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Virginia Health Insurance for Small Businesses
Nasro virginia employee benefit services include group health insurance & self-funded options:.
Own or operate a small business in Virginia? NASRO Administrators is a socially responsible employee benefits consultant working to help small businesses and non-profits manage their health care and employee benefits by providing a range of options at the most affordable rates possible.
If you are studying your Affordable Care Act health coverage requirements and options, starting a new business. expanding operations in Virginia, or just need to lower your monthly health insurance costs, you need to meet NASRO. You are not alone, and NASRO can help you. We have worked for decades to help establish the more humane health care system that Virginia is known for in our region. NASRO is helping to make sure all the health plan options available in the state are communicated clearly, completely, and professionally. If you have a question or a problem please call us for advice on a wide range of health care topics, including coverage options, network availabilities, provider quality, insurance rates, and more.
NASRO will help you with every step of the process until your enrollment is accepted. If you have questions about how to determine the best benefit plan, how to answer the questions concerning your medical history or how to coordinate your new coverage with the ending of your old coverage please call NASRO at 617-875-5140 or e-mail us at [email protected] . Information on other group health plans are listed below.
NASRO’s Clients Includes of Professional Corporations, Partnerships, LLC’s, S Corporations, and C Corporations, Non-Profits, and Co-ops,
Health and Dental Rate Information
NASRO is a non-profit, socially responsible employee benefit consultant. We provide both the information and the interpretation of what the various benefit plan levels and prices are actually buying. NASRO Administrators is staffed by Virginia health and dental insurance experts who are available to assist any company with direct answers to questions about benefit choices, cost, which Virginia health or dental insurance provider network is best for you or your employees.
Types of Virginia Health Insurance Coverage
- Point of Service Plans (POS)
- Preferred Provider Organization Plans (PPO)
- Health Maintenance Organizations (HMO)
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- Self Funded and Level Funded Plans
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- Flexible Spending Accounts
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Group dental and vision insurance.
Any individual in the tri-state area is eligible to participate in our dental plan regardless of medical pre-existing conditions. Call 617-875-5140 to find out the rates, benefits and enrollment information from the top dental carrier in the state.
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Virginia Small Business Health Insurance Information
The purpose of this guide is to provide a general overview of virginia small business health insurance. the guide reviews small business health insurance options for virginia small businesses..
Building a successful business is hard work. Finding affordable small business health insurance doesn’t have to be. All small businesses face special challenges when it comes to finding and getting health insurance coverage. Luckily, recent health care reform legislation provides small businesses with special opportunities to secure affordable health insurance.
Virginia Core Small Business Health Insurance Options
When evaluating your small business health insurance options in Virginia, you should immediately compare the costs and benefits of the following three options:
Offering Traditional Small Business Health Insurance Coverage,
Offering a Defined Contribution Health Plan that Reimburses Employees for Individual Health Insurance Coverage, and
Virginia Small Business Health Insurance Overview
There are two primary categories of health insurance for small businesses to choose from:
Individual health insurance,
Group health insurance.
1) Individual Health Insurance
Individual health insurance plans are health insurance plans purchased by individuals to cover themselves or their families. Anyone can apply for individual health insurance. Small business owners who can’t offer group coverage due minimum contribution (or minimum participation) requirements typically purchase individual and family plans for themselves and their families. In 2014, insurance companies will no longer be able to decline individuals for individual health insurance based on a pre-existing medical condition. Also, starting in 2014, there are new special tax incentives available to businesses and employees when employees purchase individual health insurance. In some cases, self-employed persons who purchase their own health insurance may be able to deduct the cost of their monthly premiums. When small businesses decide on the individual health insurance route, they often create a "Pure" Defined Contribution Health Plan to reimburse employees tax-free for individual premiums .
2) Group Health Insurance
Group health insurance plans are a form of employer-sponsored health coverage. Costs are typically shared between the employer and the employee, and coverage may also be extended to dependents. In certain states, self-employed persons without other employees may qualify for group health insurance plans.
Four Types of Virginia Small Business Health Insurance Plans
Whether you’re looking at individual health insurance or group health insurance, there are several different types of health plans available. The four you should absolutely know are:
PPO Health Insurance Plans,
HMO Health Insurance Plans,
HSA-Qualified Health Insurance Plans, and
Indemnity Health Insurance Plans.
The plan type that is best for you and your employees depends on what you and your employees want, and how much you are willing to spend. Here’s a brief review of the four popular types of health insurance plans:
1) PPO Health Insurance Plans
PPO or “Preferred Provider Organization” plans are the most common. Employees covered under a PPO plan need to get their medical care from doctors or hospitals on the insurance company’s list of preferred providers in order for claims to be paid at the highest level.
2) HMO Health Insurance Plans
HMO stands for “Health Maintenance Organization.” HMO plans offer a wide range of health care services through a network of providers that contract exclusively with the HMO, or who agree to provide services to members. Employees participating in HMO plans will typically need to select a primary care physician (“PCP”) to provide most of their health care and refer them on to HMO specialists as needed.
3) HSA-Qualified Health Insurance Plans
HSA-qualified plans are typically PPO plans designed specifically for use with Health Savings Accounts (HSAs). An HSA is a special bank account that allows participants to save money – pre-tax – to be used specifically for medical expenses in the future. Section 105 Healthcare Reimbursement Plans (HRPs) are often used in place of HSAs due to their advantages for employers.
4) Indemnity Health Insurance Plans
Indemnity plans allow members to direct their own health care and generally visit any doctor or hospital. The insurance company then pays a set portion of the total charges. Employees may be required to pay for some services up front and then apply to the insurance company for reimbursement.
Virginia Small Business Resources*
Virginia Health Insurance Coverage:
Group Plans: Benefits will vary depending on the chosen plan. Pre-existing health conditions covered.
Individual Plans: Assorted plans depending on medical needs. Pre-existing health conditions covered.
COBRA: Coverage available for 18-36 months depending on qualifying events. Benefits are what you had with your previous employer. Pre-existing health conditions covered.
HIPAA: Benefits are based on program selected. There is no expiration of coverage. Pre-existing health conditions covered.
HIPAA: Premium assistance that pays employer-sponsored health insurance or Cobra premium available. Pre-existing health conditions covered.
Virginia Health Insurance Eligibility:
Group Plans: Guaranteed coverage for companies with 2-50 employees. Eligible employees must work at least 30 hours a week. Owner can count as an employee. Owner name on business license must draw wages from the company.
Individual Plans: Eligibility is subject to medical underwriting. If you are denied coverage for a medical condition, you may be eligible for AHIP, or PCIP.
COBRA: Guaranteed coverage available for employees who work for businesses with 20 or more employees. Employees have 60 days from date of termination to sign-up.
HIPAA: Must have had 18 months of continuous coverage and completely exhausted Cobra or state continuation coverage. Must not have lost coverage due to fraud or non-payment of premiums. You have 63 days to enroll.
HIPAA: Must qualify for Medicaid and have access to Employer-Sponsored Insurance or Cobra.
Virginia Health Insurance Monthly Cost:
Group Plans: Costs depend on employer contribution and the + 20% of the Insurance company’s Index rate.
Individual Plans: Costs for Individual coverage vary. There are no rate caps.
COBRA: Costs vary between 102% to 150% of group health rates.
HIPAA: Premiums will depend on plan chosen.
HIPAA: Reimburses the full employer-sponsored insurance premium amount by check monthly. Pays the insurance company directly for people on COBRA or eligible small businesses.
Virginia : Average “Single” Premium per Enrolled Employee for Employer-Based Health Insurance, 2011*
Virginia : Average “Family” Premium per Enrolled Employee for Employer-Based Health Insurance, 2011*
Virginia : Average “Employee-Plus-One” Premium per Enrolled Employee for Employer-Based Health Insurance, 2011*
Virginia : Average Per Person Monthly Premiums in the Individual Market, 2010*
Small Business Health Insurance Reform
Are you ready for health care reform ("ACA") in 2014?
Today, employers are more stressed than ever. Here’s why:
The business environment is uncertain,
Employer-sponsored health insurance costs increase annually, and
New fees and penalties take effect next year, and most employers don’t fully understand how this will affect their financials.
It is time for employers to examine the specifics of healthcare reform, and start thinking strategically vs. emotionally. Change is hard. However, employers that educate themselves and plan ahead can avoid severe financial impacts.
The more change and disruption your business can embrace, the more cost savings (for both the company and your employees) you will be able to realize over the long term. In order to embrace this change, you must be familiar with the key aspects of ACA. For many small businesses, the solution to healthcare reform is simple: Offer a “Business Expense Account” for Healthcare. A new vehicle, called a Healthcare Reimbursement Plan (HRP), allows employers to get out of the health insurance business, and simply give select employees monthly allowances to spend on their own health insurance policy in a state health insurance exchange.
Listed below are key ACA components to consider when choosing small business health insurance.
Individual Health Insurance Tax Subsidies
Beginning 2014, individuals will have access to tax subsidies to buy private health insurance through the public exchange. These subsidies will be for those who enroll in a silver plan through the exchange. The subsidy caps the cost of individual health insurance at 2% - 9.5% of their household income if their household income is less than 400% above the federal poverty line. This equates to roughly $90,000 per year for a family of four.
Click here for more information on the premium subsidies.
Individual Health Insurance Tax Penalties
The Individual Mandate requires most individuals to purchase health insurance, or else pay a penalty on their tax return each year. The intention of the individual penalty is to reduce the "Free Riding" effect in the health insurance market (a free rider is someone who is healthy and does not purchase health insurance until they need it.
Click here for more information on individual tax penalties.
Small Business Health Insurance Tax Credits
Small businesses with up to 25 full-time equivalent employees may qualify for a tax credit for offering employee health benefits. The credit is broken in to two phases. Phase 1 (2010-2013) includes a tax credit worth up to 35% of a small business’s health insurance costs. Phase 2 (2014 and beyond) includes a tax credit up to 50% of a small business’s health insurance costs.
Click here for more information the tax credits.
Small Business Health Insurance Tax Penalties
Starting January 1, 2015, Employers with 50 or more full-time equivalents who do not offer minimum essential coverage can face monthly penalties if at least one employee uses a premium tax credit to obtain health insurance through the state health exchange. If you do not have more than 50 employees, you are not subject to these penalties.
Click here for more information on the business tax penalty.
The Future of Small Business Health Insurance - Defined Contribution Plans
Defined Contribution Plans allow employers to offer health benefits without offering a traditional group health insurance plan. Instead of paying costs for a specific group health plan, employers allocate tax-deductible monthly allowances for their employees to spend on private health insurance and other medical expenses tax-free.
Features of defined contribution plans include the following:
Employee Choice – employees choose a health insurance plan that best fits their needs.
Fixed Cost – employers control health care costs by allocating fixed monthly allowances for their employees.
Savings – employers using Defined Contribution Plans typically cost less than group health plans which results in saving for both the employer and employee.
Next Steps – Evaluate Your 3 Core Options
Immediately compare the costs and benefits of the following three options:
Offering a Defined Contribution Health Plan that Reimburses Employees for Individual Health Insurance Coverage, and
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Sana Benefits - Virginia Content
Small business health insurance in virginia.
Affordable. And built for Virginia small businesses.
Sana is bringing our dependable, high quality health plans to businesses in Virginia. Our plans meet any budget, and your employees can see any doctor they want, without paying out-of-network fees.
Sana plans in Virginia
Sana vs. everyone else.
We don’t do hidden fees. With Sana, your costs are transparent and predictable so you can budget with confidence.
Forget out-of-network hassles and limitations. Our All-Access PPO Plus network enables you and your employees to choose any provider without out-of-network costs or referrals.
Sana gives you access to high-quality providers and the ability to add dental and vision care to any plan. You get virtual care options for primary care, maternity care, mental health and more, for $0 on most plans.
Sana’s employer portal makes understanding and managing your plan simple. Our admin and member support teams are Sana experts, accessible via chat or email.
Virginia does not require any company to offer health insurance benefits, although the Affordable Care Act (ACA) does. But not all companies are under the health care mandate. If your company has 1 to 50 full-time employees, you do not have to provide them with health insurance. However, offering coverage will make you a more attractive employer to employees evaluating their options.
Sana provides plans to businesses with five or more employees.
Establish your budget and objectives. You can streamline the process by working directly with Sana, so you don’t have to use brokers or third-party administrators. In addition to providing plan administration and claims adjudication, we’ve got a seasoned implementation team to help you onboard. Also, you are not required to wait until your current plan cycle ends. You’ll be able to transition mid-year with our team’s help.
Your costs will vary depending on the percentage of employee premiums you cover, the number of people you enroll, and whether you cover employees only or also their dependents. Your choice of plan also influences costs (and that of your employees).
Sana negotiates pricing with providers based on objective, industry-accepted metrics. Shrinking provider markups reduces the cost of care, making premiums more manageable. As a small business, you can deduct the cost of employee premiums from your federal taxes. You may also qualify for a tax credit.
Of course. The dashboard on our site allows employers and administrators to easily add new employees, update contact information, adjust benefits (such as when an employee has a Qualifying Life Event), or remove employees from the plan. Additionally, plan administrators can take advantage of Mineral (formerly ThinkHR) for free. Human resource and compliance professionals can tap into Mineral’s support. Administrative employees can reach out to a team of HR advisors with questions and for assistance. They can get a compliant employee handbook with prewritten and automatic policy updates, and they can use an award-winning resource center.
See what our members say about Sana
“Thank you for everything that you’ve done for me! You made what could have been a difficult and stressful insurance process into one that is manageable. You took the time to explain everything to me and went out of your way to contact my providers. On top of that, you are one of the sweetest, kindest people I’ve had the pleasure to work with.” Kristi, Member
“We have been loving Sana, the customer service and coverage are both wonderful. You guys have been a breath of fresh air…health care carriers have always been a thorn to work with. So, working with y’all has been professional, efficient, and personable. Appreciate all you do!” Beth, Member
“We definitely reduced our cost in health insurance by about 40%. It was a big savings and a no-brainer.” Brian, Member
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Health insurance support for small business
We’re here for you — helping you balance quality and cost control with health insurance plans and unique funding created exclusively for small group needs.
Plan support and savings
Digital enrollment tools.
Help your clients manage enrollment and benefits administration with our flexible tools.
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Health plan savings
Learn about government credits to help you offset the cost of employee health benefits.
Self-insured funding built for small businesses
Control rising health care costs with Aetna Funding Advantage SM health plans. You can get the benefits typical for larger groups like surplus sharing, fewer taxes and fees and high-cost claims protection. All in one offering specially designed with your small business in mind.
A monthly payment based on the health trends of your employees — for up to 25 percent savings up front.
Online benefits shopping, enrollment, administration and other simple features for you and your employees.
Stop-loss insurance to limit the risk of high-cost claims, with money back when claims are lower.
Plan designs that provide access to Aetna’s quality, value-based network plus health and wellness benefits.
- Explore Aetna Funding Advantage benefits
A value-added package
You’ve come to the right place to balance health plan costs and quality. Explore competitive benefits, unique funding and stable cost control – with built-in wellness programs and resources to support employee health and well-being long term.
Get lower monthly payments based on health trends, low-cost local network options and 50% of any surplus returned to you at year end when you renew your plan.
Keep your costs predictable and stable with bundled products, funding options, wellness offerings, stop-loss claims protection and more.
Make life easy with a national portfolio of health insurance plan designs, online shopping and benefits administration and one common support model.
Get the job done fast with quick, accurate quoting, auto-case installation, online self-service, fixed national plan designs and more.
We’ve got the perfect fully insured plan for you
Our health benefits and insurance plans are as unique as your small business, with service in markets all across the country. So it’s easy to find quality plans offered in your state.
Public exchange options are also available in selected states through our Small Business Health Options Program (SHOP) coverage .
Everyone saves with health expense funds
As part of a consumer-directed plan, health expense funds benefit employers and employees alike. You get tax savings from salary deductions. And employees get quality care that encourages smart spending.
You can also:
- Cut FICA, unemployment and workers’ comp taxes by lowering payroll taxes
- Offer innovative plans to set aside tax-free money, like for dependent care or parking expenses
- Enhance company benefits package to attract and keep valuable employees
Are you a broker or producer?
You can find small group solutions and sales tools on our Producer World ® website.
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Applied Behavior Analysis Medical Necessity Guide
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The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.
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- Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Treating providers are solely responsible for dental advice and treatment of members. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider.
- While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Your benefits plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government.
- Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change.
- Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies.
- Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met.
Medical clinical policy bulletins
- Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider.
- While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors).
- Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error.
- CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. New and revised codes are added to the CPBs as they are updated. When billing, you must use the most appropriate code as of the effective date of the submission. Unlisted, unspecified and nonspecific codes should be avoided.
- Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern.
- In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members.
See CMS's Medicare Coverage Center
- Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change.
- Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies.
- While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans.
See Aetna's External Review Program
- The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT®), copyright 2015 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians.
- The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply.
LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT®")
CPT only copyright 2015 American Medical Association. All Rights Reserved. CPT is a registered trademark of the American Medical Association.
You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt.
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For a complete list of participating walk-in clinics, use our provider lookup. Walk in appointments are based on availability and not guaranteed. Online scheduling is recommended. Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high deductible health plans must meet their deductible before receiving covered non preventative MinuteClinic services at no cost share. However, such services are covered at negotiated contract rates. This benefit is not available in all states.
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Virginia Business Insurance
Get a full analysis of Virginia business insurance costs, companies & coverage.
Best Business Insurance Companies in Virginia
Average cost of business insurance in virginia.
- Business Insurance in Virginia FAQs
- Christine Lacagnina
- August 28, 2023
Get help from one of our Virginia independent agents
They understand your risks and will find you the coverage you need.
Find the Best Business Insurance Options in Virginia
The Blue Ridge mountains and other scenery in Virginia make it an attractive place for business owners. Anyone who owns and runs a business in Virginia needs the protection of a business insurance policy. Having business insurance can help your company get reimbursed after a major disaster like a fire, break-in, explosion, etc.
Virginia has nearly 745,900 small businesses currently, and its 1.5 million small business employees also need to be protected. Luckily, an independent insurance agent in Virginia can help you get equipped with the right business insurance policy. But for starters, here's a deep dive into Virginia business insurance.
You could find business insurance almost anywhere in Virginia, but some business insurance companies are better than others. Certain carriers offer more affordable rates and better-quality coverage. For your convenience, we've put together a list of some of our top picks for business insurance in Virginia.
- pomi: pomi sells business insurance and personal insurance. The carrier has excellent ratings from both AM Best and the Better Business Bureau (BBB) and provides online claims reporting.
- The Hanover: The Hanover offers a large catalog of business insurance and personal insurance. The carrier also has outstanding ratings from AM Best and the BBB and offers 24/7 claims reporting.
- Liberty Mutual: Liberty Mutual also offers a large catalog of business insurance and personal coverages. The carrier is a Fortune 500 company with excellent ratings from AM Best and the BBB and offers 24/7 claims reporting.
- Nationwide: Nationwide sells business insurance and many types of personal insurance. The carrier has outstanding ratings by AM Best and the BBB and offers 24/7 claims reporting.
A Virginia independent insurance agent can help you find the coverage your business is in need of from one of these top-rated carriers.
Virginia Business Insurance Requirements
Virginia state law requires businesses that regularly employ more than two workers to provide workers' compensation . This is the only type of mandatory business insurance by state law in Virginia. But while other types of coverage are technically optional, they can help prevent your company from going into bankruptcy. For example, having commercial general liability insurance can provide reimbursement for the costs of lawsuits if a third party sues your business. Having commercial auto insurance can pay to repair or replace company vehicles after accidents, theft, and more. Also, having commercial property insurance can help your business repair, rebuild, or replace buildings and inventory after many covered disasters.
The Only Mandatory Business Insurance Coverage in Virginia:
- Workers' compensation
Optional Types of Business Insurance Coverage to Consider in Virginia:
- Cyber liability insurance
- Professional liability insurance
- Business income insurance
- Commercial auto insurance
- Commercial property insurance
- Commercial general liability insurance
A Virginia independent insurance agent can help you get set up with all the coverage your business needs.
What Business Insurance Covers in Virginia
Your business insurance policy in Virginia will cover whatever you set it up to cover. The types of protection you select to go into your policy can set your business up for success after many kinds of covered disasters. You may want to build a policy that includes coverage for your employees, company vehicles, liability, network, commercial property, and more. A Virginia independent insurance agent can recommend all the types of coverage your business needs most.
Liability Coverage Options for Small Businesses in Virginia
Liability coverage can help your small business get reimbursed for attorney, court, and settlement fees if it gets sued. Since lawsuits are almost never expected and certainly not cheap, having liability coverage can be critical. Consider each of the following main types of liability protection for your Virginia small business:
- Commercial general liability insurance: This can pay for third-party claims of bodily injury or personal property damage against your business.
- Cyber liability insurance: This can pay for lawsuits and other costs associated with data breaches and other cyber incidents that may expose or sell private data like credit card information.
- Professional liability insurance: This can pay for third-party lawsuit costs if a claim of improper or inaccurate advice or services performed by your business gets filed against you.
A Virginia independent insurance agent can help you get equipped with all the liability coverage your business needs.
Property Coverage Options for Small Businesses in Virginia
Having protection for company property is key to getting it repaired or replaced if necessary. An unexpected incident like a fire or vandalism can leave your inventory damaged or destroyed. Check into getting this essential coverage for your Virginia small business:
- Commercial property insurance: This can pay for any repairs, rebuilding, or replacement of business property, including inventory and physical structures like office buildings, after a covered incident.
A Virginia independent insurance agent can help your business get set up with the right amount of commercial property coverage.
Other Insurance Options for Small Business Owners in Virginia
Your Virginia business insurance policy may not yet be complete. There are many additional types of coverage your company might require. Look into these options for your business:
- Business income insurance: This can pay for expected revenue and employee wages that would typically be earned and paid out during a temporary covered closure, such as due to a fire.
- Commercial auto insurance: This can pay for incidents involving company vehicles, including accidents, theft, lawsuits, vandalism, etc.
A Virginia independent insurance agent can help you complete your business insurance policy with the right types of coverage for your unique company.
The cost of your business insurance policy in Virginia will depend on many different things, including how much coverage and the types of coverage your company needs, your industry, exact location, company size, and more. Larger companies that have more employees and need more coverage will have to pay more for their policies. Likewise, businesses in industries like construction that are considered risky by nature will also have to pay more for their coverage than their safer counterparts.
How does your city measure up to the national average?
Number of businesses in the US: 30,819,176
Burglary rate per 1,000 residents in the US: 3.76
Auto theft rate per 1,000 vehicles in the US: 2.29
How Does Your Virginia City Measure Up?
Arlington, va common coverage options.
Commercial property coverage: If your Arlington business has any physical inventory or buildings, it needs protection for these elements. This coverage can reimburse for theft, vandalism, fire damage, and much more.
Commercial general liability coverage: Your Arlington business also needs protection against third-party lawsuits for claims of bodily injury or personal property damage at the hands of your company. This coverage can reimburse for attorney, court, and settlement costs.
Workers' compensation coverage: For any Arlington business that regularly employs at least two workers, workers' compensation coverage is mandatory by state law. This coverage can reimburse the cost of medical treatments for injured or ill workers if their ailment or injury was caused by job duties or the work environment.
Chesapeake, VA Common Coverage Options
Commercial property coverage: If your Chesapeake business has any physical inventory or buildings, it needs protection for these elements. This coverage can reimburse for theft, vandalism, fire damage, and much more.
Commercial general liability coverage: Your Chesapeake business also needs protection against third-party lawsuits for claims of bodily injury or personal property damage at the hands of your company. This coverage can reimburse for attorney, court, and settlement costs.
Workers' compensation coverage: For any Chesapeake business that regularly employs at least two workers, workers' compensation coverage is mandatory by state law. This coverage can reimburse the cost of medical treatments for injured or ill workers if their ailment or injury was caused by job duties or the work environment.
Norfolk, VA Common Coverage Options
Commercial property coverage: If your Norfolk business has any physical inventory or buildings, it needs protection for these elements. This coverage can reimburse for theft, vandalism, fire damage, and much more.
Commercial general liability coverage: Your Norfolk business also needs protection against third-party lawsuits for claims of bodily injury or personal property damage at the hands of your company. This coverage can reimburse for attorney, court, and settlement costs.
Workers' compensation coverage: For any Norfolk business that regularly employs at least two workers, workers' compensation coverage is mandatory by state law. This coverage can reimburse the cost of medical treatments for injured or ill workers if their ailment or injury was caused by job duties or the work environment.
Richmond, VA Common Coverage Options
Commercial property coverage: If your Richmond business has any physical inventory or buildings, it needs protection for these elements. This coverage can reimburse for theft, vandalism, fire damage, and much more.
Commercial general liability coverage: Your Richmond business also needs protection against third-party lawsuits for claims of bodily injury or personal property damage at the hands of your company. This coverage can reimburse for attorney, court, and settlement costs.
Workers' compensation coverage: For any Richmond business that regularly employs at least two workers, workers' compensation coverage is mandatory by state law. This coverage can reimburse the cost of medical treatments for injured or ill workers if their ailment or injury was caused by job duties or the work environment.
Virginia Beach, VA Common Coverage Options
Commercial property coverage: If your Virginia Beach business has any physical inventory or buildings, it needs protection for these elements. This coverage can reimburse for theft, vandalism, fire damage, and much more.
Commercial general liability coverage: Your Virginia Beach business also needs protection against third-party lawsuits for claims of bodily injury or personal property damage at the hands of your company. This coverage can reimburse for attorney, court, and settlement costs.
Workers' compensation coverage: For any Virginia Beach business that regularly employs at least two workers, workers' compensation coverage is mandatory by state law. This coverage can reimburse the cost of medical treatments for injured or ill workers if their ailment or injury was caused by job duties or the work environment.
Virginia Business Insurance FAQ
How much does business insurance cost in virginia.
Business insurance costs in Virginia can vary based on many different factors, including your company's size, coverage needs, number of employees, exact location, claims history, discounts earned, and more.
Is business insurance required in Virginia?
All businesses in Virginia that regularly employ two or more workers must carry workers' comp coverage by state law. Other types of business insurance are technically optional but strongly recommended.
What does business insurance cover in Virginia?
Business insurance in Virginia covers whatever you select in your policy. For example, if you need coverage for company vehicles, add commercial auto insurance. If you need coverage against lawsuits, add commercial general liability coverage. An independent insurance agent in Virginia can help recommend the exact types of coverage you should put into your policy.
What does business general liability insurance cover in Virginia?
Commercial general liability insurance in Virginia covers attorney, court, and settlement costs related to lawsuits if your business gets sued for bodily injury or personal property damage.
Are there any small business health insurance plans in Virginia?
Small business health insurance plans are available for companies in Virginia with 50 or fewer employees. If you have 25 or fewer employees, your business may also qualify for tax credits on its coverage.
What are the best business insurance companies in Virginia?
Our research found that pomi , The Hanover , Liberty Mutual , and Nationwide are the best business insurance companies in Virginia this year. We selected these carriers based on financial strength, coverage options, pricing, discounts, customer service reviews, and more.
Why work with an independent insurance agent when shopping for business insurance in Virginia?
An independent insurance agent in Virginia can help you find the kind of coverage your business needs at the best possible price. These agents shop and compare policies from a ton of different Virginia business insurance companies and narrow it down to the options that only present the best blend of coverage and cost for you.
Do You Know What Your Business Insurance Covers in Virginia?
Virginia Small Business Health Insurance Guide
Virginia market overview.
The Virginia small business health insurance market is a competitive and complex insurance market. For a small business, there are many health insurance options to choose from – multiple carriers, tiered doctor networks, government exchange vs private market plans, etc. The large number of options in the Virginia market can make looking for the right health insurance plan intimidating, but can also provide substantial savings opportunities by narrowing in on the most appropriate plan for specific needs.
We’ve summarized the various options into a high level set of recommendations, factoring in the options of small business health insurance carriers, networks, and plans available in Virginia.
Virginia Health Insurance Carriers at a Glance
Looking for specific coverage & rate information? See every carrier & plan online at SimplyInsured.com .
Insurance Carrier Overview:
Aetna is a national carrier offering medical, dental, and vision coverage. Aetna several networks including PPO and HMO networks options, and allows companies can mix and match up to 5 different plans to offer employees.
Aetna’s full PPO and HMO networks are very broad and includes a large number of hospitals and doctors. ( View Aetna plans & rates )
- Open Choice PPO : Aetna’s largest network in Virginia, with access to expansive network of doctors and hospitals. Offers nationwide coverage through Aetna’s national network.
- HealthNetwork Only ( HNOnly ) : Statewide HMO network with a fairly broad network of doctors and hospitals. While a HMO network, HNOnly plans does not require members to select a primary care physician and can utilize specialists without a referral. Plans are ~10% less expensive than the full network.
- HMO : The traditional HMO network utilizes the same doctor network as HNOnly. The HMO network does require members to select a primary care physician and obtain a PCP referral to utilize a specialist. Plans are ~12% less expensive than the full network.
Insurance Carrier Overview:
Anthem Blue Cross Blue Cross is a part of Wellpoint and offers medical, dental, and vision coverage. Anthem’s service area is limited to companies in the western part of Virginia, specifically west of State Route 123.
Anthem plans offer access to a very strong statewide network, and national coverage through the BCBS BlueCard network. ( View Anthem Blue Cross plans & rates )
- PPO Network: Full PPO network with access to one of the largest network in Virginia, and nationwide coverage through the BlueCard network. One of the best doctor networks available to small businesses.
- HealthKeepers Open Access POS: The Anthem HealthKeepers point of service network is nearly the same size of the full PPO network, and costs 2% less. HealthKeeper point of service plans require members to select a primary care physician, but referrals are not required to see a specialist.
- HealthKeepers POS : The Anthem HealthKeepers standard point of service network costs 5% less, and also requires members to get a primary care physician referral to see a specialist.
CareFirst BlueCross Blue Shield serves the northern Virginia / mid-Atlantic region, and offers medical, dental, and vision coverage. CareFirst offers several networks and variants of plans within each network. Companies can choose to multiple offer multiple plans. PPO plans provide national coverage through the Blue Cross Blue Shield BlueCard network. ( View CareFirst BlueCross BlueShield plans & rates )
- BluePreferred PPO: Full PPO network with access to a very large network within the mid-Atlantic region. When traveling outside of the mid-Atlantic region and nationally, in-network coverage is provided through the national BlueCard network.
- HealthyBlue : HealthBlue offers both PPO and HMO plan options on the same network. Similar to the BluePreferred network, when traveling outside of the mid-Atlantic region and nationally, in-network coverage is provided through the national BlueCard network. Plans are 10% less expensive compared to the full network. HealthyBlue plans also encourage use of primary care providers and incentives for completing a wellness program.
- BlueChoice : The Blue Choice HMO network utilizes the same network as the overall network, but requires the use of a primary care physician and does not provide out of network coverage. When traveling out of state, only emergency care is covered in-network.
Kaiser Permanente is non-profit HMO carrier that offers medical coverage in the Virginia, Maryland, and Washington DC area. Kaiser is unique in that it both provides health insurance coverage and medical services through its own network of doctors and hospitals. Kaiser plans are only available to companies located in the Fairfax / mid-Atlantic region of Virginia.
Kaiser primarily offers HMO plans, and plans on the Signature network can only utilize Kaiser facilities. Out of state employees have the option of enrolling on a PPO plan with access to the Private Healthcare Systems network. Kaiser plans are also available through the Covered California SHOP exchange. ( View Kaiser Permanente plans & rates )
- Select HMO Network: The Kaiser Select network is the widest network available, giving access to both the Kaiser Permanente network of physicians as well as community physicians outside of the Kaiser network.
- Signature HMO Network: The Signature HMO network includes Kaiser’s mid-Atlantic footprint, which consists of ~1200 physicians and ~38 hospital locations.
Insurance Carrier Overview:
United Healthcare is the largest carrier in the country, and offers medical, dental, and vision coverage in Virginia. United Healthcare PPO plans provide access to the nationwide United Healthcare network. United Healthcare offers two tiers of PPO networks and a HMO network, and allows any number of plans to be offered. ( View United Healthcare plans & rates )
- Choice Plus PPO : Full PPO network with access to one of the largest network of doctors and hospitals in Virginia and nationwide coverage through United Healthcare’s national network.
- Choice EPO: The Choice EPO network uses the same network as the Choice Plus network, but does not include out-of-network coverage. Choice EPO plans are ~3% less expensive than the full PPO version.
- OCI HMO: Narrow network PPO with 85% of the doctors in the full network. Core PPOs have access to coverage nationally as well. Core PPO plans are ~16% less expensive than the full PPO version.
- Core Essential HMO: Narrow network PPO with 85% of the doctors in the full network. Core PPOs have access to coverage nationally as well. Core PPO plans are ~16% less expensive than the full PPO version.
- Navigate HMO : Fairly large HMO network with 50% of the doctors and 70% of the hospitals of the PPO network. One of the largest HMO networks in Virginia, and plans are ~23% less expensive than the full PPO.
Individual vs Small Business Health Insurance Guide: San Jose Edition
What’s the Better Value in San Jose – Individual or Small Business Health Insurance? We get asked that question a lot from small business owners on whether it is better to get coverage under their business or from the individual health insurance exchanges. To find whether individual or small business health insurance is better, we looked…
Small Businesses’ Guide to 2020 Open Enrollment
As a business owner interested in health insurance for your small business, you have likely heard the term “Open Enrollment.” Open Enrollment is the time at the end of the year when individuals can choose their health insurance plan for the upcoming year. If you’re signing up for an individual health plan through the federal…
Small Business Health Insurance Guide
Introduction to small business health insurance
Choosing the Right Health Insurance for Your Small Business
For a small business, offering a comprehensive health insurance plan to your compensation package for employees will help you attract and retain the talent you need for your business. However, choosing a provider, specific benefits packages, and determining employee and employer contributions, can be overwhelming. SimplyInsured provides a platform where you can weigh all of…
How to Qualify for Small Business Health Insurance
You probably qualify! In this article we will discuss qualifying for small business health insurance. Small business health insurance is medical, dental, and vision coverage for employees of a company or organization. Also known as an employer-sponsored plan or a group plan, small business health insurance plans are typically a lower cost option compared to…
Illinois Small Business Health Insurance Guide
Illinois Market Overview The Illinois small business health insurance market is a competitive and complex insurance market. For a small business, there are many health insurance options to choose from – multiple carriers, tiered doctor networks, government exchange vs private market plans, etc. The large number of options in the Illinois market can make looking for…
Small Business Health Insurance in Virginia: Finding Affordable Coverage
Small businesses in Virginia face unique challenges when providing health insurance for their employees. With the rising cost of healthcare, finding the right small business health insurance Virginia can be daunting. This in-depth guide will examine the options available to small business owners, the key providers, the costs involved, and strategies to secure the best coverage for your employees. We’ll also address frequently asked questions about small business health insurance in Virginia to help you make informed decisions.
Understanding Small Business Health Insurance in Virginia
Small business health insurance in Virginia is designed to provide healthcare coverage to employees of small businesses, typically those with fewer than 50 employees. While offering health insurance may not be legally required for small companies, it is a valuable perk for workers that can help you find and keep the best employees.
1. Options for Small Business Health Insurance
A. group health insurance plans.
· Group health insurance plans are a popular choice for small businesses in Virginia. These plans allow business owners to provide healthcare coverage to their employees as a group, which can result in cost savings. Employers and employees share the premium costs.
· Group plans often provide a range of coverage options, including medica l, dental, and vision insurance. They may also offer options for dependent coverage.
· Popular group health insurance providers in Virginia include Anthem, Aetna, and UnitedHealthcare.
b. Health Maintenance Organization (HMO)
· HMOs offer a network of healthcare providers for employees to choose from. These plans usually require members to select a primary care physician (PCP) and obtain referrals from the PCP to see specialists.
· HMOs can be cost-effective, but they require employees to seek care within the network of providers.
· Optima Health and Kaiser Permanente are some HMO providers in Virginia.
c. Preferred Provider Organization (PPO)
· PPO plans to provide a broader network of healthcare providers, allowing employees to visit specialists without referrals.
· While PPO plans tend to have higher premiums, they offer greater flexibility in choosing healthcare providers.
· Providers like Cigna and Humana offer PPO plans in Virginia.
2. The Cost of Small Business Health Insurance
Small business health insurance costs in Virginia can be very different based on the number of employees, the level of coverage, and the chosen provider. Here are some key cost considerations:
· Your premiums are your regular payments to keep your health insurance . Rates may change based on the plan type and the coverage amount. The premium is usually paid in part by the small business owner, while the workers pay the rest.
· Deductibles are the amount employees must pay out-of-pocket for covered medical services before the insurance plan starts covering costs. Plans with higher deductibles typically have lower premiums.
c. Copayments and Coinsurance
· Copayments and coinsurance are additional costs employees may need to pay for specific medical services or prescriptions. These costs can vary depending on the plan.
Keyword Integration: Small business health insurance Virginia cost
3. Strategies to Find Affordable Small Business Health Insurance in Virginia
A. compare quotes.
· It’s essential to get prices from more than one place. Multiple insurance providers. Different companies offer various plans, and the rates can vary significantly.
b. Consider Level-Funded Plans
· Level-funded plans are a hybrid between fully insured and self-insured plans. They often provide more control over costs and are a choice that can save small businesses money.
c. Utilize Healthcare Tax Credits
· The Small Business Health Care Tax Credit is available for eligible small businesses that offer health insurance to employees. It can help offset the cost of premiums.
d. Evaluate the Needs of Your Employees
· Understanding your employees’ healthcare needs can help you select a plan that provides the right level of coverage without unnecessary expenses.
Frequently Asked Questions (FAQs)
1. is small business health insurance in virginia mandatory.
Small businesses in Virginia are not legally required to offer health insurance to their employees. However, providing health insurance can be a valuable incentive for attracting and retaining talented employees.
2. What is the Health Care Tax Credit for Small Businesses?
The Small Business Health Care Tax Credit is a tax break the government gives to small businesses that cover their workers’ health care. It helps lower the cost of insurance and can help businesses that qualify a lot.
3. How can I find Virginia’s best small business health insurance?
Find the best health insurance for your small business in Virginia by getting offers from multiple companies. Consider what your employees need and consider cost-effective choices like level-funded plans. It can also be helpful to talk to an insurance agent or broker.
4. How are HMO and PPO plans different?
Health Maintenance Organization (HMO) plans make their users pick a primary care doctor (PCP) and get referrals to see specialists. Projects with a PPO (Preferred Provider Organization) network let you see more experts without getting a referral. PPO plans give you more options, but the fees may be higher.
Finding affordable small business health insurance in Virginia is essential for business owners and employees. By understanding the available options, comparing costs, and exploring strategies to save on premiums, small businesses can provide valuable healthcare coverage to their employees without breaking the bank.
While the cost of small business health insurance in Virginia can be a significant concern, the long-term benefits of offering this benefit to your employees far outweigh the expenses. It can lead to a healthier and more satisfied workforce, increased employee retention, and a competitive edge in the job market.
Remember that the healthcare landscape is continuously evolving, and getting updated on the latest events and changes in healthcare policies and insurance options is crucial. Doing so can ensure that your small business health insurance in Virginia remains cost-effective and beneficial for your employees.
1. Prioritizing Affordable Coverage
Finding affordable small business health insurance in Virginia is essential for business owners and employees. It’s a commitment to the well-being of your workforce and a competitive advantage in talent retention.
2. Long-Term Employee Satisfaction
Offering health insurance attracts talent and fosters a healthier, more content workforce. People who are cared for are more likely to stay with your company, which saves you money on transfer costs.
3. Competitive Edge in the Job Market
In today’s competitive job market, offering health insurance can set your business apart. Prospective employees often consider benefits when choosing an employer, making it a valuable recruiting tool.
4. Staying Informed and Adapting
The healthcare landscape is in constant flux. Staying informed about evolving healthcare policies and insurance options is vital. Regularly reassess your small business health insurance in Virginia to ensure it remains cost-effective and benefits your employees.
By keeping these points in mind and continually evaluating your options, you can successfully navigate the complexities of small business health insurance in Virginia. Your commitment to affordable, high-quality healthcare benefits both your business and the well-being of your employees.
Invest in your employees’ well-being today. Visit www.newhealthinsurance.com for free quotes and secure the best small business health insurance in Virginia.
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Virginia Small Business Health Insurance Plans 2023
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Get the best VA small business health insurance plans quotes & info on cost, coverage, deductibles, network, the Affordable Care Act (Obamacare) & more.
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VA Small Business Health Insurance Plans
Virginia Small Business Health Insurance Plans 2023 . The following is an overview of the rules that govern small group health insurance plans in the State of Virginia.
The information that is discussed below includes the laws that have been mandated by the Affordable Care Act (ACA or "Obamacare"), as well as the laws that are required by Virginia State government.
If you own and operate a VA small business and you already offer small group health insurance or you're thinking about offering small group health insurance - this guide can help you better understand the regulations, requirements and available Virginia small business health insurance plans available.
Learn how to get Virginia small business health insurance plans for 1 to 50 employees. The best small business health insurance providers in VA offer affordable rates, flexible coverage options and access to a large network of medical providers.
Below are some answers to commonly asked VA small business health insurance plan questions:
How Much Does Virginia Small Business Health Insurance Cost?
What are the small business health insurance regulations in virginia, does virginia participate in the affordable care act, what are the affordable care act requirements for virginia small businesses.
- How Are VA Health Insurance Premiums Are Determined?
What Types Of Health Insurance Plans Are Available For Virginia Small Businesses?
The average price of a standard Virginia small business health insurance policy ranges from around $583 to over $1706 per employee per month based on; single or family, location, coverages offered, deductibles and more.
Virginia imposes fewer regulations on small business health insurance policies than other states; however, that doesn't mean that it isn't important to be aware of these regulations. If you are a small business owner in Virginia, familiarizing yourself with these regulations will allow you to make the right choice for yourself and your employees.
Among the most notable health insurance laws regulations in Virginia are those that specifically pertain to the policies. For example, health insurance companies can impose pre-existing conditions exclusion periods.
If a health insurer imposes this exclusion period, they are not required to cover costs that are related to medical care that was provided for pre-existing conditions during this period. The exclusion period can be no longer than 12 months before the effective date of Virginia small business health insurance plans .
A pre-existing condition is defined as any health issue that was diagnosed or treated 12 months prior to the effective date of the health insurance policy.
Additionally, health insurance companies in Virginia are legally allowed to institute exclusion riders on policies. If applied, this type of rider excludes coverage for pre-existing medical conditions on a permanent basis.
Lastly, all health insurance policies in Virginia must feature a guaranteed renewability provision. This provision guarantees that at the end of a policy's term, the insured can renew it if they would like to.
According to Virginia State Corporation Commission , Many consumers across Virginia have questions about the Patient Protection and Affordable Care Act, (PPACA) (Public Law. No. 111-148) or the "Affordable Care Act" or "ACA". This page is presented to assist consumers in better understanding the many changes this sweeping legislation will bring about, and when to expect these changes.
The Bureau of Insurance and other involved agencies are making good progress sorting through the details and interpretations included in the Affordable Care Act, but there are still many unknowns, and many of the details have yet to be fully determined.
In 2010, the Affordable Care Act (ACA or "ObamaCare") was passed by the United States Congress and was signed into law by Obama. Following its passage, provisions of the law have continued to be phased in, and as of January 1, 2014, the majority of American citizens and legal residents of the United States are required, by law, to have qualifying health care coverage.
If they fail to have coverage, they are responsible for paying an annual tax penalty for each month they aren't insured, which is known as the "individual mandate".
The cost of the penalty for failure to have qualifying coverage is $95 per adult and $47.50 per child, or 1% of your total taxable income; whichever amount is higher - as much as $285 per family. In 2017, the penalty increased, and has continued to increase thereafter.
Qualifying Exemptions For The Individual Mandate
Individuals who meet one of the following are exempt from the individual mandate and the associated tax penalties in VA:
- Illegal aliens
- Jailed individuals
- Religious objections
- The cost of health insurance coverage is higher than 8% of your household income
- Those who aren't covered for less than three months during the calendar year
- Those who have hardship waivers
- Your income level is blow the 100% poverty level
If you're a small business owner in Virginia, you must provide your employees with insurance. This is a requirement that was put into place by the Affordable Care Act.
Referred to as the Employer Shared Responsibility provision, all employers must offer their employees at least one of the ACA-compliant Virginia small business health insurance plans, otherwise then can face fines of up to $2,000 per employee.
Virginia small business owners can purchase coverage for their employees through the state's Small Health Option Program (SHOP) exchange, or from a private insurance agent or broker.
Affordable Care Act Standardized Essential Health Benefits
As per the ACA, all qualifying health insurance plans must offer 10 standardized essential benefits.
Depending on the state, additional benefits may also be required. The 10 ACA standardized essential benefits are as follows:
- Ambulatory patient services (medical care that is offered without being admitted to a hospital)
- Emergency services
- Hospitalizations, such as overnight stays and surgical procedures
- Lab services
- Mental health and substance abuse disorder services, including behavioral health treatments, such as psychotherapy and counseling
- Pediatric health care services, including vision and oral care; however, adult vision and dental coverage aren't essential health benefits under ACA
- Pregnancy, maternity, and newborn care, including before and after birth
- Prescription pharmaceuticals
- Preventative and wellness services, as well as management for chronic diseases
- Rehabilitative and habilitative services and devices, including services and devices for injuries, disabilities, and chronic health conditions
Additional Health Benefits Mandated In Virginia
In addition to including the essential standardized benefits that the Affordable Care Act requires, in Virginia, health insurance policies must also include benefits that have been mandated by the state government. These benefits exceed the requirements of the ACA and include the following:
- Coverage for procedures that pertain to bones and joints
- Clinical trials for cancer treatment studies
- Diabetes care management
- Early intervention services
- Hospice services
- Health care coverage for victims of rape and incest
- Reconstructive surgery following mastectomy
Standardized Virginia Small Business Health Insurance Plans
In order to make it easier to compare costs and benefits, the Affordable Care Act has designated all qualifying Virginia small business health insurance plans to be one of four metal colors, including Bronze, Silver, Gold, and Platinum.
Each of these designations is based on the average amount of health care costs that the plan will cover, which is illustrates at percentages of how much the insurance company will cover for health care, as well as the amount the insured will have to pay out-of-pocket.
All insurance companies that are participating in the federal or state health care exchange program must offer at least the Silver and Gold Virginia small business health insurance plans.
All four of the metal plans have a shared maximum out-of-pocked amount that the insured can be charged during any calendar year. The following table illustrates this information:
As per the ACA, individuals cannot be denied coverage or charged higher premiums because of their past health history, or their gender.
Additionally, look-back and waiting periods cannot be imposed. Additionally, policies are effective when they are issued and all coverage is renewable if the individual chooses to renew the policy.
However, plans can be canceled if the individual fails to pay their premiums or commits fraud.
How Are VA Health Insurance Premiums Determined?
A premium is the amount the insured must pay out-of-pocket in order to maintain their health insurance policy. The premiums that are charged for any of the qualifying metal plans can be based on the following:
- Age of the individual
- Whether or not the individual uses tobacco
- Where the individual lives, based on a rating area
- The number of family members who will be enrolling
While there are several types of health insurance plans to choose from, the following plans are the most popular among VA small business owners:
Health Maintenance Organization - Simply known as an "HMO", this type of plan offers a variety of health-related services via a network of health care providers and hospitals that exclusively contract with the HMO, or who agree to offer their services to members of the HMO. Employees who participate in this type of plan usually have to choose a primary care physician (PCP), and receive most of their care from this physician. If a specialist is needed, the PCP will recommend one that is affiliated with the HMO.
Preferred Provider Organization - More commonly referred to simply as "PPO", this type of health insurance plan is the most common among Virginia small business owners. The insurance company provides a preferred list of health care providers, and employees must receive their medical care from the doctors and hospitals on that list for their claims to be paid at the highest level possible - but they also have the flexibility to see any other provider anywhere in or out of state.
Point-of-Service Plan - Known as a (POS), this type of health insurance plan provides access to health care services at a lower overall cost, but with fewer choices. Members can access care from in-network or out-of-network providers and facilities, but coverage is better when you stay in-network. POS plans may vary, but generally, plans are considered a blend of HMO and PPO plans - offering more flexibility than HMOs, but less than PPOs.
Health Savings Account - A health savings account (HSA) is a special type of bank account that allows participants in the insurance plan to save money that can be used specifically for the medical care they require in the future. HSA-qualified health insurance plans are usually PPO plans that are specifically designed to be used with an HSA.
Indemnity Health Insurance - This type of health insurance plan allows members to control their own health care and to visit any doctor or hospital they choose. The insurance company would then pay a pre-determined percentage of the total charges for the services that were rendered. Employees may have to pay for some types of services up-front and then they can submit a request for reimbursement with the insurance company.
Virginia Small Business Health Insurance Plans - The Bottom Line
We strongly advise business owners to speak with a CPA and a VA health insurance broker before jumping in and getting any type of the Virginia small business health insurance plans available.
Make sure that you know exactly what each option can do for your company and the potential drawbacks associated with it.
Request a free Virginia small business health insurance plans quote in these other VA cities: Alexandria, Annandale, Arlington, Ashburn, Bailey's Crossroads, Blacksburg, Bon Air, Brambleton, Brandermill, Bristol, Broadlands, Buckhall, Bull Run, Burke, Burke Centre, Cave Spring, Centreville, Chantilly, Charlottesville, Cherry Hill, Chesapeake, Chester, Christiansburg, Colonial Heights, Culpeper, Dale City, Danville, East Highland Park, Fair Oaks, Fairfax, Falls Church, Fort Hunt, Franconia, Franklin Farm, Fredericksburg, Front Royal, Gainesville, Glen Allen, Great Falls, Groveton, Hampton, Harrisonburg, Herndon, Highland Springs, Hollins, Hopewell, Hybla Valley, Idylwood, Kings Park West, Kingstowne, Lake Ridge, Lakeside, Laurel, Leesburg, Lincolnia, Linton Hall, Lorton, Lynchburg, Manassas, Manassas Park, Martinsville, Marumsco, McLean, McNair, Meadowbrook, Mechanicsville, Merrifield, Montclair, Neabsco, Newington, Newport News, Norfolk, Oakton, Petersburg, Portsmouth, Radford, Reston, Richmond, Roanoke, Rose Hill, Salem, Short Pump, South Riding, Springfield, Staunton, Sterling, Sudley, Suffolk, Timberlake, Tuckahoe, Tysons, Vienna, Virginia Beach , Waynesboro, West Falls Church, West Springfield, Williamsburg, Winchester, Wolf Trap, Woodlawn and all other VA cities & Virginia counties near me in Old Dominion.
Learn about Virginia small business insurance requirements for general liability, business property, commercial auto & workers compensation including VA business insurance costs. Call us (703) 747-9779 .
Small Business Health Insurance Plans By State
You can find more state specific small business health insurance information including requirments and coverage by clicking on the state below:
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Virginia health insurance plans
You have more insurance options for your health than you think, Virginia
If you’re self-employed or without insurance from your employer — in other words, you’re looking for individual or family health insurance in Virginia — you might be looking for Affordable Care Act insurance, what's often called Obamacare. However, we want to make you aware of the whole range of individual and family insurance products we have available in your state.
Plans for health insurance coverage in Virginia
Short term health insurance in virginia.
A temporary medical insurance plan like short term health insurance 1 underwritten by Golden Rule Insurance Company may provide:
- Budget-friendly monthly payments
- Health care coverage while you search for a long term option
Questions about short term insurance? Call 1-844-711-0168 / TTY 711 to talk to a representative.
UnitedHealthcare Individual & Family ACA Marketplace plans in Virginia
Looking for health care plans on the Affordable Care Act (ACA) Marketplace? UnitedHealthcare Individual & Family ACA Marketplace plans offer affordable, reliable coverage options from Optimum Choice, Inc.
As part of the American Rescue Plan Act of 2021 and Inflation Reduction Act of 2022 , many individuals and families are now eligible for lower — or in some cases $0 2, 3, 4 — monthly premiums for ACA Marketplace health coverage.
Call 1-800-273-8095 / TTY 711 to talk to a licensed insurance agent.
Already a member with a UnitedHealthcare Individual & Family ACA Marketplace plan? Sign in or call 1-877-265-9199 / TTY 711
Supplemental, dental and vision insurance in Virginia
Hospital & doctor insurance.
Health ProtectorGuard fixed indemnity insurance , 5 underwritten by Golden Rule Insurance Company, can supplement your major medical plan by paying cash for eligible, covered medical services, like a doctor visit, a trip to urgent care or a surgical procedure.
- No deductibles or copays to pay first
- Benefits paid regardless of other insurance
- Money to pay costs not covered by major medical plans, like a deductible
Accidental injuries happen when you least expect them. Those unexpected expenses can strain any budget. Accident insurance 5 can help by paying cash benefits for covered injuries.
Browse coverage options in Virginia
From Richmond to Virginia Beach, Norfolk to Alexandria, explore these Virginia health insurance options and more that may be available now.
Looking for other health plans?
- Small business plans
- Self-employed health insurance plans
- College student health insurance
Need help finding a plan?
Answer a few questions to see which insurance options may be available for you.
Health insurance for individuals who are 65 or older , or those under 65 who may qualify because of a disability or another special situation.
Call 1-844-232-1426 to learn more.
We offer low cost or no cost health insurance plans for those with limited incomes.