As a small business owner, you may be wondering whether you can get small business health insurance through your LLC. You may be eligible to purchase small business health insurance or individual health insurance for yourself, depending upon how you set up your LLC and its tax structure.

You can generally deduct the cost of individual health insurance from your taxes as a self-employed LLC member, although this ultimately depends on several factors, including the tax classification of the LLC and for whom the deduction is being taken out.

Continue reading to learn about how health insurance works for LLCs.

What is an LLC?

A limited liability company, commonly abbreviated as LLC, is a business structure with both “pass-through” taxation and legal liability separate from its owner.

• Like a sole proprietorship, an LLC has “pass-through taxation,” which means that the income and loss of the business is reported on the personal income tax form of the business owner. This means that an LLC does not constitute a separate entity for tax purposes, according to the IRS.
• According to LegalZoom, unlike a sole proprietorship, an LLC has separate legal liability (like a corporation). If a suit was filed against your LLC, then the LLC itself would be sued, not you as the individual. As a result, in most cases the plaintiff would only be entitled to recover the LLC’s business assets, not your personal property or assets.

The owners of an LLC are called members. Single-member LLCs are taxed as sole proprietorships, while multiple-member LLCs are taxed as partnerships.

An LLC can also decide to be taxed as a corporation or S corporation, and its members would then pay taxes like shareholders of a corporation or S corporation owners.

Understanding health insurance options for an LLC

Navigating health insurance choices for a Limited Liability Company (LLC) can be complex yet crucial for ensuring the well-being of both the business and its employees. In this section, we’ll explore the various health insurance options available to LLCs, empowering business owners to make informed decisions that best suit their needs and the needs of their workforce. Whether you’re a small startup or an established enterprise, understanding your health insurance options is essential for fostering a healthy and thriving workplace environment.

Can you get small business insurance for LLC?

You usually cannot get small business health insurance or a group plan through your LLC if you have no employees, although you can still get individual health insurance as an LLC owner or member.

If your LLC does not have employees besides yourself, you would most likely be a sole proprietor and could only enroll in individual health insurance, not small business health insurance.

However, sole proprietorships with one employee besides the business owner can usually qualify for group health coverage.

In other words, single-member LLCs would likely only qualify for individual health insurance instead of group health insurance.

Suitable health insurance plan options for small businesses

Small businesses have several health insurance options to consider, each catering to different needs and preferences. Group health insurance plans are a popular choice, offering coverage for employees and sometimes their families, with premiums shared between the employer and employees. Health Savings Accounts (HSAs) provide a tax-advantaged way for employees to save for medical expenses, often paired with high-deductible health plans (HDHPs). Health Reimbursement Arrangements (HRAs) allow employers to reimburse employees for medical expenses, providing flexibility in plan design. Additionally, individual health insurance options are available for employees who prefer to seek coverage independently outside of group plans. Understanding these options enables small businesses to select the most suitable health insurance plan for their workforce.

Can an LLC deduct health insurance premiums?

Getting a health insurance LLC deduction depends on whether the deduction is being taken out for non-member employees or members of the LLC, as well as the legal and tax status of the LLC and whether the LLC is classified as a sole proprietorship, partnership, or corporation. According to LegalZoom:

• For non-member employees – An LLC can deduct the cost of medical insurance for all employees who are not members of the LLC. This deduction can also include the amount the LLC pays for employees to have qualified long-term health coverage.
• For the self-employed – Members of an LLC are considered self-employed if their LLC is a sole proprietorship or partnership. While self-employed business owners can deduct the cost of acquiring health insurance for themselves, a spouse, and qualified dependents, they may or may not be able to qualify for small business health insurance. For example, sole proprietors usually would not qualify for a group plan unless they have employees, but a sole proprietor could still enroll in an individual health insurance plan.
• For corporations – If shareholders of an LLC receive corporate tax treatment, they would not be considered eligible to receive health insurance from the business unless they are bona fide employees. If a corporation provides health insurance to non-employee shareholders, then the company could not take this deduction on their corporate tax return.

Overall, self-employed LLC members can usually deduct health insurance as a business expense.

Legal and compliance considerations for LLCs

Navigating the legal and compliance landscape is paramount for any Limited Liability Company (LLC) to operate smoothly and mitigate risks. In this section, we’ll delve into the essential legal and compliance considerations that LLCs must address, ensuring adherence to regulations and safeguarding the business’s integrity. From formation requirements to tax obligations and regulatory compliance, understanding these considerations is vital for the success and sustainability of an LLC.   

Legal requirements for offering health insurance as an LLC

As an LLC offering health insurance, several legal requirements must be considered to ensure compliance and smooth operation. Firstly, it’s crucial to comply with federal and state laws governing health insurance, such as the Affordable Care Act (ACA) regulations. Additionally, the LLC must adhere to any applicable employment laws, including the Employee Retirement Income Security Act (ERISA), which sets standards for employee benefit plans. Furthermore, the LLC must accurately disclose plan details to employees, including coverage options, costs, and enrollment procedures, to fulfill transparency requirements. Lastly, maintaining proper documentation and records related to health insurance offerings is essential for legal compliance and potential audits. Understanding and adhering to these legal requirements is vital for LLCs to provide health insurance benefits effectively and lawfully.

Compliance with the Affordable Care Act (ACA) regulations

For LLCs offering health insurance, compliance with the Affordable Care Act (ACA) regulations is paramount. The ACA mandates that applicable large employers, including many LLCs, provide affordable health insurance coverage to their full-time employees or face penalties. To comply, LLCs must offer health insurance plans that meet minimum essential coverage requirements and affordability standards set by the ACA. This includes providing comprehensive coverage for essential health benefits and ensuring that employee contributions for coverage do not exceed a certain percentage of their income. Additionally, LLCs must accurately report health insurance coverage information to the IRS and provide employees with required ACA notices, such as the Summary of Benefits and Coverage (SBC). By adhering to ACA regulations, LLCs can ensure compliance with federal healthcare laws and avoid penalties while providing essential health coverage to their employees.

Understanding state-specific health insurance laws and regulations

When offering health insurance as an LLC, it’s crucial to understand state-specific legal considerations, as each state may have its own laws and regulations governing health insurance. For example, some states may have additional requirements for health insurance plans beyond federal mandates, such as coverage mandates for specific services or eligibility criteria for small group plans. Additionally, state insurance departments regulate insurance companies operating within their jurisdiction, which can impact plan availability, pricing, and consumer protections. LLCs must ensure compliance with these state-specific laws and regulations to avoid legal issues and provide comprehensive coverage to their employees.

For example, California mandates that health insurance plans cover specific benefits like maternity care and autism treatment, while New York requires plans to offer infertility treatments. Some states, such as Massachusetts, have their own individual mandate requiring residents to have health insurance or face penalties. Additionally, states like Texas may have unique regulations regarding the sale and administration of health insurance policies. Understanding these state-specific laws and regulations ensures compliance and effective coverage for LLCs operating in different regions. Working closely with legal advisors and insurance professionals familiar with the intricacies of each state’s laws is essential for navigating these complexities.

Selecting the right health insurance plan for an LLC 

Choosing the appropriate health insurance plan for your Limited Liability Company (LLC) involves careful consideration of various factors to ensure it meets the needs and requirements of both the business and its employees. In this section, we’ll explore key considerations for selecting a plan that provides comprehensive coverage, aligns with your budget, and complies with legal and regulatory obligations. By understanding these factors, LLC owners can make informed decisions to safeguard the health and well-being of their workforce while supporting the financial stability of the business.

Assessing health insurance needs for your LLC

 When selecting a health insurance plan for your LLC, it’s essential to evaluate several factors to ensure it adequately meets the needs of your workforce:

• The size and demographics of the workforce: Consider the number of employees in your LLC and their demographics, such as age, marital status, and dependents. Larger companies may require more extensive coverage options to accommodate a diverse workforce, while smaller businesses may opt for more streamlined plans.
• The healthcare needs and preferences of employees: Take into account the specific healthcare needs and preferences of your employees. Consider factors such as chronic conditions, prescription medication requirements, and preferred doctors or healthcare providers. Providing coverage that aligns with employee preferences can enhance satisfaction and retention.
• The budget for health insurance coverage: Evaluate your LLC’s budgetary constraints and determine how much you can allocate to health insurance coverage. Balance the cost of premiums, deductibles, and copayments with the level of coverage provided to ensure affordability for both the company and its employees.

By carefully assessing these factors, you can select a health insurance plan that strikes the right balance between comprehensive coverage, employee satisfaction, and financial feasibility for your LLC.

Comparing coverage options, premiums, and deductibles

When choosing a health insurance plan for your LLC, it’s crucial to thoroughly evaluate coverage options, premiums, and deductibles to ensure the plan aligns with your needs and budget.

• Coverage Options: Assess the breadth and depth of coverage provided by each plan, including services, treatments, and medications covered. Consider whether the plan includes essential benefits and any additional perks, such as wellness programs or telehealth services, that may benefit your employees.
• Premiums: Compare the monthly premiums required for each plan. While lower premiums may seem attractive, ensure they don’t come at the expense of adequate coverage. Balance the cost of premiums with the level of coverage provided to find the right balance for your LLC’s budget.
• Deductibles: Evaluate the deductibles associated with each plan, which represent the amount you must pay out of pocket before the insurance coverage kicks in. Consider how deductibles impact both the company and its employees’ financial responsibilities and weigh them against the overall cost of the plan.

By carefully comparing coverage options, premiums, and deductibles, you can select a health insurance plan that offers comprehensive coverage, aligns with your budgetary constraints, and meets the healthcare needs of your LLC and its employees.

How purchasing health insurance works as an LLC business owner

It may be helpful to illustrate how purchasing health insurance as an LLC business owner works.

Mary is a sole proprietor of an LLC with no employees. She purchases ACA individual health insurance on the Marketplace. Her premium cost is $9,000 for the year. Her business earns $75,000 for the year. She may deduct her $9,000 annual health insurance expense from her gross income for federal and state income tax purposes. Since her combined federal and state income tax rate is 22%, this saves her $1,980 in income taxes. If her business had earned less than $9,000, she could not have taken a tax deduction. The self-employed health insurance deduction is a personal deduction. It doesn’t reduce her business income for self-employment tax purposes.

eHealth can help you get health insurance for your LLC

With eHealth, you can shop for health insurance that fits the needs of your LLC. Whether you are a business owner with employees and are looking for small business health insurance, or are a sole proprietor seeking individual health insurance, eHealth makes it easy to find the right health plan for your cost and coverage preferences.

Visit eHealth.com or speak with one of our licensed health insurance agents today to find the optimal health care solution for your small business.

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.