Small Business Health Insurance in Lombard, Illinois

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

Small businesses in Lombard can access group health plans through GetCoveredIllinois (SHOP) or directly from private carriers.
In 2026, 5 carriers offer marketplace plans in Rating Area 2, which covers DuPage and Kane counties.
Businesses with fewer than 25 full-time equivalent employees may qualify for the Small Business Health Care Tax Credit, covering up to 50% of premium costs.
Illinois offers a wide range of plan types, including HMO, EPO, and PPO options, for small group health insurance.

Navigating health insurance options for your small business in Lombard, Illinois, involves understanding both state-specific regulations and the local market. Small businesses have several avenues for providing coverage, from traditional group plans to more flexible arrangements like Health Reimbursement Arrangements (HRAs). The Illinois health insurance marketplace, GetCoveredIllinois, offers a Small Business Health Options Program (SHOP) where eligible employers can find plans and potentially qualify for tax credits. Additionally, many private carriers offer small group plans directly, providing a broader range of choices outside the marketplace.

Get Your Free Health Insurance Quote

A licensed agent can compare coverage options for you at no cost.

✓

You're all set!

A licensed agent will reach out shortly.

What Are Your Small Business Health Insurance Options in Lombard?

For small businesses in Lombard, providing health coverage to employees is a critical decision that impacts recruitment, retention, and employee well-being. Illinois offers a robust market with several pathways to secure coverage:

SHOP Marketplace (GetCoveredIllinois): The Small Business Health Options Program (SHOP) is part of GetCoveredIllinois, the state-based marketplace. It allows eligible small employers (typically those with 1-50 employees) to offer health and dental coverage to their employees. This is also the only place where small businesses can qualify for the Small Business Health Care Tax Credit.
Direct from Private Insurers: Many insurance carriers offer small group health plans directly to businesses outside of the SHOP marketplace. These plans often provide more flexibility in terms of network options and benefits, though they do not qualify for the federal tax credit.
Health Reimbursement Arrangements (HRAs): HRAs, such as Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs) or Individual Coverage Health Reimbursement Arrangements (ICHRAs), allow employers to reimburse employees for health insurance premiums purchased on the individual market or for out-of-pocket medical expenses. This option gives employees more control over their plan choices.
Professional Employer Organizations (PEOs): PEOs allow small businesses to "co-employ" their staff, gaining access to large group health benefits that might otherwise be unavailable or cost-prohibitive.

Choosing the right option depends on your business size, budget, and desired level of flexibility for your employees.

Understanding Small Business Health Care Tax Credits in Illinois

The Small Business Health Care Tax Credit can significantly reduce the cost of providing health insurance for eligible small employers in Lombard. This credit is available to businesses that:

Have fewer than 25 full-time equivalent (FTE) employees.
Pay average annual wages of less than approximately $58,000 (this figure is indexed for inflation).
Contribute at least 50% of the premium cost for single (not family) coverage for each employee.
Purchase coverage through the SHOP Marketplace on GetCoveredIllinois.

The maximum credit is 50% of the employer's contribution to premiums for small businesses and 35% for tax-exempt organizations. This credit can be claimed for two consecutive tax years, offering substantial savings to qualifying Lombard businesses.

Health Insurance Carriers in Lombard

For small businesses seeking group health plans in Lombard, the carrier options are determined by the local rating area. Lombard is located in DuPage County, which is part of Illinois Rating Area 2. In 2026, 5 carriers offer marketplace plans in Rating Area 2, which covers DuPage, Kane counties. These carriers include:

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

These carriers provide a variety of plan types, including Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Preferred Provider Organization (PPO) plans. Blue Cross and Blue Shield of Illinois, for example, is known for offering PPO plans on-exchange, giving Lombard small businesses and their employees more choice in provider networks. When selecting a plan, consider the network size, specific benefits, and cost-sharing structures to ensure it meets the needs of your employees.

Lombard, a city of 43,619 residents per U.S. Census Bureau ACS 2024 5-year estimates, is situated in DuPage County, which is served by Illinois Rating Area 2. DuPage County itself has a population of 930,024 and an uninsured rate of 5.2%, reflecting a community with generally good access to coverage. Residents needing acute care often travel to neighboring counties, as DuPage County currently has no acute care hospitals within its boundaries.

Navigating Medicaid and CHIP for Employees in Lombard

While small business health insurance primarily focuses on group plans, it's important to understand the broader landscape of coverage in Illinois, especially for employees who may not qualify for or opt into a group plan. Illinois expanded Medicaid in 2014, meaning adults with income up to 138% of the Federal Poverty Level (FPL) may qualify for comprehensive health coverage through Illinois Medicaid. This eliminates the "coverage gap" seen in non-expansion states. For families, Illinois also provides extensive support:

Pregnant Women Medicaid: Illinois Medicaid covers pregnant women with income up to 213% FPL, one of the highest thresholds in the country. This coverage includes prenatal care, labor, delivery, and 12 months of postpartum care. Applications can be made through ABE (abe.illinois.gov) or by calling the DHS helpline.
CHIP for Children (Illinois All Kids): The Illinois All Kids program, the state's CHIP equivalent, offers low-cost coverage for children up to 313% FPL, making it one of the most expansive child coverage programs nationwide.

Understanding these programs ensures that all employees, regardless of their enrollment in a small business plan, have potential pathways to affordable health care.

Making the Right Decision for Your Lombard Small Business

Choosing the ideal health insurance solution for your small business in Lombard requires careful consideration of several factors:

Budget: Determine how much your business can realistically contribute to premiums and administrative costs.
Employee Needs: Consider the demographics and health care needs of your workforce. Do they prefer broad networks (PPO) or lower premiums (HMO)?
Tax Credits: Evaluate if your business qualifies for the Small Business Health Care Tax Credit through the SHOP marketplace.
Administrative Burden: Assess the administrative effort involved with each option. HRAs and PEOs can sometimes simplify administration compared to traditional group plans.

A licensed health insurance producer can provide personalized guidance, comparing plans from multiple carriers and helping you understand the financial implications for your specific business.

Frequently Asked Questions

What are the primary options for small business health insurance in Lombard, IL?

Small businesses in Lombard can explore group health plans through the SHOP Marketplace on GetCoveredIllinois, directly from private insurers, or by offering a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) or Individual Coverage Health Reimbursement Arrangement (ICHRA).

Can small businesses in Lombard qualify for tax credits to help with health insurance costs?

Yes, small businesses with fewer than 25 full-time equivalent (FTE) employees and average wages of less than approximately $58,000 (adjusted annually for inflation) may qualify for the Small Business Health Care Tax Credit, which can cover up to 50% of the employer's premium contributions.

Are PPO plans available for small businesses on the Illinois health insurance marketplace?

Yes, PPO plans are available on the Illinois health insurance marketplace, GetCoveredIllinois. Small businesses in Lombard can choose from PPO, HMO, and EPO plan structures when selecting coverage for their employees.

What are the employee eligibility requirements for small group health insurance in Illinois?

Generally, to be eligible for small group health insurance in Illinois, a business must have at least one common-law employee (who is not an owner or spouse). Most plans require at least 70% of eligible employees to enroll in the plan, though this can vary by carrier and situation.