Robin Wiener has achieved something many small-business owners have struggled to do: She has lowered her firm’s health-care premiums.

The dip isn’t huge. Her health-care IT firm, Get Real Health in Rockville, Maryland, has saved about 1 percent. But achieving the small savings took some careful planning, given that her firm—which covers 100 percent of employees’ health-care costs—has a high-quality PPO.

“Our employees really like it,” said Wiener, whose firm has 38 employees in the U.S. and about 40 overseas and generates annual revenue in the $6 million to $8 million range.

As many small-business owners have found, reducing their spending on health care, or even keeping it relatively flat, takes some deft maneuvering. The average annual premium for family health insurance coverage is now $16,834, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2014 Employer Health Benefits Survey.” For individual plans, premiums average $6,025. For comparison, premiums were $16,351 for a family and $5,884 for individuals in 2013.

As a result, many small firms can’t afford to offer health coverage. The Bureau of Labor Statistics recently found that only 57 percent of workers at firms with 100 employees or less have access to employer-sponsored health care.

And many of those who do offer health care are worried about the rising price tag. In a recent national survey by Bank of America, 72 percent of small-business owners said they are concerned about health-care costs.

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