Small Business Health and Dental Insurance: Options and Cost

Medically reviewed by Jawad Arshad, MD, FACEP. Last reviewed: October 5, 2026.

Small business health and dental insurance is two products that get sold together. Medical covers doctors and hospitals, and dental covers cleanings, fillings and crowns. Most small employers add both so a job offer looks complete, then look for a way to keep the bill down.

Key facts

• HealthCare.gov SHOP lets an eligible employer offer only health coverage, only dental coverage, or both (HealthCare.gov, 2026).
• Average family coverage cost $26,993 a year and single coverage cost $9,325 in 2025 (KFF Employer Health Benefits Survey, 2025).
• Workers paid an average of $1,440 a year toward single coverage and $6,850 toward family coverage in 2025 (KFF Employer Health Benefits Survey, 2025).
• Employer-provided accident and health benefits are generally excluded from employee wages for income tax, Social Security and Medicare (IRS Publication 15-B, 2026).
• Employers pay 6.2% Social Security tax on wages up to $184,500 in 2026 and 1.45% Medicare tax with no cap (Social Security Administration, 2026).
• Summit Health Benefits charges a $35 per enrolled employee per month admin fee, paid out of the FICA savings the plan creates (Summit Health Benefits, 2026).

What is small business health and dental insurance?

Small business health and dental insurance is group coverage where an employer offers medical and dental benefits to employees, usually as two separate policies. The HealthCare.gov SHOP marketplace lets an eligible employer offer only health coverage, only dental coverage, or both. Vision is usually added as a third, low-cost policy.

HealthCare.gov (2026) says a SHOP employer generally must have 1 to 50 employees. You can also buy directly from a carrier or through a broker. Our best small business health insurance guide compares the main medical carriers.

The practical point is that dental is a separate decision. You can offer it without changing your medical plan, and you can change it without touching medical.

Which small business health plans include dental and vision?

Most small business medical plans do not include adult dental or vision, so employers add them as separate policies or as a carrier bundle. The HealthCare.gov SHOP lets you pick medical, dental or both.

Table: Ways to add dental and vision to small business health coverage

If your team is under 50, ask a broker to price the bundle and the stand-alone version side by side. Our group health insurance quotes checklist lists what to ask for. Our page on dental and vision benefits for small business covers the basics for first-time buyers.

What is the best value small business health coverage with dental and vision?

The best value plan is the one your employees will use, at a price your company can repeat every year. Network fit and employer share matter more than the lowest sticker price.

Check five things before you sign:

1. Dentist network. Look up the two or three dentists your staff already use.
2. Annual maximum. Many dental plans cap what they pay in a year, so ask for the number.
3. Orthodontia. If you have employees with children, ask whether braces are covered and at what percent.
4. Waiting periods. Ask whether crowns and major work have a wait.
5. Employer share. Decide what percent of the premium you pay and what percent employees pay.

The medical side is still the larger number. KFF's 2025 survey found average annual premiums of $9,325 for single coverage and $26,993 for family coverage, so most of your budget decision sits there. Our small business health insurance costs guide breaks that down.

How much does dental add to small business health insurance?

Dental adds a small monthly amount on top of a much larger medical premium, and the exact figure depends on the carrier, the plan and your area. Get written quotes, because published averages vary widely.

Here is a worked example. The premiums are hypothetical so you can see the math. Your quotes will differ. A 12-person company buys dental at $45 and vision at $9 per employee per month, and the company and each employee split the premium 50/50.

1. Total dental and vision premium: $45 + $9 = $54 per employee per month.
2. Company share: $54 x 50% = $27 per employee per month.
3. Company cost for the year: $27 x 12 months x 12 employees = $3,888.
4. Employee share: another $27 per month, or $324 a year each.

Now apply Section 125. If each employee pays the $324 before tax:

The 7.65% is Social Security at 6.2% plus Medicare at 1.45% (Social Security Administration, 2026). Dental and vision alone produce about $297 a year in employer FICA savings for this team. Add medical premiums and the savings grow, because the same 7.65% applies to every pre-tax premium dollar.

Can employees pay for health and dental insurance before tax?

Yes. A Section 125 cafeteria plan lets employees pay their share of health, dental and vision premiums before tax, which lowers their taxable wages and your payroll tax.

IRS Publication 15-B (2026) describes a cafeteria plan as a written plan that lets employees choose between cash and certain qualified benefits, including accident and health benefits. Pay for the coverage through the plan and the employee's income tax, Social Security and Medicare wages all drop by that amount. Read our Section 125 cafeteria plan guide for the full rules and our guide to employee premium contributions in a cafeteria plan for payroll set-up.

Here is how the Summit Health Benefits fee works, using Summit's own planning ranges (Summit Health Benefits, 2026):

The fee is paid out of the FICA savings the plan creates, so the employer nets the amount in the third row. A simple break-even rule applies. The $35 fee divided by the 7.65% FICA rate is about $457, so a plan covers its own fee from premiums alone once an employee pays about $457 a month before tax. In the 12-person example above, each employee pays $427 a month toward medical, dental and vision, which is just under that line, so FSAs and other qualified benefits fill the gap. See maximizing FICA tax savings for the full calculation.

Do small businesses qualify for help paying for health and dental?

Some do. The HealthCare.gov SHOP says a small business may qualify for the tax credit with fewer than 25 full-time equivalent employees earning an average of about $65,000 or less.

The credit applies to health coverage bought through SHOP. Read our guide to the small business health care tax credit for the rules and how to claim it. Small employers that do not qualify can still deduct their share of premiums as a business expense.

What should I ask my broker about health and dental plans?

Ask your broker for health, dental and vision quotes side by side, and ask whether Section 125 is already running on your premiums. Many employers pay for coverage with after-tax deductions for years because nobody asked.

Copy this email and send it as written:

Subject: Health, dental and vision quotes for our team

>

Hi, we are reviewing group coverage for next plan year. Please send: (1) medical, dental and vision quotes as a bundle and as separate policies, (2) the dentist network count within 10 miles of our office, (3) the dental annual maximum and orthodontia terms, (4) whether employee premiums are deducted pre-tax under a written Section 125 plan, and (5) what we pay for administration, if anything. Thank you.

If the answer to question four is no, you are paying FICA on dollars that could be exempt.

Frequently Asked Questions

Sources: HealthCare.gov, SHOP health insurance overview (2026); KFF, 2025 Employer Health Benefits Survey (2025); IRS Publication 15-B, Employer's Tax Guide to Fringe Benefits (2026); Social Security Administration, Contribution and Benefit Base and tax rates (2026); Summit Health Benefits, plan pricing and FICA recapture ranges (2026).