Small Business Health Insurance in Des Plaines, Illinois

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

Small businesses in Des Plaines with fewer than 50 employees can use the SHOP Marketplace via GetCoveredIllinois.
Eligible small businesses may qualify for a tax credit covering up to 50% of premium costs when purchasing through SHOP.
In 2026, 5 carriers offer marketplace plans in Rating Area 1, which includes Des Plaines, offering HMO, EPO, and PPO options.
Businesses can choose from fully-insured plans, which shift risk to the insurer, or consider self-funded options for greater control.

Navigating health insurance options for your small business in Des Plaines, Illinois, involves understanding both state-specific regulations and marketplace opportunities. For employers with 1 to 50 full-time equivalent employees, the Small Business Health Options Program (SHOP) through GetCoveredIllinois offers a streamlined way to provide coverage. This marketplace provides access to a variety of plans, including Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) options, allowing businesses to select plans that best fit their budget and employees' needs. Furthermore, qualified small businesses may be eligible for significant tax credits to help offset the cost of premiums, making employer-sponsored coverage more accessible.

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What Are Your Options for Small Business Health Insurance in Des Plaines?

Small businesses in Des Plaines have several avenues to explore when providing health benefits:

SHOP Marketplace (GetCoveredIllinois): This is the official state-based marketplace for small employers. It simplifies the process of offering health and dental insurance to employees. To qualify, you generally need to have at least one common-law employee and fewer than 50 full-time equivalent employees. You must also offer coverage to all full-time employees and contribute a minimum percentage towards their premiums (typically 50%).
Off-Marketplace Plans: Many private insurance carriers offer small group health insurance plans directly or through brokers outside of the SHOP Marketplace. These plans may offer a wider range of options or different network structures, but they do not qualify your business for the Small Business Health Care Tax Credit.
Self-Funded Plans: For some small businesses, particularly those with a healthier workforce or specific needs, self-funding (or partially self-funding) can be an option. This involves the business paying for employee claims directly, often with stop-loss insurance to limit financial risk. While offering greater control, this approach requires careful management and can carry more risk.
Individual Coverage Health Reimbursement Arrangements (ICHRAs): An ICHRA allows employers to reimburse employees for individual health insurance premiums and other medical expenses. This gives employees more choice in their own plans while providing a tax-advantaged benefit.

Cook County, including Des Plaines, is part of Illinois Rating Area 1. This rating area serves a population of 5,182,090, with an uninsured rate of 8.9% per U.S. Census Bureau ACS 2024 5-year estimates. Local medical facilities, such as Loyola Gottlieb Memorial Hospital in nearby Melrose Park, are part of the extensive network available to residents.

Understanding the Small Business Health Care Tax Credit

One of the most compelling reasons for small businesses in Des Plaines to use the SHOP Marketplace is the Small Business Health Care Tax Credit. This credit can significantly reduce the cost of offering health insurance. Key eligibility requirements for the tax credit:

You must have fewer than 25 full-time equivalent (FTE) employees.
Your average employee wage must be less than approximately $60,000 per year (this figure is indexed for inflation).
You must pay at least 50% of your employees' premium costs.
You must purchase a health insurance plan through the SHOP Marketplace (GetCoveredIllinois).

The maximum credit is 50% of the employer-paid premiums for small businesses and 35% for small tax-exempt organizations. The credit is available for two consecutive tax years. This credit can be a game-changer for businesses looking to attract and retain talent by offering competitive benefits.

Health Insurance Carriers in Des Plaines

For small businesses in Des Plaines, which is located in Illinois Rating Area 1, there are several confirmed carriers offering marketplace plans for the 2026 plan year. In 2026, 5 carriers offer marketplace plans in Rating Area 1. These include:

Ambetter
Blue Cross and Blue Shield of Illinois
Molina Healthcare
Oscar Health
United Healthcare

These carriers offer a range of plan types, including HMO, EPO, and PPO plans, giving Des Plaines businesses flexibility in choosing coverage that aligns with their employees' preferences and their budget. It's important to compare plan networks, deductibles, and out-of-pocket maximums across these carriers to find the best fit.

How to Choose the Right Plan for Your Des Plaines Business

Selecting the ideal health insurance plan involves balancing cost, coverage, and employee needs. Here’s a decision-making framework:

Business Situation	Recommended Action	Key Considerations
Fewer than 25 FTEs, average wages under $60k	Explore SHOP Marketplace via GetCoveredIllinois.	Likely eligible for the Small Business Health Care Tax Credit (up to 50% of premiums). Offers HMO, EPO, and PPO plans.
25-49 FTEs	Explore SHOP Marketplace via GetCoveredIllinois or private off-marketplace plans.	Not eligible for the tax credit, but SHOP provides simplified administration. Off-marketplace may offer more plan variety.
Prioritize cost control and predictable expenses	Consider fully-insured plans.	Fixed monthly premiums, carrier assumes claims risk. Less administrative burden.
Desire greater control over plan design and potential savings	Investigate self-funded or partially self-funded plans (with stop-loss insurance).	Higher risk, but potential for lower costs if claims are low. More administrative responsibility.
Want to give employees maximum choice in individual plans	Look into Individual Coverage Health Reimbursement Arrangements (ICHRAs).	Employees choose their own plans and get reimbursed. Tax-advantaged for both employer and employee.

For businesses with a population of 59,156 and a median income of $97,875 per U.S. Census Bureau ACS 2024 5-year estimates, attracting and retaining skilled employees is crucial. Offering robust health benefits is a key component of a competitive compensation package. A licensed health insurance producer can help you analyze your specific business needs, employee demographics, and budget to find the most suitable and cost-effective solution among the available options in Des Plaines.

Frequently Asked Questions

What are the minimum requirements for offering small business health insurance in Des Plaines?

To offer a Small Business Health Options Program (SHOP) plan through GetCoveredIllinois, you typically need at least one common-law employee (not a spouse or dependent) and fewer than 50 full-time equivalent employees. You must also offer coverage to all full-time employees and contribute at least 50% of the premium cost.

Can I get a tax credit for offering small business health insurance in Des Plaines?

Yes, small businesses in Des Plaines with fewer than 25 full-time equivalent employees and average wages below approximately $60,000 may qualify for the Small Business Health Care Tax Credit. This credit can cover up to 50% of your premium contributions (35% for non-profits) if you purchase a SHOP plan through GetCoveredIllinois.

Are PPO plans available for small businesses in Des Plaines?

Yes, PPO plans are available for small businesses in Des Plaines, Illinois, both on and off the GetCoveredIllinois marketplace. In 2026, carriers like Blue Cross and Blue Shield of Illinois offer PPO plans, alongside HMO and EPO options, giving employers flexibility in plan design.

What is the difference between fully-insured and self-funded plans for small businesses?

With a fully-insured plan, your business pays a fixed premium to an insurance carrier, and the carrier assumes all the risk for claims. In a self-funded plan, your business pays for employee healthcare claims directly, often with stop-loss insurance to protect against high costs. Self-funding offers more control but carries greater risk, typically for larger small businesses.