SMALL GROUP FROM BLUE CROSS BLUE SHIELD OF ILLINOIS

Small Business Insurance Services Inc. is a brokerage firm that has no allegiance to any insurance company. Our agents are also multi state licensed. We will shop all major carriers for you so you always get the best plan at the lowest price. There are many ways for consumers to purchase health insurance. The best way is to use an experienced broker, most especially since it costs nothing extra to do so.

Call us directly at (630) 674 1551. If you are outside of Illinois call us toll free at (866) 724-7123 for a free no obligation telephone consultation from one of our licensed brokers. Or, complete the form below to submit your group’s census so we can prepare quotes for your business. If you have a copy of your company census, please also upload that in the section provided.

Group health insurance carriers represented by HealthInsuranceMentors.com

Blue Cross Blue Shield of Illinois was named as one of America’s best insurance companies by Forbes magazine.

BCBSIL Small Group Health Insurance PPO and HMO outpatient prescription drug Formulary lists:

Click here to search the BCBSIL 2025 outpatient prescription drug Formulary list for PPO ACA-qualified (Obamacare) plans.

Click here to search the BCBSIL 2025 outpatient prescription drug list for HMO ACA-qualified (Obamacare) plans.

2025 QHP Small Group Summary of Benefits & Coverage

Blue Choice Preferred PPO Platinum Plans

Blue Choice Preferred Gold PPO Plans

Blue Choice Preferred Silver PPO Plans

Blue Choice Preferred Bronze PPO Plans

Blue Options Platinum Plans

P5N1OPT Blue Options Platinum PPO 403

Blue Options Gold Plans

Blue Options Silver PPO Plans

Blue PPO Platinum Plans

Blue PPO Gold Plans

Blue PPO Silver Plans

Blue PPO Bronze Plans

Blue Precision Platinum HMO Plans

Blue Precision Gold HMO Plans

Blue Precision Silver HMO Plans

2025 Fully Insured Small Group Policy Design Changes

Click here to download small group policy design changes coming in 2025.

2025 Fully Insured Small Group Summary of Dental Benefits

Contributory

Voluntary

2025 Embedded Pediatric Dental Benefit for Medical Plans

Click here to search the 2024 BCBSIL outpatient prescription drug Formulary list for PPO and HMO ACA-qualified (Obamacare) plans. Once at that page, scroll down and click on “Prescription Drug Lists for Employer-offered Metallic Plans: Small Group (1-50)“

2024 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

B5N1BCE Blue Choice Preferred Bronze PPO 401 for 2024
B536BCE Blue Choice Preferred Bronze PPO 132 for 2024 – (HSA-qualified)
B535BCE Blue Choice Preferred Bronze PPO 106 for 2024 – (HSA-qualified)

S535BCE Blue Choice Preferred Silver PPO 105 for 2024
S534BCE Blue Choice Preferred Silver PPO 133 for 2024 – (HSA-qualified)
S532BCE Blue Choice Preferred Silver PPO 120 for 2024
S531BCE Blue Choice Preferred Silver PPO 104 for 2024
S5J1BCE Blue Choice Preferred Silver PPO 202 for 2024 – (HSA-qualified)

G535BCE Blue Choice Preferred Gold PPO 115 for 2024 – (HSA-qualified)
G533BCE Blue Choice Preferred Gold PPO 113 for 2024 – (HSA-qualified)
G532BCE Blue Choice Preferred Gold PPO 107 for 2024
G531BCE Blue Choice Preferred Gold PPO 102 for 2024
G530BCE Blue Choice Preferred Gold PPO 101 for 2024

P5E2BCE Blue Choice Preferred Platinum PPO 119 for 2024
P5E1BCE Blue Choice Preferred Platinum PPO 136 for 2024

Fully Insured Small Group Summary of Dental Benefits

Contributory

Voluntary

Embedded Pediatric Dental Benefit for Medical Plans

2023 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

B536BCE Blue Choice Preferred Bronze PPO 132 for 2023 – (HSA-qualified)
B535BCE Blue Choice Preferred Bronze PPO 106 for 2023 – (HSA-qualified)

S535BCE Blue Choice Preferred Silver PPO 105 for 2023
S534BCE Blue Choice Preferred Silver PPO 133 for 2023 – (HSA-qualified)
S532BCE Blue Choice Preferred Silver PPO 120 for 2023
S531BCE Blue Choice Preferred Silver PPO 104 for 2023
S5J1BCE Blue Choice Preferred Silver PPO 202 for 2023 – (HSA-qualified)

G535BCE Blue Choice Preferred Gold PPO 115 for 2023 – (HSA-qualified)
G533BCE Blue Choice Preferred Gold PPO 113 for 2023 – (HSA-qualified)
G532BCE Blue Choice Preferred Gold PPO 107 for 2023
G531BCE Blue Choice Preferred Gold PPO 102 for 2023
G530BCE Blue Choice Preferred Gold PPO 101 for 2023

P5E2BCE Blue Choice Preferred Platinum PPO 119 for 2023
P5E1BCE Blue Choice Preferred Platinum PPO 136 for 2023

2023 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

S506OPT Blue Options Silver PPO 104 for 2023
S507OPT Blue Options Silver PPO 107 for 2023 – (HSA-qualified)

G506OPT Blue Options Gold PPO 101 for 2023
G507OPT Blue Options Gold PPO 102 for 2023
G508OPT Blue Options Gold PPO 106 for 2023
G5K10OPT Blue Options Gold PPO 200 for 2023 – (HSA-qualified)

2023 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

B536PPO Blue PPO Bronze 132 for 2023 – (HSA-qualified)
B535PPO Blue PPO Bronze 106 for 2023 – (HSA-qualified)

S535PPO Blue PPO Silver 105 for 2023
S534PPO Blue PPO Silver 133 for 2023 – (HSA-qualified)
S532PPO Blue PPO Silver 120 for 2023
S531PPO Blue PPO Silver 104 for 2023
S5J1PPO Blue PPO Silver 200 for 2023 – (HSA-qualified)

G537PPO Blue PPO Gold 123 for 2023
G536PPO Blue PPO Gold 116 for 2023
G535PPO Blue PPO Gold 115 for 2023 – (HSA-qualified)
G534PPO Blue PPO Gold 114 for 2023
G533PPO Blue PPO Gold 113 for 2023 – (HSA-qualified)
G532PPO Blue PPO Gold 107 for 2023
G531PPO Blue PPO Gold 102 for 2023
G530PPO Blue PPO Gold 101 for 2023

P503PPO Blue PPO Platinum 119 for 2023
P5E1PPO Blue PPO Platinum 136 for 2023

2023 BCBSIL Blue Precision HMO Small Group Plan Brochures:

S531PSN Blue Precision Silver HMO 106 for 2023
S530PSN Blue Precision Silver HMO 102 for 2023

G532PSN Blue Precision Gold HMO 101 for 2023
G5J2PSN Blue Precision Gold HMO 201 for 2023

P506PSN Blue Precision Platinum HMO 107 for 2023
P5J1PSN Blue Precision Platinum HMO 200 for 2023
P5E1PSN Blue Precision Platinum HMO 110 for 2023

2022 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

B536BCE Blue Choice Preferred Bronze PPO 132 for 2022 – (HSA-qualified)
B535BCE Blue Choice Preferred Bronze PPO 106 for 2022 – (HSA-qualified)

S535BCE Blue Choice Preferred Silver PPO 105 for 2022
S534BCE Blue Choice Preferred Silver PPO 133 for 2022 – (HSA-qualified)
S532BCE Blue Choice Preferred Silver PPO 120 for 2022
S531BCE Blue Choice Preferred Silver PPO 104 for 2022
S5J1BCE Blue Choice Preferred Silver PPO 202 for 2022 – (HSA-qualified)

G535BCE Blue Choice Preferred Gold PPO 115 for 2022 – (HSA-qualified)
G533BCE Blue Choice Preferred Gold PPO 113 for 2022 – (HSA-qualified)
G532BCE Blue Choice Preferred Gold PPO 107 for 2022
G531BCE Blue Choice Preferred Gold PPO 102 for 2022
G530BCE Blue Choice Preferred Gold PPO 101 for 2022

P5E2BCE Blue Choice Preferred Platinum PPO 119 for 2022
P5E1BCE Blue Choice Preferred Platinum PPO 136 for 2022

2022 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

S506OPT Blue Options Silver PPO 104 for 2022
S507OPT Blue Options Silver PPO 107 for 2022 – (HSA-qualified)

G506OPT Blue Options Gold PPO 101 for 2022
G507OPT Blue Options Gold PPO 102 for 2022
G508OPT Blue Options Gold PPO 106 for 2022
G5K10OPT Blue Options Gold PPO 200 for 2022

2022 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

B536PPO Blue PPO Bronze 132 for 2022 – (HSA-qualified)
B535PPO Blue PPO Bronze 106 for 2022 – (HSA-qualified)

S535PPO Blue PPO Silver 105 for 2022
S534PPO Blue PPO Silver 133 for 2022 – (HSA-qualified)
S532PPO Blue PPO Silver 120 for 2022
S531PPO Blue PPO Silver 104 for 2022
S5J1PPO Blue PPO Silver 200 for 2022 – (HSA-qualified)

G537PPO Blue PPO Gold 123 for 2022
G536PPO Blue PPO Gold 116 for 2022
G535PPO Blue PPO Gold 115 for 2022 – (HSA-qualified)
G534PPO Blue PPO Gold 114 for 2022
G533PPO Blue PPO Gold 113 for 2022 – (HSA-qualified)
G532PPO Blue PPO Gold 107 for 2022
G531PPO Blue PPO Gold 102 for 2022
G530PPO Blue PPO Gold 101 for 2022

P503PPO Blue PPO Platinum 119 for 2022
P5E1PPO Blue PPO Platinum 136 for 2022

2022 BCBSIL Blue Precision HMO Small Group Plan Brochures:

S531PSN Blue Precision Silver HMO 106 for 2022
S530PSN Blue Precision Silver HMO 102 for 2022

G532PSN Blue Precision Gold HMO 101 for 2022
G5J2PSN Blue Precision Gold HMO 201 for 2022

P506PSN Blue Precision Platinum HMO 107 for 2022
P5J1PSN Blue Precision Platinum HMO 200 for 2022
P5E1PSN Blue Precision Platinum HMO 110 for 2022

2022 BCBSTX Small Group Plans summary of benefits.

Blue Cross Blue Shield of Texas 2022 Small Group Plans.

BlueCare Dental PPO (Small Group) Plans

To help you make an informed decision about your dental coverage, a Small Group (1 to 50 employees) Summary of Dental Benefits document is available for each of our fully insured plans. The summary describes key features such as:

Program basics
Covered services
Orthodontic services

Pediatric dental coverage is included in all small group qualified health plans as an essential health benefit embedded into the medical plan.

Embedded Pediatric Dental Benefit for Medical Plans
- IL PPO Medical Plan
- IL HMO Medical Plan
Fully Insured Small Group Summary of Dental Benefits
Contributory
Voluntary

Principal Broker, C. Steven Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the impact of the “Inflation Reduction Act” on Medicare Part D and enhanced ACA health insurance subsidies now extended until 2026 – 08/17/2022. Replay below:

2021 BCBSIL Small Group Health Insurance PPO and HMO outpatient prescription drug Formulary lists:

Click here to search the outpatient prescription drug Formulary list for PPO ACA-qualified (Obamacare) plans. Once at that page, scroll down and click on
“Prescription Drug Lists for Employer-offered Metallic Plans: Small Group (1-50)“

2021 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

B536BCE Blue Choice Preferred Bronze PPO 132 for 2021 – (HSA-qualified)
B535BCE Blue Choice Preferred Bronze PPO 106 for 2021 – (HSA-qualified)

S535BCE Blue Choice Preferred Silver PPO 105 for 2021
S534BCE Blue Choice Preferred Silver PPO 133 for 2021 – (HSA-qualified)
S532BCE Blue Choice Preferred Silver PPO 120 for 2021
S531BCE Blue Choice Preferred Silver PPO 104 for 2021
S501BCE Blue Choice Preferred Silver PPO 135 for 2021
S5J1BCE Blue Choice Preferred Silver PPO 202 for 2021 – (HSA-qualified)

G535BCE Blue Choice Preferred Gold PPO 115 for 2021 – (HSA-qualified)
G533BCE Blue Choice Preferred Gold PPO 113 for 2021 – (HSA-qualified)
G532BCE Blue Choice Preferred Gold PPO 107 for 2021
G531BCE Blue Choice Preferred Gold PPO 102 for 2021
G530BCE Blue Choice Preferred Gold PPO 101 for 2021

P532BCE Blue Choice Preferred Platinum 119 for 2021
P5E1BCE Blue Choice Preferred Platinum 136 for 2021

2021 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

S506OPT Blue Options Silver PPO 104 for 2021
S507OPT Blue Options Silver PPO 107 for 2021 – (HSA-qualified)

G506OPT Blue Options Gold PPO 101 for 2021
G507OPT Blue Options Gold PPO 102 for 2021
G508OPT Blue Options Gold PPO 106 for 2021

2021 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

B536PPO Blue PPO Bronze 132 for 2021 – (HSA-qualified)
B535PPO Blue PPO Bronze 106 for 2021 – (HSA-qualified)

S535PPO Blue PPO Silver 105 for 2021
S534PPO Blue PPO Silver 133 for 2021 – (HSA-qualified)
S532PPO Blue PPO Silver 120 for 2021
S531PPO Blue PPO Silver 104 for 2021
S501PPO Blue PPO Silver 135 for 2021
S5J1PPO Blue PPO Silver 200 for 2021 – (HSA-qualified)

G537PPO Blue PPO Gold 123 for 2021
G536PPO Blue PPO Gold 116 for 2021
G535PPO Blue PPO Gold 115 for 2021 – (HSA-qualified)
G534PPO Blue PPO Gold 114 for 2021
G533PPO Blue PPO Gold 113 for 2021 – (HSA-qualified)
G532PPO Blue PPO Gold 107 for 2021
G531PPO Blue PPO Gold 102 for 2021
G530PPO Blue PPO Gold 101 for 2021

P503PPO Blue PPO Platinum 119 for 2021

2021 BCBSIL Blue Precision HMO Small Group Plan Brochures:

S531PSN Blue Precision Silver HMO 106 for 2021
S530PSN Blue Precision Silver HMO 102 for 2021

G532PSN Blue Precision Gold HMO 101 for 2021
G5J2PSN Blue Precision Gold HMO 201 for 2021

P506PSN Blue Precision Platinum HMO 107 for 2021
P5J1PSN Blue Precision Platinum HMO 200 for 2021
P5E1PSN Blue Precision Platinum HMO 110 for 2021

Group health insurance for ONE PERSON ensures access to Chicago Teaching hospitals for small businesses owners.

In November of 2015, Chicagoland residents were shocked to learn that Northwestern Memorial hospital, University of Chicago medical center, Rush University medical center and the Lurie Children’s hospital would no longer accept patients who have ACA-qualified (Obamacare) individual health insurance plans. This action led to a significant increase in the purchase of small group health insurance policies which still provide national PPO networks and still ensure access to the aforementioned teaching hospitals in Chicago.

For small corporations who could afford to insure themselves and 70% of their eligible full time employees (the usual minimum participation requirement), purchasing small group health insurance was a costly fix to the new narrow networks in the individual health insurance marketplace. The ability to purchase group health insurance for you and your full-time employees is well known. What is not well known is the fact that you can purchase a small group health insurance policy without insuring any of your employees during a small window each year. That window begins on November 1st and ends on December 15th. The same time period the annual ACA Open Enrollment for individual plans begins and ends.

During this little known ‘relaxed underwriting’ period, an owner of a small corporation (less than 50 full-time employees) can purchase small group health insurance while employees ‘waive’ coverage without producing an eligible waiver. Normally, 70% of all full-time employees must participate in a group health insurance plan unless they have an eligible waiver such as an offer of group health insurance from a spouse’s employer or Medicare and Medicaid coverage. If you do decide to offer coverage to your full-time W2 employees during this Special Enrollment period, you do not have to insure any of your employees and instead can only insure yourself and or your family without insuring employees. Normal 70% minimum participation requirements are waived.

If you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or, your employees simply do not want to participate in a group health insurance plan. Now is the time to learn more about “relaxed underwriting period”. The cost for group health insurance is now commensurate with individual health insurance but the PPO network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace. Want to learn more? Call us for a free consultation at (630) 582-1043 or click on “contact” at the top of this page.

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2021 Mid Market Small Group Health Plan Offerings:

MIEEE2060 Summary of Benefits

MIESA210 Summary of Benefits

Other small group carriers brokered by HealthInsuranceMentors.com

United Healthcare Small Group plans for Chicagoland 2021

NW Indiana Plans

51+ lives – Small Group Product Portfolio Illinois & Northwest Indiana

Chicago/NW IN 51+ ATNE

2020 BCBSIL Blue Precision HMO Small Group Health Insurance Plan Brochures:

P506PSN Blue Precision Platinum HMO 107

P5E1PSN Blue Precision Platinum HMO 110

G532PSN Blue Precision Gold HMO 101

G533PSN Blue Precision Gold HMO 109

S531PSN Blue Precision Silver HMO 106

S530PSN Blue Precision Silver HMO 102

2020 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

P5E1BCE Blue Choice Preferred Platinum PPO 136

P5E2BCE Blue Choice Preferred Platinum PPO 119

G530BCE Blue Choice Preferred Gold PPO 101

G532BCE Blue Choice Preferred Gold PPO 107

S531BCE Blue Choice Preferred Silver PPO 104

S532BCE Blue Choice Preferred Silver PPO 120

S535BCE Blue Choice Preferred Silver PPO 105

HSA-qualified BCBSIL Blue Choice Preferred PPO Small Group offerings:

G533BCE Blue Choice Preferred Gold PPO 113

G535BCE Blue Choice Preferred Gold PPO 115

S534BCE Blue Choice Preferred Silver PPO 133

B536BCE Blue Choice Preferred Bronze PPO 132

B535BCE Blue Choice Preferred Bronze PPO 106

2020 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

G506OPT Blue Options Gold PPO 101

G508OPT Blue Options Gold PPO 106

G507OPT Blue Options Gold PPO 102

S506OPT Blue Options Silver PPO 104

S507OPT Blue Options Silver PPO 107 HSA-qualified plan

2020 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

P503PPO Blue PPO Platinum 119

P5E1PPO Blue PPO Platinum 136

G534PPO Blue PPO Gold 114

G532PPO Blue PPO Gold 107

G536PPO Blue PPO Gold 116

G537PPO Blue PPO Gold 123

G531PPO Blue PPO Gold 102

G530PPO Blue PPO Gold 101

S532PPO Blue PPO Silver 120

S501PPO Blue PPO Silver 135

S531PPO Blue PPO Silver 104

S535PPO Blue PPO Silver 105

HSA-qualified BCBSIL Blue PPO Small Group offerings:

G533PPO Blue PPO Gold 113

G535PPO Blue PPO Gold 115

S534PPO Blue PPO Silver 133

B536PPO Blue PPO Bronze 132

B535PPO Blue PPO Bronze 106

2019 BCBSIL Small Group Health Insurance Plan Brochures:

P503PPO Blue PPO Platinum 119

P500 PPO Blue PPO Platinum 019

G536PPO Blue PPO Gold 116

G512PPO Blue PPO Gold 011

G515PPO Blue PPO Gold 014

G533PPO Blue PPO Gold 113

G530PPO Blue PPO Gold 101

S531PPO Blue PPO Silver 104

S534PPO Blue PPO Silver 133

B535PPO Blue PPO Bronze 106

B535BCE Blue Choice Preferred Bronze PPO 106

S531BCE Blue Choice Preferred Silver PPO 104

S530PSN Blue Precision Silver HMO 102

G506OPT Blue Options Gold PPO 101

G508OPT Blue Options Gold PPO 106

G507OPT Blue Options Gold PPO 102

S506OPT Blue Options Silver PPO 104

S507OPT Blue Options Silver PPO 107

BCBSIL B520 PPO Blue PPO Bronze 006

BCBSIL S508 PPO Blue PPO Silver 030

BCBSIL S500 PPO Blue PPO Silver 031

BCBSIL B501PPO Blue PPO Bronze 032

P502PSN Blue Precision Platinum HMO 007

Blue Precision HMO 2016 group certificate

2018 BCBSIL Small Group Health Insurance Plan Brochures:

S534PPO Blue PPO Silver 133

S534BCE Blue Choice Preferred Silver PPO 133

S532BCH Blue Care Direct Silver 106 with Advocate

2017 BCBSIL Small Group Health Insurance Plan Brochures:

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s508ppobluepposilver030

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2016 BCBSIL Small Group Health Insurance Plan Brochures:

P500 PPO Blue PPO Platinum 019

G512PPO Blue PPO Gold 011

G515PPO Blue PPO Gold 014

BCBSIL B520 PPO Blue PPO Bronze 006

BCBSIL S508 PPO Blue PPO Silver 030

BCBSIL S500 PPO Blue PPO Silver 031

BCBSIL B501PPO Blue PPO Bronze 032

P502PSN Blue Precision Platinum HMO 007

Blue Precision HMO 2016 group certificate

BlueCare Dental DILHR03

BlueCare Dental DILHR04

BlueCare Dental DILLM11

BlueCare Dental DILLM15

2015 BCBSIL Small Group Health Insurance Plan Brochures:

BCBSIL 2015 Small Group P500PPO Platinum 019

BCBSIL 2015 Small Group G515PPO Blue PPO Gold 014

BCBSIL 2015 Small Group G511PPO Blue PPO Gold 010

BCBSIL 2015 Small Group G510PPO Blue PPO Gold 002

BCBSIL 2015 Small Group G517PPO Blue PPO Gold 016

BCBSIL 2015 Small Group G518PPO Blue PPO Gold 023

BCBSIL 2015 Small Group G509PPO Blue PPO Gold 001

BCBSIL G511CHC Blue Choice Gold PPO 007

BCBSIL 2015 Small Group S506PPO Blue PPO Silver 020

BCBSIL 2015 Small Group S503PPO Blue PPO Silver 004

BCBSIL S508 PSN Blue Precision Silver HMO 002

BCBSIL S503CHC Small Group plan 2015

BCBSIL 2015 Small Group S502PPO Blue PPO Silver 003

BCBSIL 2015 Small Group B519PPO Blue PPO Bronze 005

BCBSIL 2015 Small Group P501PPO Blue PPO Platinum 022

BCBSIL 2015 Small Group G519PPO Blue PPO Gold 024

BCBSIL 2015 Small Group G512PPO Blue PPO Gold 011

BCBSIL 2015 Small Group G520PPO Blue PPO Gold 025

BCBSIL 2015 Small Group G513PPO Blue PPO Gold 012

BCBSIL 2015 Small Group B520PPO Blue PPO Bronze 006

BCBSIL 2015 Small Group G521PPO Blue PPO Gold 026

BCBSIL RHHHB10C Blue Advantage HMO Small Group 2015

BCBSIL P501PSN Blue Precision Platinum 004 Small Group

BCBSIL RPPC3424 Blue Advantage Entrepreneur PPO Small Group 2015

BCBSIL Blue Advantage Entrepreneur Small Group PPO Certificate Of Coverage

BCBSIL Small Group PPO Blue Care Dental Freedom policy

BCBSIL Ancillary Small Group Dental Insurance Plan Brochures:

BlueCare Dental DILHR01

BlueCare Dental DILHR03

BlueCare Dental DILHR04

BlueCare Dental DILLM11

BlueCare Dental Group Dental Plans 2019

Small and large employer obligations under the Patient Protection & Affordable Care Act (Obamacare)

Employers with 100 or more FTE – Full Time Equivalent – employees are required to offer “affordable health insurance” (employee’s share of the annual premium for self-only coverage is no greater than 9.5% of annual household income) to all of their Full Time employees and their dependent children (first 30 Full Time employees are excluded) or pay a non tax deductible “Employer Shared Responsibility” payment to the IRS.

This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.

To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”

Click here to determine how many ‘Full Time Equivalent’ employees you have.

Employers with 50 to 100 FTE – Full Time Equivalent – employees are required to offer affordable health insurance to all their Full Time employees and their dependents (children under 26) or pay a monthly non tax deductible “Employer Shared Responsibility” payment to IRS for all but 30 of their Full Time Equivalent employees.

Click here to determine how many ‘Full Time Equivalent’ employees you have.

The “Employer Shared Responsibility” payment is triggered and assessed in one of two ways:

1.) $2,000 per employee penalty to employers that do not offer affordable, qualified health insurance to their Full Time Equivalent employees and their dependent children. This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.

2.) $3,000 per employee penalty to employers that do offer health insurance but that health insurance is deemed either not ‘affordable’ or not a ‘qualified health plan’ and one or more Full Time employee buys health insurance on the exchange and receives an APTC – Advance Premium Tax Credit – (subsidy). In this scenario the employer would be assessed a $3,000 penalty for each employee who received a subsidy.

How does an employer know whether the coverage it offers is affordable?

If an employee’s share of the premium for employer-provided coverage would cost the employee more than 9.5% of that employee’s annual household income, the coverage is not considered affordable for that employee. Because employers generally will not know their employee’s household incomes, employers can take advantage of one or more of the three affordability safe harbors set forth in the final regulations that are based on information the employer will have available, such as the employee’s Form W-2 wages or the employee’s rate of pay. If an employer meets the requirements of any of these safe harbors, the offer of coverage will be deemed affordable for purposes of the Employer Shared Responsibility provisions regardless of whether it was affordable to the employee for purposes of the premium tax credit.

The three affordability safe harbors are (1) the Form W-2 wages safe harbor, (2) the rate of pay safe harbor, and (3) the federal poverty line safe harbor. These safe harbors are all optional. An employer may use one or more of the safe harbors only if the employer offers its full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan that provides minimum value for the self-only coverage offered to the employee. An employer may choose to use one or more of the safe harbors for all of its employees or for any reasonable category of employees, provided it does so on a uniform and consistent basis for all employees in a category. If an employer offers multiple healthcare coverage options, the affordability test applies to the lowest-cost self-only option available to the employee that also meets the minimum value requirement.

The Form W-2 wages safe harbor generally is based on the amount of wages paid to the employee that are reported in Box 1 of that employee’s Form W-2. The rate of pay safe harbor generally is based on the employeeâs rate of pay at the beginning of the coverage period, with adjustments permitted, for an hourly employee, if the rate of pay is decreased (but not if the rate of pay is increased). The federal poverty line safe harbor generally treats coverage as affordable if the employee contribution for the year does not exceed 9.5% of the federal poverty line for a single individual for the applicable calendar year. The final regulations provide additional information on these affordability safe harbors.

How does an employer know whether the coverage it offers provides minimum value?

A plan provides minimum value if it covers at least 60 percent of the total allowed cost of benefits that are expected to be incurred under the plan. The Department of Health and Human Services (HHS) and the IRS have produced a minimum value calculator. By entering certain information about the plan, such as deductibles and co-pays, into the calculator employers can get a determination as to whether the plan provides minimum value. Additionally, on May 3, 2013, Treasury and the IRS issued proposed regulations regarding the other methods available to determine minimum value.

If an employer offers health coverage that is affordable and that provides minimum value to its full-time employees and offers health coverage to the dependents of those employees, will it be subject to an Employer Shared Responsibility payment if some of its employees purchase health insurance through a Marketplace or if some of its employees enroll in Medicare or Medicaid?

No. An applicable large employer will not be subject to an Employer Shared Responsibility payment solely because one, some, or all of its employees purchase health insurance coverage through a Marketplace or enroll in Medicare or Medicaid. An employer will not be liable for an Employer Shared Responsibility payment unless at least one full-time employee receives a premium tax credit. In general, an employee will not be eligible for a premium tax credit if the employer has offered that employee health coverage that is affordable and that provides minimum value, even if that employee rejects the offer of coverage and instead enrolls in coverage through a Marketplace or enrolls in Medicare or Medicaid. If no full-time employee receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment.

If an employer offers health coverage that is affordable and that provides minimum value to its full-time employees and offers health coverage to the dependents of those employees, will it be subject to an Employer Shared Responsibility payment if an employee’s spouse purchases health insurance through a Marketplace, or if a spouse enrolls in Medicare or Medicaid?

No. To avoid a potential Employer Shared Responsibility payment an applicable large employer must offer health coverage that is affordable and provides minimum value to its full-time employees and must offer health coverage to the dependents of those employees. For this purpose, a spouse is not a dependent. An applicable large employer will not be subject to an Employer Shared Responsibility payment solely because it does not offer health coverage to an employeeâs spouse or if the spouse purchases health insurance coverage through a Marketplace or enrolls in Medicare or Medicaid. An employer will not be liable for an Employer Shared Responsibility payment unless a full-time employee receives a premium tax credit. If no full-time employee receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment. Thus, even if an employeeâs spouse receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment.

If an applicable large employer offers health coverage that is affordable and that provides minimum value to a full-time employeeâs spouse, the spouse will not be eligible for the premium tax credit. For more information about eligibility for the premium tax credit, see our final regulations and questions and answers.

All penalties are collected by the Internal Revenue Service and enforced by the Department of the U.S. Treasury.

Under the PPACA – Patient Protection and Affordable Care Act – employer group plans now must offer an annual open enrollment period which begins November 15th and ends December 15th of each calendar year.

Special enrollment periods for Group health insurance plans.

Small Group Frequently Asked Questions

SMALL GROUP FROM BLUE CROSS BLUE SHIELD OF ILLINOIS

Group health insurance carriers represented by HealthInsuranceMentors.com

Blue Cross Blue Shield of Illinois was named as one of America’s best insurance companies by Forbes magazine.

BCBSIL Small Group Health Insurance PPO and HMO outpatient prescription drug Formulary lists:

2025 QHP Small Group Summary of Benefits & Coverage

Blue Choice Preferred PPO Platinum Plans

Blue Choice Preferred Gold PPO Plans

Blue Choice Preferred Silver PPO Plans

Blue Choice Preferred Bronze PPO Plans

Blue Options Platinum Plans

Blue Options Gold Plans

Blue Options Silver PPO Plans

Blue PPO Platinum Plans

Blue PPO Gold Plans

Blue PPO Silver Plans

Blue PPO Bronze Plans

Blue Precision Platinum HMO Plans

Blue Precision Gold HMO Plans

Blue Precision Silver HMO Plans

2025 Fully Insured Small Group Policy Design Changes

Click here to download small group policy design changes coming in 2025.

2025 Fully Insured Small Group Summary of Dental Benefits

2025 Embedded Pediatric Dental Benefit for Medical Plans

2024 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

2024 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

2024 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

2024 BCBSIL Blue Precision HMO Small Group Plan Brochures:

Fully Insured Small Group Summary of Dental Benefits

Embedded Pediatric Dental Benefit for Medical Plans

2023 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

2023 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

2023 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

2023 BCBSIL Blue Precision HMO Small Group Plan Brochures:

2022 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

2022 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

2022 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

2022 BCBSIL Blue Precision HMO Small Group Plan Brochures:

2022 BCBSTX Small Group Plans summary of benefits.

BlueCare Dental PPO (Small Group) Plans

Embedded Pediatric Dental Benefit for Medical Plans

Fully Insured Small Group Summary of Dental Benefits

Principal Broker, C. Steven Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the impact of the “Inflation Reduction Act” on Medicare Part D and enhanced ACA health insurance subsidies now extended until 2026 – 08/17/2022. Replay below:

2021 BCBSIL Small Group Health Insurance PPO and HMO outpatient prescription drug Formulary lists:

2021 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

2021 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

2021 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

2021 BCBSIL Blue Precision HMO Small Group Plan Brochures:

Group health insurance for ONE PERSON ensures access to Chicago Teaching hospitals for small businesses owners.

Group health insurance quote request form

2021 Mid Market Small Group Health Plan Offerings:

Other small group carriers brokered by HealthInsuranceMentors.com

United Healthcare Small Group plans for Chicagoland 2021

2020 BCBSIL Blue Precision HMO Small Group Health Insurance Plan Brochures:

2020 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:

2020 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:

2020 BCBSIL Blue PPO Small Group Health Insurance plan offerings:

2019 BCBSIL Small Group Health Insurance Plan Brochures:

2018 BCBSIL Small Group Health Insurance Plan Brochures:

2017 BCBSIL Small Group Health Insurance Plan Brochures:

2016 BCBSIL Small Group Health Insurance Plan Brochures:

2015 BCBSIL Small Group Health Insurance Plan Brochures:

BCBSIL Ancillary Small Group Dental Insurance Plan Brochures:

Small and large employer obligations under the Patient Protection & Affordable Care Act (Obamacare)