Health Insurance Options for Independent Restaurants
For small restaurant owners, navigating the options for providing health benefits can be challenging, as each approach comes with unique advantages and drawbacks. Some plans offer tax incentives and flexibility, like Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs), which allow employers to reimburse employees for health expenses but puts the burden on the employees to manage their own insurance purchases. Other solutions, such as small business health insurance plans or Professional Employer Organizations (PEOs), provide more traditional group coverage options but often come with higher costs, limited flexibility, or added administrative burdens that can be difficult for small businesses to manage on their own.
1 - Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)
QSEHRA is a tax-free reimbursement arrangement allowing small businesses to reimburse employees for health insurance premiums and other medical expenses up to a specified limit.
- Pros: Offers flexibility; business owners set contribution levels.
- Cons: Limited to businesses with fewer than 50 employees; employees must buy their own insurance, which can be cumbersome and may not provide comprehensive coverage. There is also a good bit of administrative burden put on both the employee and the employer to ensure proper reimbursement and documentation.
2 - Small Business Health Insurance (Individual Plan)
Owners can purchase health insurance plans on the open market, either directly through insurers with the support of a broker or via the Small Business Health Options Program (SHOP) marketplace.
- Pros: Access to standard small-group insurance options.
- Cons: Costs are often high, with fluctuating premiums and few affordable options for part-time or seasonal staff. Also, for the SHOP marketplace provided by the ACA, it requires 70% participation from your team, which can be challenging for small businesses to achieve. To put this in perspective, most teams in the hospitality industry see only 15-30% participation, often dependent on the employer’s contribution level.
3 - Professional Employer Organization (PEO)
A PEO is a co-employment arrangement where the PEO handles HR functions, including benefits administration, for the business.
- Pros: Simplifies HR management, provides access to benefits often reserved for larger companies.
- Cons: High administrative fees and loss of direct control over certain HR functions. Often unaffordable for smaller businesses with lean budgets.
4 - Medicaid
Medicaid is a federal and state program that provides free or low-cost healthcare coverage to eligible low-income individuals and families, with eligibility and covered services varying by state.
- Pros: Provides basic healthcare access at minimal or no cost for eligible employees, helping those in low-wage positions or with fluctuating income to access essential care.
- Cons: Not all employees may qualify due to income thresholds, and some states have limited Medicaid expansion, meaning that coverage may not be as comprehensive or accessible as private insurance options. Medicaid also does not cover all medical services, potentially leaving some healthcare needs unmet.