Updated July 2026 · UtahPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Small Business Health Insurance for Medical Practices in Clearfield, Utah

Small medical practices in Clearfield with fewer than 50 full-time employees have several options, including SHOP marketplace plans and direct-to-carrier policies.
In 2026, 4 health insurance carriers offer marketplace plans in Rating Area 3, which includes Clearfield. These plans are HMO and EPO only, as PPOs are not available on-exchange in Utah.
Practices with fewer than 25 full-time equivalent employees may qualify for a tax credit of up to 50% of premium contributions if they cover at least 50% of employee premiums.
Employees with incomes up to 138% of the Federal Poverty Level may qualify for Utah Medicaid, which expanded in 2020.

Finding the right health insurance for your medical practice in Clearfield, Utah, involves understanding both your business size and the specific options available in Rating Area 3. As a small business, you have access to plans through HealthCare.gov's Small Business Health Options Program (SHOP), as well as direct-to-carrier options. It's crucial to select a plan that meets the needs of your employees while also being financially sustainable for your practice. Utah's marketplace offers HMO and EPO plans, but PPO plans are not available on-exchange.

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What Are the Health Insurance Options for Clearfield Medical Practices?

For small medical practices in Clearfield, several avenues exist to provide health coverage to employees. The primary options depend on the size of your practice and your budget:

SHOP Marketplace Plans: The Small Business Health Options Program (SHOP) is part of HealthCare.gov and is designed for businesses with 1 to 50 full-time equivalent (FTE) employees. Through SHOP, you can offer your employees a choice of plans from different carriers or a single plan. Crucially, qualifying practices may be eligible for the Small Business Health Care Tax Credit, which can significantly reduce premium costs.
Direct-to-Carrier Plans: Many insurance carriers also offer small group health plans directly, outside of the SHOP marketplace. These plans may offer a broader range of options or network structures, though they typically do not come with the same tax credit eligibility as SHOP plans. It's important to compare both on-exchange and off-exchange options.
Qualified Small Employer Health Reimbursement Arrangement (QSEHRA): If your practice has fewer than 50 full-time employees and does not offer a group health plan, you can offer a QSEHRA. This allows you to reimburse employees for individual health insurance premiums and other medical expenses on a tax-free basis. Employees purchase their own individual plans through HealthCare.gov, and you reimburse them up to a set limit.
Individual Coverage Health Reimbursement Arrangement (ICHRA): For practices of any size, an ICHRA allows you to offer tax-free money for employees to pay for individual health insurance premiums and medical expenses. Unlike QSEHRA, it has no employer size limits and no maximum contribution limits, offering greater flexibility.

Understanding the nuances of these options, especially concerning network types like HMOs and EPOs which are prevalent in Utah, is key to making an informed decision for your medical practice.

Which Health Insurance Carriers Serve Clearfield Businesses in 2026?

In 2026, 4 carriers offer marketplace plans in Rating Area 3, which covers Davis, Salt Lake, Summit, Tooele, and Wasatch counties, including Clearfield. For small medical practices seeking group health insurance through HealthCare.gov, these are the confirmed options:

BridgeSpan Health Company: Offers a variety of health plans, typically focused on regional networks.
Regence BlueCross BlueShield of Utah: A well-established insurer offering a range of plan designs and network access.
Select Health: A Utah-based plan known for its integrated health system approach with Intermountain Health.
University of Utah Health Plans: Provides plans with access to the University of Utah Health's facilities and providers.

It is important to review each carrier's specific plan offerings, provider networks, and formularies to ensure they align with your practice's needs and your employees' preferred healthcare providers, especially those in Davis County like Holy Cross Hospital-davis, Lakeview Hospital, and Intermountain Health Layton Hospital.

Understanding Plan Types and Costs for Small Businesses

The health insurance landscape in Utah, including Clearfield, is primarily shaped by Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans on the marketplace. PPO plans are not available on-exchange in Utah, meaning small businesses will choose between HMOs and EPOs for subsidy-eligible coverage.

Plan Type	Network Structure	Referral Requirement	Out-of-Network Coverage	Typical Cost for Small Group (Clearfield)
HMO (Health Maintenance Organization)	Requires you to choose a Primary Care Provider (PCP) within the network.	Yes, typically required for specialists.	Generally no, except for emergencies.	Often the most affordable premium, but strict network.
EPO (Exclusive Provider Organization)	Provides a network of doctors and hospitals.	No, typically not required.	Generally no, except for emergencies.	Moderate premiums, more flexibility than HMO within network.

Premiums for small group plans can vary significantly based on the age of your employees, the metal tier (Bronze, Silver, Gold, Platinum) you choose, and the specific plan design. Bronze plans have the lowest premiums but the highest out-of-pocket costs, while Gold and Platinum plans have higher premiums but lower out-of-pocket maximums and deductibles.

Small Business Health Care Tax Credit Eligibility

One of the most significant advantages for small medical practices offering health insurance through the SHOP marketplace is the potential to qualify for the Small Business Health Care Tax Credit. This credit can offset a substantial portion of your premium contributions, making group coverage more affordable. To be eligible for the maximum credit, your practice must meet specific criteria:

Fewer than 25 FTE Employees: Your practice must employ fewer than 25 full-time equivalent (FTE) employees.
Average Wages Below Threshold: The average annual wages of your employees must be less than $64,000 (adjusted annually for inflation).
Employer Contribution: You must contribute at least 50% of the cost of employees' health insurance premiums.

The maximum tax credit is 50% of the employer-paid premiums for small businesses and 35% for small tax-exempt organizations. This credit is available for two consecutive tax years. For a medical practice in Clearfield, taking advantage of this credit can significantly impact the overall cost of providing employee benefits. Clearfield, with a population of 33,523 and a median income of $75,495, is part of Davis County, which has a larger population of 370,924. The uninsured rate in Clearfield is 9.6%, while Davis County has a lower uninsured rate of 5.7%, per U.S. Census Bureau ACS 2024 5-year estimates. This local context underscores the importance of accessible and affordable health insurance options for small businesses and their employees.

Making the Right Decision for Your Clearfield Medical Practice

Choosing the ideal health insurance plan for your medical practice requires careful consideration of your budget, your employees' needs, and the administrative burden of each option.

If your practice has:

1-50 FTE Employees and seeks tax credits: Explore SHOP plans on HealthCare.gov. This is your best route for potential tax credits and structured plan options.
Fewer than 50 FTE Employees and wants to reimburse individual premiums: Consider a QSEHRA or ICHRA. This offers flexibility for employees to choose their own plans while you provide tax-free contributions.
Specific network needs or prefers off-marketplace options: Research direct-to-carrier small group plans. Be aware that these typically do not qualify for the Small Business Health Care Tax Credit.

A licensed health insurance producer can provide invaluable assistance in navigating these choices, comparing plans, and ensuring your practice complies with all applicable regulations. They can help you understand the specific benefits and limitations of each carrier and plan type available in Clearfield, Utah.

Frequently Asked Questions

What are the primary health insurance options for a small medical practice in Clearfield?

Small medical practices in Clearfield can explore the Small Business Health Options Program (SHOP) on HealthCare.gov, direct plans from carriers, or consider a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) if they have fewer than 50 full-time employees and don't offer group coverage.

Can my medical practice qualify for tax credits when offering health insurance?

Yes, if your medical practice has fewer than 25 full-time equivalent (FTE) employees, pays average wages of less than $64,000 per year, and covers at least 50% of your employees' premium costs, you may qualify for the Small Business Health Care Tax Credit, which can be up to 50% of your contribution.

Are PPO plans available for small businesses in Clearfield through the marketplace?

No, PPO plans are not available on-exchange in Utah, including Clearfield. Small businesses looking for marketplace plans will find options structured as Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs). PPOs may be available off-marketplace without subsidies.

How does Medicaid expansion in Utah affect my employees?

Utah expanded Medicaid in 2020. This means employees in your medical practice, or their family members, with incomes up to 138% of the Federal Poverty Level (FPL) may qualify for Utah Medicaid. This provides a safety net for lower-income individuals who might not otherwise afford coverage, and for pregnant women up to 144% FPL.