Pros and Cons of a Traditional Group Health Insurance Plan

vs. Individual Health Insurance Reimbursement

Weighing the pros and cons of a traditional group health insurance plan vs. individual health insurance reimbursement for Small Businesses.

What are Individual Health Insurance and Group Health Insurance policies?

  • Individual health insurance is a type of health policy an individual purchases for himself and/or his family. Individual health insurance policies are often purchased with the guidance of an insurance agent to help navigate plan choices and premium costs. Insurance companies may no longer deny or charge more based on medical conditions and premium tax credits are available to those qualify (based on income).
  • Group health insurance coverage is a type of health policy purchased by an employer and offered to eligible company employees and their dependents. Currently, more than half of working Americans have group health insurance coverage through their employer, or the employer of a family member. With group health insurance, the employer selects the plan (or plans) to offer to employees. The premium cost is often split between the employer and employee, and there is a minimum percentage rate the employer must contribute.

Individual Health Insurance vs. Group Health Insurance – Cost 

The average national annual premium costs for health insurance with a group health insurance plan and with individual health insurance were as follows:

Cost for Single Coverage

Average Group Health Insurance Plan, 2018 – $6,896/year

Individual Health Insurance Plan, 2018 – $7,452/year


Why is small business group health insurance cheaper than individual health insurance?

There are a few reasons why small group health insurance usually ends up costing less per person than individual plans.

  • Employer contributions – For employees, a clear reason for affordability of group plans is that their employer generally pays for at least half of the premium.
  • Tax benefits for employees – In addition to benefitting from employer contributions, employees are usually paying for their part of the premium with pre-tax money, which can add up to significant savings.
  • Tax benefits for employers – As an employer of a small business, don’t think that all the burden of health insurance will fall on you though. There are definite perks to being a small business owner and providing small business group health insurance. You will likely pay at least fifty percent of the monthly premiums for your employees, and you may be able to deduct these costs from your business taxes. In some cases, you may even be eligible for special tax credits.
  • Risk pool advantages – As the Small Business Administration explains, the spread of risk across a group is a fundamental theory of insurance. High costs of one insured person have a smaller effect in a larger pool.  In other words, more people are paying to support the few who use the benefits of being covered to their full extent.

Of course there are different reasons why plans cost less or more, and cost will vary from plan to plan. Call us at the Independent Benefit Advisors and we can help you find the right benefit plan for your small business!

The small group health insurance market is relatively stable

In addition to being cheaper in the moment, it may be a relief for some people to know that the prices on small group health insurance plans have remained pretty similar for quite some time.

One thing that has remained consistent in the individual market: rising prices. Average premiums on individual plans increased 18% from 2016 to 2017, and another 16% between the 2017 and 2018 open enrollment periods. Year after year, prices continue to rise, but you’ll find that this is not the case when shopping for small group plans.

From 2016 to 2017, per-person coverage on group plans only increased by 8%, and the year before it actually decreased by 1%.

Better prices might be why smaller groups are switching to group coverage for the first time

If you have a small business, it will be worth your time to look into small business health insurance.  Let’s see if it can help you and your employees save on health insurance costs. Previously, it was common for small business owners not to bother with group health insurance, but now many are starting to enroll in these plans.  We know that consumers are looking for affordable options to traditional individual health insurance.

Getting Group Health Insurance has never been easier.

Don’t waste time, get started and have a quote in seconds – Call us at 919-303-9690.

Here at the Independent Benefit Advisors, we can list the pros and cons of each model and help you develop a small group health insurance plan that is right for your small business.



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Contact The Independent Benefit Advisors for Group Health Insurance in North Carolina

Give us a call at 919-303-9690 so that we can help you develop a small group health insurance plan that is right for your small business.