Q: What options in health care benefits do small business owners have to attract good employees?

A: As competition for talented employees intensifies in the coming years, small businesses will have to find ways to lure and keep good workers. According to the U.S. Department of Health and Human Services (HHS), less than half of U.S. businesses with fewer than 10 employees offer health insurance. Only 15 percent of companies with 25 to 100 workers do. So, health coverage may well be an important bargaining chip.

One solution is to take advantage of a high-deductible health insurance plan - an HDHP - with a health savings account, or an HSA.

Less costly than conventional plans, HDHPs cover major health and medical expenses for those who can afford some up-front medical costs. Participants have the option to open and make pre-tax contributions to an HSA. Withdrawals are tax-free when spent on qualified medical expenses. Unspent HSA funds carry over, so you can accumulate significant balances over time.

What's more, employer contributions to a tax-favored HSA are exempt from payroll taxes. As a result, premiums can be 40 percent lower in a high-deductible HSA-qualified health insurance plan than those in a conventional co-pay plan. The National Association of Health Underwriters site, http://www.nahu.org, has helpful information on HSAs.

Also, the Affordable Care Act, the ACA, offers incentives to small businesses that want to provide insurance for their employees. Businesses with 50 or fewer full-time employees can shop for health care with the federal Small Business Health Options Program (SHOP) Marketplaces for comparing insurance companies and plans. Currently, small businesses pay on average 18 percent more than larger businesses for health insurance.

The SHOP Marketplace offers small employers increased purchasing because small employers can pool their risks and reduce costs. If you have fewer than 25 employees and you supply health insurance for all of your full-time employees via SHOP, you can get tax credits of up to 50 percent of the cost.

Businesses with 10 or fewer full-time employees that provide health insurance could be eligible for full tax crediting. For more information on the ACA provisions for small businesses, visit sba.com and go to the tab on managing a business.

There's much more to learn about the ACA at the SCORE workshop 'Understanding the Affordable Healthcare Act' presented by Khoa Ho of Agility Insurance Services. It's open enrollment time, so learn about health care reform, what you can buy, when and how. To register, visit http://www.scorehouston.org.

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Small-business Q&A: Explore your health care options