How to Choose the Best PEO for Health Insurance

For 7 out of 10 US workers, health insurance is a make-or-break workplace benefit. More important than retirement savings plans or paid time off, today’s workers heavily rely on and value employer-sponsored health insurance.

As an employer, meeting this need requires high-quality, affordable plans without an overwhelming amount of admin work for your team, especially as you scale. With Deel PEO, you get a completely in-house solution with hands-on support from certified experts, built-in compliance, and exclusive Aetna International plans.

Here’s how to evaluate the best professional employer organizations (PEOs) for health insurance for your team. Learn about the impact of PEOs and compare leading vendors before taking the next step.

Benefits of using a PEO for health insurance

A PEO makes it easier to offer high-quality, affordable health coverage while reducing administrative burden, improving compliance, and strengthening your ability to attract and retain talent.

• Comprehensive coverage: PEOs give businesses access to top-tier health plans, including medical, dental, vision, life, and disability coverage

• Lower insurance premiums: Group purchasing power allows PEOs to negotiate lower insurance premiums than most companies could obtain independently

• Additional benefit options: Health coverage through a PEO often includes additional options like flexible spending accounts (FSA), EAPs, and wellness benefits

• Hands-off administration: PEOs manage benefits administration, including benefits enrollment, renewals, claims processing, and employee support

• Reduced HR burden: Administrative support from a PEO reduces the workload on internal HR and finance teams

• Built-in compliance: PEOs ensure compliance with regulations such as ACA, COBRA, HIPAA, and multi-state health mandates

• Modern benefits technology: Integrated HR platforms and employee self-service tools streamline benefits management and reduce errors

• Improved talent retention: Comprehensive benefits packages through a PEO improve employee retention and support competitive hiring

• Predictable budgeting: Predictable pricing models and centralized billing help finance teams manage budgets more effectively

Evaluation checklist: Choosing a PEO for health insurance

Choosing the right PEO means finding a partner who can deliver high-quality benefits, simplify compliance, and help your business grow. Here’s a comprehensive look at what to evaluate, especially when health insurance is a key driver.

Health insurance plan offerings

Most PEOs offer common plan types like HMOs, PPOs, and HDHPs. But the real value lies in the details. Look closely at the plan designs, coverage levels, deductibles, out-of-pocket maximums, and prescription drug policies.

Evaluate whether the plans accommodate a range of employee needs, from basic preventative care to ongoing medical management. Don’t overlook dental, vision, life, and disability insurance, which are often available as add-ons and can meaningfully enhance your benefits offering.

Key questions to ask:

• What types of health insurance plans (HMO, PPO, HDHP) do you offer?
• What are the coverage levels, co-pays, deductibles, and out-of-pocket maximums for each plan?
• Which insurance carriers do you partner with?
• Do you offer dental and vision insurance?
• What about life and disability insurance?
• What is the underwriting criteria?
• What is the minimum employee count required?

Provider networks and telehealth access

An excellent health plan falls short if employees can’t see their existing doctors. Check the depth and reach of each plan’s provider network. This is particularly important for distributed teams. Strong telehealth services, including virtual visits and remote mental health support, are now standard expectations, especially in remote-first work environments.

Key questions to ask:

• What is the geographic reach of your provider networks?
• Do the networks include key specialists and hospitals in our regions?
• Do you offer telehealth services?
• What do those services cover (e.g., virtual doctor visits, mental health counseling)?

Cost and pricing structure

A professional employer organization’s value hinges on pricing transparency. Whether the fee model is per employee or a percentage of payroll, you should understand how administrative fees and insurance premiums are structured. Ask for historical pricing trends to get a sense of long-term affordability.

Key questions to ask:

• What is the total cost of your services, including administrative fees and insurance premiums?
• What are your pricing models (percentage of payroll vs. per employee)?
• Are there any hidden costs, setup fees, or termination fees?
• How have your rates and premiums changed historically?
• What is your process for annual renewals?

Administrative capabilities

One of the biggest advantages of a PEO is offloading time-consuming benefits management. Evaluate how the PEO handles onboarding, qualifying life event changes, open enrollment, and claims. A user-friendly tech platform, with self-service access and clear workflows, can save hours each month.

Key questions to ask:

• Can we see a demo of your online platform for benefits enrollment and management?
• How do you handle claims processing and employee support?
• What is your process for managing open enrollment?
• What reporting capabilities do you offer for benefits usage and cost tracking?

Compliance and legal support

State and federal compliance is high-risk and high-effort. Your PEO should bring deep expertise in ACA, COBRA, HIPAA, and other regulatory areas. They should manage filings, monitor legislative changes, and provide guidance for multi-state compliance. Strong risk management practices add another layer of protection for your business.

Key questions to ask:

• What is your expertise in health insurance laws and regulations (ACA, COBRA, HIPAA)?
• How do you assist with compliance reporting and filings?
• What is your approach to risk management and workplace safety?

Broader HR and payroll services

Health insurance is often the entry point, but a strong PEO solution should offer end-to-end HR services. This includes payroll, tax reporting, onboarding, employee relations, and even talent support. The more cohesive the services, the more operational value you gain.

Key questions to ask:

• What other HR services do you offer beyond health insurance?
• What are your payroll processing and tax administration capabilities?
• What HR management support do you provide?
• Do you offer talent acquisition and development services?
• What is your workers’ compensation coverage and claims management process?

Technology and integration

The PEO’s technology platform will become part of your HR and finance operations. It should be intuitive, secure, and integrable with your existing tools. Look for employee self-service functionality, mobile access, and strong data protection protocols.

Key questions to ask:

• Does your platform offer employee self-service and mobile app access?
• Can your platform integrate with our existing HR or finance systems?
• What are your data security measures and certifications?

Expertise and reputation

Finally, vet the PEO’s industry experience, financial health, and client satisfaction. Speaking directly with current or past clients is the most effective way to validate performance.

Key questions to ask:

• How much experience do you have working with companies in our industry or of our size?
• Can you provide PEO client testimonials and references?
• What is your financial health and track record?

How Superfiliate manages US benefits and payroll with Deel PEO

As US company Superfilite grew, it needed compliance and payroll support for its expanding US workforce. Watch the video below to hear how they used Deel to 10x their growth and consolidate multiple workforce platforms into one.

PEO vs broker vs HRA for health insurance

While a professional employer organization is a multi-beneficial approach to providing employee health insurance, it’s not the only option. Here’s how PEOs compare to insurance brokers, direct purchasing, and health reimbursement arrangements (HRAs).

Want to learn more about how working with PEOs compares to other HR services? Read: What’s the Difference Between PEO vs Payroll Services? or PEO vs EOR: The Difference (And Why It Matters).

Compare the best professional employer organizations

With a 4.8/5 rating and over 35,000 clients globally, Deel is one of the leading HR and payroll platforms on the market. Here’s how just some of Deel’s features compare to other vendors.

Deel PEO: Comprehensive, flexible benefits for modern teams

Deel’s professional employer organization delivers enterprise-grade benefits to small and mid-sized businesses by combining large-group plan access, global coverage, and hands-on support—all through a unified, easy-to-manage human resources and payroll platform.

Competitive domestic health benefits

Deel makes it possible for you to offer high-quality, affordable healthcare plans that meet today’s employee expectations.

• Large-group pricing power: By quoting employers under a large-group master plan, we unlock competitive pricing and plan availability typically reserved for large enterprises

• Flexible plan design: You can choose from 60+ domestic health plan options from major carriers to match workforce needs and budget, balancing coverage depth with cost control

• Regional flexibility: Deel supports local carrier carveouts to honor employee preferences without disrupting centralized administration

Exclusive international plan options

For globally mobile teams, Deel offers an international plan through Aetna International that’s unlike any other on the market.

• Aetna International plan: A full-featured US master health plan that extends care abroad with the same level of coverage as within the US for W-2 employees

• Seamless global coverage: Employees retain one insurance card and one benefits experience, whether they’re in the US, abroad temporarily, or working across regions year-round

• Embedded in payroll and HR workflows: No separate systems, no manual reconciliation—international employee benefits are managed just like domestic ones within Deel’s platform

Full suite of primary and ancillary employee benefits

Deel provides access to a wide range of medical, financial, and supplemental health benefits, all integrated into one system.

Core offerings:

• Major medical through Aetna, with access to covered care from over one million physicians and providers nationwide

• Dental and vision plans at competitive group rates

• Retirement planning via sponsored 401(k) plans, with options for matching, profit sharing, and safe harbor plans

• HSA and FSA administration for pre-tax savings on healthcare expenses

• Care navigation with Rightway’s clinical concierge team, free with all Aetna plans

Ancillary options:

• Life and AD&D insurance with both basic and voluntary employee-paid tiers

• Short-term and long-term disability to support income continuity during health-related absences

• Hospital indemnity, accident, and critical illness coverage to bridge high deductibles or unexpected medical costs

Streamlined benefits enrollment and administration

From plan selection to open enrollment and COBRA, Deel makes benefits administration simple, digital, and hands-off.

• Centralized platform: Digital plan selection, enrollment, and compliance documents are all managed in one place

• Simplified COBRA administration: Deel handles participant notifications, payments, and compliance deadlines

• Open enrollment support: Deel hosts meetings, answers employee questions, and helps employers structure effective contribution strategies

• Employee benefits renewal guidance: Deel provides usage-based plan analysis and market benchmarks to support smarter benefits decisions

Built-in compliance, powered by in-house expertise

Deel automates and manages compliance with federal and state benefit laws to reduce your risk and save time.

• Expert guidance: Our full team of experts helps you navigate ACA, COBRA, HIPAA, FMLA, and state-level leave laws based on employee status and location

• Real-time prompts: The platform flags eligibility changes and filing needs as you onboard, offboard, or update employee records

• Full ACA reporting: Deel handles Form 1095 filings for eligible employers and adjusts reporting obligations accordingly

Dedicated support from certified professionals

Every client gets a dedicated team with deep expertise in HR, payroll, and compliance — no call centers or third-party brokers.

• Hands-on HR and payroll support: Clients are assigned an HR Business Partner and a Payroll Manager, not generalists or outsourced reps

• Certified expertise at every step: From employee handbook creation and compliance policy design to handling complex leave or termination cases

• In-house delivery: Deel’s payroll, tax, and benefits operations are all managed internally for faster response times and tighter integration

For further guidance, download our PEO Services Guide: Feature Comparison and Checklist. To speak with an expert about how Deel can support your US workforce, book a 30-minute demo with an expert.