosing a Business Health Insurance Plan

When it comes to selecting a business health insurance plan, there are a number of options to choose from:

Fully insured plan —

The employer contracts with another organization to assume financial responsibility for the enrollees’ medical claims and for all incurred administrative costs.

Partially self-funded plan —

The employer assumes some of the financial risk for providing health care benefits to employees. These plans will have an administrator and a reinsurer to reduce the risk to the company.

Managed care plans —

Provide comprehensive health services to their members, and offer financial incentives for patients to use the providers who belong to the plan. Types of managed care plans include:

  • Preferred Provider Organization (PPO)
  • Exclusive Provider Organization (EPO)
  • Health Maintenance Organization (HMO)
  • Point-of-Service (POS)
Physician-Hospital Organization (PHO) —

Alliances between physicians and hospitals to help providers attain market share, improve bargaining power and reduce administrative costs. Physician-Hospital Organizations sell their services to managed care organizations or directly to employers.

High Deductible Health Plans (HDHP) —

Features higher deductibles than traditional insurance plans. High Deductible Health Plans can be combined with a health savings account or a health reimbursement arrangement to allow employees to pay for qualified out-of-pocket medical expenses on a pre-tax basis.

Financial tools to help control costs

Offered as part of an employee’s benefits package, health care accounts can be used to provide tax advantages and help employees make the most of their health care dollars.

Flexible Spending Accounts/Arrangements (FSA) —

Offered and administered by employers for employees to set aside pretax dollars to pay for their share of insurance premiums or medical expenses not covered by the employer’s health plan.

Health Reimbursement Accounts (HRA) —

Established by employers to pay for certain medical expenses, a Health Reimbursement Account is owned by the employer and administered by a vendor who handles reimbursement as claims are submitted. HRAs are funded solely by the employer who decides the on the amount.

Health Savings Accounts (HSA) —

A tax-advantaged medical savings account available to participants enrolled in a High Deductible Health Plan. A Health Savings Account can be funded by an employer or employee and is owned by employee. Funds contributed to the Health Savings Account are tax-free and can be used to pay for qualified health care expenses.

How commercial health insurance can benefit your business

Offering business health insurance as part of a comprehensive benefits package can be critical to the success of your business. Group health insurance coverage usually gives your staff access to a more affordable alternative to an individual policy. Plus, group health benefits can be a huge selling point for potential employees and may be a key factor in attracting and retaining top talent.

ADPIA: Helping you make the most of your business health insurance investment

Offering business health insurance is a business investment that may help keep employees engaged and satisfied. And when it comes to protecting your business and employees, you deserve to work with knowledgeable professionals. ADPIA will work with you to develop a strategy that meets your current and long-term group health insurance needs. We are committed to helping you simplify administrative tasks, identify affordable group health plan options and eliminate the worry and complexity of selecting the right coverage.

Health Benefits are available in AZ, CA, CO, CT, FL, GA, IL, IN, MA, MD, MI, NJ, NY, OH, PA, TX, VA and District of Columbia.

Automatic Data Processing Insurance Agency, Inc. (ADPIA) is an affiliate of ADP, LLC.

All insurance products will be offered and sold only through ADPIA, its licensed agents or its licensed insurance partners; 1 ADP Blvd. Roseland, NJ 07068. CA license #0D04044. Licensed in 50 states. Certain services may not be available in all states. Some of these services are provided by the carrier partners of ADPIA, and the carrier may charge an additional fee for services. The information provided herein is general and not intended as tax, legal or claims advice. Should you have questions, you should consult with your tax or legal advisor. ADPIA does not handle claims administration and is not a third party administrator. For specific claims questions, please contact your health plan carrier.

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