Work-based Private Insurance
The most common way of getting health insurance is through an employer. In the United States, most employers offer their workers the opportunity to join a group health plan, and approximately 92 percent of private health insurance is provided through employer-sponsored group health plans.
Depending on the number of employees, an employer might buy insurance in the small group market (usually between 2 and 50 employees) or the large group market.
- Small Group (usually 2 to 50 employees) – In Maine, the federal Marketplace will offer a variety of plans for employers through the Small Business Health Options Program (SHOP). In addition, tax credits are available for some small group coverage purchased on the Marketplace, to make it easier for small employers to offer coverage. The amount of credit a business will receive is based on a sliding scale, depending on the size of the business and average salary of the workers.
- Large Group (usually over 50) – Large employers tend to pay most of their employees’ premiums, but often contribute less, if anything, toward insurance for employees’ family members. It is generally the most affordable coverage for workers, although the qualify of coverage can vary significantly. Many companies with large group plans are “self-insured” which means they assume the risk and pay claims themselves, and are subject to different consumer protections and laws.