6 ms·

Ask HN: What does your small startup do for health insurance?

12 points by issa 5y ago

We have a headcount under 10 and are looking for health care solutions for a remote team in various US states. This seems like it should have an easy solution. What is yours?

verdverm 5y ago
Gusto has good options for small teams both for insurance and 401k
- e1g 5y ago
  We dealt through Gusto as well (with Oscar) - they’ll work with you if you have 2+ people on payroll. Never had issues with them.
  - issa 5y ago
    Gusto is what we use now, but they don't seem to be able to handle health insurance for a distributed team. Am I missing something?
toast0 5y ago
When I was at a small startup (although a bit more than 10), they used TriNet, an 'employee leasing'/outsourced HR vendor. More or less, your employees are also employees of the leasing firm, and that firm has access to employer paid health plans from well known vendor. I think you select from a large menu of options (including employer/employee split) to make a small menu for your employees. TriNet also did payroll, AFAIK. I'm sure there are other options, but as an employee the presented menu was very similar to what I saw at Facebook and Yahoo.
satya71 5y ago
Our local chamber of commerce will let you sign up to their pool if you have at least 2 full-time people on payroll. We didn't qualify, but heard from others the rates were better than the exchange (which is the fallback)
- issa 5y ago
  I think the key here is that we are distributed across many states/cities.
  - satya71 5y ago
    Some of these plans may have multi-state as an option. May be worth checking with chamber of commerce at HQ.
dnh44 5y ago
This won't be of much help to you but I moved to the UK specifically to start a business. Not having to worry about healthcare was nice. I do have private health insurance now with Bupa but it's less than $100 per month.
- issa 5y ago
  Ha. Yeah, the number one thing in the US hurting small business is lack of universal health care. It has been a problem my entire adult life.
  - dnh44 5y ago
    That's one aspect of the universal health care argument that I've never heard get talked about until your comment. Universal health care is great for small businesses and entrepreneurs.
elamje 5y ago
We use Rippling for all our HR needs right now. I highly recommend it - they have an entire “App” ecosystem which basically unlocks various features and services for a low cost. They do healthcare for companies your size for a very good price.
- issa 5y ago
  Ended up signing up with Rippling. Thanks for the recommendation. They are the perfect solution for us.
stevesearer 5y ago
We use a Qualified Small Business HRA administered through PeopleKeep. Basically your employees buy their own insurance plans and submit for reimbursement up to a specified dollar amount. They can also be reimbursed for other qualified medical expenses in addition to health insurance premiums. Using this program the employees do not qualify for healthcare subsidy. We tried to do a traditional group plan initially, but didn’t have enough employees in a single state to qualify. https://www.healthcare.gov/small-businesses/learn-more/qsehra/ https://www.healthcare.gov/small-businesses/learn-more/qsehr...
- issa 5y ago
  As a temp solution we've just been reimbursing people and having them get their insurance on the exchange. Probably about the same.
  - stevesearer 5y ago
    Some employees might qualify for a subsidy which would end up making your company health insurance plan subsidized by the government which isn't allowed. Having a 3rd party administrator is also good so employees aren't having to submit private health insurance documents to you for reimbursement.
    - issa 5y ago
      Interesting. But I don't think anyone qualifies for a subsidy.

12 points by issa 5y ago

We have a headcount under 10 and are looking for health care solutions for a remote team in various US states. This seems like it should have an easy solution. What is yours?

verdverm 5y ago

Gusto has good options for small teams both for insurance and 401k

e1g 5y ago
We dealt through Gusto as well (with Oscar) - they’ll work with you if you have 2+ people on payroll. Never had issues with them.
- issa 5y ago
  Gusto is what we use now, but they don't seem to be able to handle health insurance for a distributed team. Am I missing something?

toast0 5y ago

When I was at a small startup (although a bit more than 10), they used TriNet, an 'employee leasing'/outsourced HR vendor. More or less, your employees are also employees of the leasing firm, and that firm has access to employer paid health plans from well known vendor. I think you select from a large menu of options (including employer/employee split) to make a small menu for your employees. TriNet also did payroll, AFAIK. I'm sure there are other options, but as an employee the presented menu was very similar to what I saw at Facebook and Yahoo.

satya71 5y ago

Our local chamber of commerce will let you sign up to their pool if you have at least 2 full-time people on payroll. We didn't qualify, but heard from others the rates were better than the exchange (which is the fallback)

issa 5y ago
I think the key here is that we are distributed across many states/cities.
- satya71 5y ago
  Some of these plans may have multi-state as an option. May be worth checking with chamber of commerce at HQ.

dnh44 5y ago

This won't be of much help to you but I moved to the UK specifically to start a business. Not having to worry about healthcare was nice. I do have private health insurance now with Bupa but it's less than $100 per month.

issa 5y ago
Ha. Yeah, the number one thing in the US hurting small business is lack of universal health care. It has been a problem my entire adult life.
- dnh44 5y ago
  That's one aspect of the universal health care argument that I've never heard get talked about until your comment. Universal health care is great for small businesses and entrepreneurs.

elamje 5y ago

We use Rippling for all our HR needs right now. I highly recommend it - they have an entire “App” ecosystem which basically unlocks various features and services for a low cost. They do healthcare for companies your size for a very good price.

issa 5y ago
Ended up signing up with Rippling. Thanks for the recommendation. They are the perfect solution for us.

stevesearer 5y ago

We use a Qualified Small Business HRA administered through PeopleKeep. Basically your employees buy their own insurance plans and submit for reimbursement up to a specified dollar amount. They can also be reimbursed for other qualified medical expenses in addition to health insurance premiums. Using this program the employees do not qualify for healthcare subsidy. We tried to do a traditional group plan initially, but didn’t have enough employees in a single state to qualify. https://www.healthcare.gov/small-businesses/learn-more/qsehra/ https://www.healthcare.gov/small-businesses/learn-more/qsehr...

issa 5y ago
As a temp solution we've just been reimbursing people and having them get their insurance on the exchange. Probably about the same.
- stevesearer 5y ago
  Some employees might qualify for a subsidy which would end up making your company health insurance plan subsidized by the government which isn't allowed. Having a 3rd party administrator is also good so employees aren't having to submit private health insurance documents to you for reimbursement.
  - issa 5y ago
    Interesting. But I don't think anyone qualifies for a subsidy.