Quarterly Spotlight

Cost and Complexity of Healthcare Pose Challenges for Small Business

This quarter, the MetLife & U.S. Chamber of Commerce Small Business Index surveyed small businesses about how they select healthcare plans for their employees.

The survey tracked three important trends about how small businesses learn about and select healthcare plans:

Survey respondents added that small business owners are most commonly (41%) responsible for choosing healthcare coverage and other benefits. But larger small businesses tend to delegate this duty to their HR departments.

Most Small Businesses Find Choosing Healthcare Plans Time Consuming

The survey revealed that small businesses find they have enough information to make informed decisions about healthcare, but that they find it time consuming to select the right plan.

Attitudes Toward Healthcare Coverage Decision makingGraphic indicating attitudes toward healthcare coverage decision making


Small businesses go to a variety of sources of information to learn about offering healthcare coverage for their workers, but clearly prefer talking to actual human experts about available options:

The top priorities for small business owners when considering healthcare coverage options are keeping insurance premiums and out-of-pocket costs low.

Here’s a breakdown of the top priorities for small businesses considering a healthcare plan:

Priorities for healthcare coverage options across regionsGraphic indicating the priorities for healthcare coverage options across regions


Small businesses are the most familiar with more traditional forms of healthcare coverage options, such as traditional group health insurance (66%).

They are less familiar with other options:

By sector, retailers struggle the most to find information to enable them to make informed decisions about healthcare. Small business sectors reporting that they have enough information to make informed decisions about healthcare coverage are:

Costs of offering healthcare are a big concern for the majority of small businesses. A majority (57%) say the cost of healthcare crowds out other priorities for their business and 41% report not being able to provide their employees with good coverage options.

Familiarity with coverage options across industriesGraphic indicating familiarity with coverage options across industries

By sector, concerns over healthcare costs are greatest in manufacturing (62%), as compared to services (57%), professional services (55%), and retail (53%).

Retailers are also the least likely to report they are able to provide good healthcare coverage options by a significant margin. Here’s how sectors rated themselves on their ability to provide good healthcare options for their employees:

The Cost of healthcare crowds out other priorities for our businessGraphic indicating how the Cost of healthcare crowds out other priorities for our business