Best Small-Business Group Health Insurance Plans
Blue Cross Blue Shield, Kaiser Permanente and Aetna are among the best health insurance plans for small businesses.
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Senior Editor & Content Strategist Choosing the right group health insurance plan for your employees depends on your budget, the number of employees you have, how old they are and where they live.
You can purchase insurance through the federal government’s Small Business Health Options marketplace, directly from an insurance provider or using an insurance broker.
Here are our picks for the top small-business group health insurance providers to consider.
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Blue Cross Blue Shield
Best overall commercial health insurance provider
Pros:
- Largest provider network in the country.
Cons:
- Limited plan details available online; must talk to a sales representative.
Why we like it: Blue Cross Blue Shield is an association of 34 locally operated insurance companies throughout the country. Together, the association says it provides access to 93% of doctors and 96% of hospitals nationwide. BCBS also provides a variety of plan options for your employees, including preferred provider organizations, health maintenance organizations and high-deductible health plans, as well as group dental and vision plans.
The company ranks well in J.D. Power’s 2025 Commercial Member Health Plan Study, which measures member satisfaction. Blue Cross Blue Shield wins the top spot in 10 U.S. regions.
For 2026, the average rating for Blue Cross Blue Shield plans on the National Committee for Quality Assurance website was 3.5 on a scale of 1 to 5. The NCQA rates plans on factors such as clinical quality and member satisfaction.
Kaiser Permanente
Best low-cost plans, highest customer satisfaction
Pros:
- Low-cost HMO plans.
- Small-business plan comparisons available online.
Cons:
- Available only in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington and Washington, D.C.
Why we like it: Kaiser Permanente is only available in a handful of states. But it is well-rated in those regions, according to the J.D. Power study. Its average rating on the NCQA website is also quite high, at 4.6.
Kaiser is best known for its HMO plans, which it offers at a low cost because patients are generally required to see providers within a small network. As a small-business owner, you can easily view the details of all of Kaiser's group offerings, including pricing information, on its website.
Aetna/CVS Health
Best for HSAs
Pros:
- Large network of providers.
- Access to walk-in appointments at CVS MinuteClinics.
Cons:
- Limited plan details available online.
Why we like it: Aetna has a comprehensive set of health expense funds that you can offer employees for pre-tax savings, such as health savings accounts and flexible savings accounts, as well as health and retirement reimbursement arrangements.
Aetna ranks high on J.D. Power’s Commercial Member Health Plan Study and has an average NCQA rating of 3.6.
Cigna
Best for smaller businesses
Pros:
- Offers locally focused plans with smaller networks, which can be cheaper.
Cons:
- Below-average customer satisfaction ratings.
Why we like it: Cigna offers several plans designed to control costs, which may be helpful for smaller businesses. To achieve this, plans include fewer in-network doctors and facilities.
In J.D. Power’s Commercial Member Health Plan Study, Cigna has below-average customer satisfaction ratings in most states. It has an average NCQA rating of 3.1.
Save up to 30% on business insurance
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Other health insurance options for small businesses
If you have fewer than 50 employees, you are not required by law to offer a group health insurance plan. But you may still want to consider it as a tool to hire and retain workers and to claim tax benefits for your business.
Here are a few alternatives to the insurance companies above:
Small Business Health Options Program (SHOP)
SHOP is the Affordable Care Act marketplace for small businesses. Companies with up to 50 employees are eligible to buy SHOP insurance, as long as you offer coverage to everyone who works full-time and 70% of your employees accept coverage.
SHOP policyholders may qualify for the Small Business Health Care Tax Credit. This credit can refund as much as 50% of what you spend on health insurance premiums.
To get the credit, you must:
- Have fewer than 25 full-time employees.
- Pay an average salary of less than $65,000.
- Pay at least 50% of the premium for employee-only coverage (not family coverage).
Smaller employers are eligible for bigger credits. You can check the potential size of your credit using the Healthcare.gov calculator here.
Chambers of Commerce
Some Chambers offer cooperative group health insurance to their member businesses via an Association Health Plan, or AHP.
The logic is: Insurance might be cost-prohibitive for a small business with 10 employees. But if 10 businesses join together to buy insurance for 100 employees, that distributes risk much more widely. That usually makes coverage cheaper for everyone.
Talk to your local Chamber to see if they offer a group health insurance plan.
Professional Employer Organizations (PEOs)
A professional employer organization is a company that you can hire for a variety of back-office services. These may include employee benefits, like health insurance and retirement plans, along with HR services like payroll administration. About 15% of companies with 50-99 employees and around 14% of companies with 20-49 employees use PEOs.
If you want broader administrative support, not just health insurance, a PEO may be a good choice.
Employee reimbursements
If you don't want to manage health insurance, you can give your employees a tax-free monthly allowance to buy their own insurance. These arrangements follow the following steps:
- Your company sets an annual maximum amount that you'll contribute to employees' healthcare costs.
- Employees buy their own Marketplace insurance.
- Once they've incurred an expense, employees submit proof of payment for reimbursement.
- Employers reimburse employees regularly, up to the predefined maximum
Reimbursement plans fall into two categories:
- Qualified Small Employer HRA, or QSEHRA. Only companies with fewer than 50 employees can offer a QSEHRA, and you must offer the same maximum reimbursement amount to all employees. Contributions are capped. For 2026, the maximum contribution is $6,450 for single coverage and $13,100 for family coverage.
- Individual coverage Health Reimbursement Arrangement, or HRA. Employers of any size are eligible. There are no contribution caps, and you can offer different limits to different classes of employees.
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- 1. J.D. Power. Gap Widens between Highest- and Lowest-Performing Employer-Sponsored Health Plans, J.D. Power Finds. Accessed Apr 24, 2026.
- 2. HealthCare.gov. Overview of SHOP: Health insurance for small businesses. Accessed Apr 24, 2026.
- 3. HealthCare.gov. Health insurance for businesses. Accessed Apr 24, 2026.
- 4. HealthCare.gov. Health Reimbursement Arrangements (HRAs) for small employers. Accessed Apr 24, 2026.
