Navigating Health Insurance as a Small Business Owner

How to responsibly manage the question: "Should I offer health coverage to my employees?"

Offering health insurance as a small business owner offers more benefits beyond giving your employees increased access to quality healthcare.

Providing health insurance coverage can be good for your business in several ways.

First, it can be a great way to attract and retain qualified talent in a labor market that has become increasingly tight due to the growth of the Nashville area economy. Offering health benefits can set you apart from your competition and set you up for future success.

Second, healthy employees are more productive than employees that suffer from illness. This increase in productivity comes from both being physically present in the office and performing at full efficiency. Furthermore, having health benefits can reduce stress and may even lead employees to work harder due to increased morale.

Finally, offering health insurance coverage may lead to personal benefits for small business owners. Health benefits can be used to offset salary costs, can help you qualify for significant tax deductions and can even allow you to save money on your own health benefits by being part of a group plan.

This guide will serve to answer your pressing questions about health insurance as a small business and how you can responsibly manage the benefits and costs of providing coverage.

The information provided in this resource assumes that theAffordable Care Act will remain in place. We will make updates to this page as necessary to accommodate any changes to health care policy that may affect small business owners.

I’d like to start providing coverage for my small business.

What are my options?

Health insurance options for small businesses are rather limited in Tennessee compared with other states, but there are choices to find coverage.

One option for providing small business health insurance is through an insurer that specializes in small business coverage.

In fact, Nashville small business owners have a unique opportunity to explore health insurance options as the region has been chosen as a hub for a new partnership between Humana and Oscar Health. Oscar, founded in 2012, originally focused on providing individual plans that focused offered tech-friendly customer service.

Now, in partnering with Humana, Oscar will be reaching into the small business market here in Nashville to offer new, employer-based plans, under the name  Oscar for Business, that still retain the unique customer concierge services and tech integrations that launched their business.

Nashville was chosen as a market for this new product due to our robust population growth and reputation as a  hotbed of entrepreneurship, particularly in healthcare and technology.

No matter which option you choose, it’s important to remain compliant with open enrollment procedures and requirements. Paradigm Group here in Nashville offers plenty of resources for businesses that offer health insurance.  You can learn more about how to handle health insurance administration needs here.

Unfortunately, the Small Business Health Options Program (SHOP) Marketplace, part of the Affordable Care Act's infrastructure, is not offering plans in Tennessee for 2018 . However, you can find brokers and agents trying to fill that gap on's local directory.

Providing health insurance coverage is wonderful, but employers can always do more to create a workplace that encourages healthy choices and lifestyles for employees. Investing in your employees’ health, whether that means encouraging employees to move more, eat healthier or reduce stress, can lead to big returns in boosted morale and increased productivity.

My small business is a sole proprietorship.

What can I do to get covered? offers information on signing up for health insurance coverage specifically for sole proprietorship owners and self-employed individuals. Even if you are self-employed, you need to have health insurance coverage or you may be subject to penalties under the Affordable Care Act.

The good news is that owners of sole-proprietorships can deduct health insurance premiums for yourself, your spouse and any dependents from your taxes as long as you, your spouse or your dependents could not have been covered by any other employer-subsidized plan. For example, if your spouse has an employer-subsidized plan that you could be covered under, then you can’t deduct your insurance premiums. However, this deduction offers relief for sole proprietors that may be worried about the cost burden of health insurance coverage.

If you are unable to purchase health insurance on the individual market due to the rising costs of care, you can still receive needed care by reaching out to community partners and nonprofits that specialize in helping uninsured and underinsured people get the care they need.

I can’t afford to provide health insurance for my employees.

What are my options?

Many small business owners want to provide some kind of health and wellness support to their employees even if they can’t afford traditional health insurance coverage. Research shows that healthy employees are more productive than their counterparts that suffer from chronic illness, so it is in employers’ best interests to promote health in the workplace.

If providing coverage is truly out of reach, there are still ways that you can support employee health.

The first is to be proactive about making sure your employees are aware of the open enrollment period for the Affordable Care Act and when the enrollment period will close. Individuals can sign up for health insurance coverage until December 15 or they may face penalties.

You can direct employees to to see their options.

However, the exchanges can be confusing for people unfamiliar with the process. It can be helpful to get help from someone that can help you decide what coverage you need. The local organization, Get Covered Tennessee, allows users to schedule appointments online to meet with Navigators that are trained to help people get covered under the Affordable Care Act.

Other resources that your employees may find helpful are the“safety net” services that help uninsured people get the care they need.individuals in the Nashville area can get help from the Safety Net Consortium of Middle Tennessee.

“The Safety Net Consortium of Middle Tennessee seeks to ease the burden of finding health care while uninsured, or underinsured, by connecting individuals to a primary care home through a new website - The website connects users with not-for-profit, community based clinics across Nashville and surrounding areas,” says Laura Hobson, President and CEO of Faith Family Medical Center.

You can also support employee health with health and wellness programs in the office. The Centers for Disease Control and Prevention(CDC) have published free online resources to help employers establish and evaluate employee health and wellness programs. Visit their Workplace Health Resource Center to read more about the efforts your small business can make to create a healthier workplace environment.

Running a small business comes with a lot of challenges.Investing in your employee’s health is important and could save you money in the long run. Our research here at the Chamber shows that chronic illness in the region’s workforce costs the Nashville area almost half a billion dollars every year. Don’t let poor employee health keep your business from growing.

The Chamber’s goal as an organization is to create economic prosperity by facilitating community leadership. One of the ways we achieve that goal is by providing resources to small businesses that help them create more jobs, more economic growth and a better future for our region. Furthermore, the intersection of employee health and business growth is well-documented and we want to support the efforts of employers to create a healthier, more productive workforce.

You can learn more about our small business programming here.