Small Business Health Insurance in Davis County, Utah

Small businesses in Davis County with 1 to 50 employees can use the Small Business Health Options Program (SHOP) via HealthCare.gov.
In 2026, four carriers offer marketplace plans in Rating Area 3, which covers Davis, Salt Lake, Summit, Tooele, Wasatch counties.
Eligible small businesses may qualify for a tax credit covering up to 50% of premium contributions if they have fewer than 25 FTEs and meet wage requirements.
Marketplace plans in Utah offer Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) network types; PPO plans are not available on-exchange.

For small business owners in Davis County, Utah, providing health insurance to employees is a crucial decision that balances budget considerations with employee well-being. Whether you're a sole proprietor looking to expand coverage or an established small business with a growing team, understanding your options is the first step. In Davis County, you can access health plans through the Small Business Health Options Program (SHOP) on HealthCare.gov, or explore private plans directly from carriers. The local market offers a range of Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans, designed to meet diverse needs while adhering to state and federal regulations.

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What Are Small Business Health Insurance Options in Davis County?

Small businesses in Davis County have several avenues to secure health insurance coverage for their employees. The primary options include the federal marketplace (SHOP) and direct enrollment with private carriers.

SHOP Marketplace Plans (HealthCare.gov)

The Small Business Health Options Program (SHOP) is part of the Affordable Care Act (ACA) and is managed through HealthCare.gov in Utah. It's designed for businesses with 1 to 50 full-time equivalent (FTE) employees. Using SHOP allows eligible businesses to:

Offer employees a choice of plans from different carriers.
Potentially qualify for the Small Business Health Care Tax Credit, which can cover a significant portion of premium costs.
Simplify the enrollment and administration process.

To be eligible for SHOP, a business must have at least one employee besides the owner, spouse, or family members. All plans offered through the SHOP marketplace cover essential health benefits as mandated by the ACA.

Private & Off-Exchange Plans

Small businesses can also purchase health insurance directly from carriers or through a licensed insurance producer outside of HealthCare.gov. These are often referred to as "off-exchange" plans. While off-exchange plans offer flexibility in terms of plan design and network options (including some PPO plans not available on-exchange in Utah), businesses purchasing these plans are not eligible for the Small Business Health Care Tax Credit. It's important to compare benefits, networks, and costs carefully when considering off-exchange options.

Understanding Plan Types and Networks in Utah's Marketplace

When selecting a small business health plan in Davis County, you'll primarily encounter two types of network structures on the HealthCare.gov marketplace: Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO).

Health Maintenance Organization (HMO): HMO plans typically require employees to choose a primary care provider (PCP) within the plan's network. This PCP then coordinates all care and provides referrals to specialists. HMOs often have lower out-of-pocket costs and premiums but offer less flexibility in choosing providers outside the network.
Exclusive Provider Organization (EPO): EPO plans also use a specific network of doctors and hospitals. Unlike HMOs, EPOs generally do not require a referral to see a specialist, offering more direct access. However, care received outside the EPO network is typically not covered, except in emergencies.

It is important to note that PPO (Preferred Provider Organization) plans are NOT available on-exchange through HealthCare.gov in Utah. While PPO plans may be offered by private carriers off-exchange, they would not be eligible for federal subsidies or tax credits for your business. For marketplace shoppers, the choice is between HMO and EPO network structures.

Small Business Health Care Tax Credit Eligibility

One of the most significant advantages of purchasing small business health insurance through the SHOP marketplace is the potential to qualify for the Small Business Health Care Tax Credit. This credit can help make offering coverage more affordable for many employers.

Who Qualifies?

To be eligible for the tax credit, your small business in Davis County must meet specific criteria:

You must have fewer than 25 full-time equivalent (FTE) employees.
Your average annual employee wages must be less than $58,000 (for tax year 2024, this amount is subject to annual adjustment).
You must contribute at least 50% of the cost of employee-only (not family) health insurance premiums.
You must purchase coverage through the SHOP Marketplace on HealthCare.gov.

The maximum credit is 50% of the employer's contribution to premiums for small businesses and 35% for tax-exempt organizations. The credit is available for two consecutive tax years, providing substantial savings for qualifying businesses.

Health Insurance Carriers in Davis County

In 2026, 4 carriers offer marketplace plans in Rating Area 3, which covers Davis, Salt Lake, Summit, Tooele, Wasatch counties. These carriers provide a range of HMO and EPO plans for small businesses and individuals:

BridgeSpan Health Company
Regence BlueCross BlueShield of Utah
Select Health
University of Utah Health Plans

These carriers offer various plan tiers (Bronze, Silver, Gold) with different levels of cost-sharing and benefits. Small business owners should compare the networks, formularies, and specific plan benefits offered by each to find the best fit for their employees' needs and their company's budget.

Davis County, home to 370,924 residents, boasts a median income of $110,884, significantly above the state average, and an uninsured rate of 5.7% as of U.S. Census Bureau ACS 2024 5-year estimates. The county is served by four acute care hospitals, including Holy Cross Hospital-davis in Layton, Lakeview Hospital in Bountiful, Intermountain Health Layton Hospital in Layton, and Western Peaks Specialty Hospital in Bountiful, providing robust healthcare infrastructure for plan participants in Rating Area 3.

Making the Right Decision for Your Small Business

Choosing the right health insurance plan for your small business in Davis County involves evaluating several factors:

Budget: Determine how much your business can realistically contribute to premiums and what out-of-pocket costs employees can manage.
Employee Needs: Consider the demographics of your workforce. Do they prioritize lower premiums, extensive networks, or specific benefits?
Plan Types: Decide between HMO and EPO structures based on the flexibility and referral requirements that best suit your employees.
Tax Credits: Assess your eligibility for the Small Business Health Care Tax Credit if purchasing through the SHOP marketplace.

A licensed health insurance producer can help you navigate these choices, compare plans from different carriers, and determine your eligibility for tax credits. Their expertise ensures you find a compliant and cost-effective solution tailored to your Davis County business.

Frequently Asked Questions

What is the minimum number of employees required for small business health insurance in Davis County?

To qualify for a Small Business Health Options Program (SHOP) plan through HealthCare.gov, you generally need at least one full-time equivalent (FTE) employee besides yourself (the owner). If you are self-employed with no employees, you would typically purchase individual coverage.

Can my small business in Davis County qualify for tax credits?

Yes, small businesses with fewer than 25 full-time equivalent employees and average annual wages of less than $58,000 (for tax year 2024) may qualify for the Small Business Health Care Tax Credit. You must purchase coverage through the SHOP Marketplace (HealthCare.gov) to be eligible, and the credit can cover up to 50% of your contributions to employee premiums.

Are PPO plans available for small businesses on the HealthCare.gov marketplace in Utah?

No, PPO plans are not available on the HealthCare.gov marketplace in Utah, including Davis County. Small businesses purchasing through the marketplace will find plans with HMO and EPO network structures. PPO plans may be available directly from private carriers off-exchange, but these plans are not eligible for federal tax credits.

How do I choose between an HMO and EPO plan for my small business employees?

HMO (Health Maintenance Organization) plans typically require employees to choose a primary care provider (PCP) and get referrals for specialists. EPO (Exclusive Provider Organization) plans offer more flexibility, allowing employees to see specialists without referrals, but generally only cover care from providers within the plan's specific network (except for emergencies).