The index overall score increased this quarter to 68.7, meaning that nearly 69 percent of small business owners currently have a positive outlook about their companies, as well as the environment for small business within the U.S.

This 3.1-point rebound follows a drop during the first three months of 2019 and matches the largest quarter-to-quarter increase in economic confidence in the history of the Index.

“Small business owners are showing renewed confidence that the nation's economy is poised for growth, following the resolution of the longest shutdown in government history,” says Jessica Moser, senior vice president and head of MetLife's group benefits small & specialty business. “This rebound in small business sentiment is a powerful leading indicator, as small companies have long been a significant growth engine for our country.”

This quarter, the index asked small business owners about how they select health care plans for their employees. Most (69 percent) say the process of navigating health care options can be time consuming, including Natalie Kaddas, president and CEO of Kaddas Enterprises in Salt Lake City.

“We work with a broker, and they put together 'here are your annual increases' and 'here are some other offers you could do,'” Kaddas says, “We take that data and put it into a spreadsheet to look at usage and how our employees used the insurance in the past.”

Still, Kaddas says she and her staff could use more guidance.

“I wish I had some more data and information,” Kaddas says. “I feel like some of my employees are choosing a plan without a lot of information. There's an educational component that's missing, and I don't necessarily have the skill set to try and bridge that gap—but I try.”

Other key survey findings include:

• The most important criteria for selecting a health care plan are low premiums (20 percent) and low out-of-pocket costs like co-pays and deductibles (20 percent).
• For larger small businesses with 100 or more employees, flexibility and variety in choice is also a major consideration, with 21 percent seeing this as a priority, compared to just 7 percent for mid-size and 9 percent for small size small businesses. These larger small businesses also prioritize keeping out-of-pocket costs (25 percent) and insurance premiums low (24 percent).
• Small businesses are the most familiar with more traditional forms of health care coverage options, such as traditional group health insurance (66 percent). They are less familiar with other options: 43 percent are familiar with changes to contribution limits for health savings accounts; 35 percent are aware of group coverage health reimbursement accounts; 28 percent are familiar with Association Health Plans; 22 percent know about a qualified small employer health reimbursement arrangement and 19 percent have heard of taxable stipends.
• Small businesses most commonly turn to health insurance or benefit brokers, consultants, or agents (32 percent) for information regarding benefit plans. Fewer turn to Google or other search engines (9 percent), other business owners (7 percent), or some “other” type of resource (11 percent) to find information on health care options. A small percentage (7 percent) says they do not know where to go for information on choosing a health care plan.

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• Small business owners turning attention to boosting benefits