Small teams, a short season and care that crosses water.
The county's hospital is PeaceHealth Peace Island Medical Center in Friday Harbor, a 10-bed critical access hospital that opened in November 2012 with a 24-hour emergency department. On Orcas, Island Primary Care Orcas opened in Eastsound in April 2021 as the island's single district-supported clinic. Lopez Island has a primary care clinic of its own.
Serious cases and many specialist visits go to the mainland, often to Bellingham, Mount Vernon or Seattle. For an employee, that means ferry time, missed work and sometimes air transport. A plan's out-of-area rules, referral process and telehealth matter more here than a small premium difference.
Island employers are usually small: inns, restaurants, marine businesses, builders and shops, with crews that grow in summer. That points toward clear eligibility rules, options that suit owner-run businesses and benefits employees can use off-island.
Three decisions for island employers.
Owners and family members
If the only people on payroll are owners and their spouses, small group rules may not apply. We sort out what is available before you spend time on quotes. See our family-owned businesses page.
Summer crews
Decide how seasonal staff are treated, how hours are counted and when coverage starts, then apply it the same way every year. Our hourly, seasonal and remote teams page has examples.
Care off the island
Check how each plan treats specialists in Skagit, Whatcom and King counties, whether referrals need prior authorization and what telehealth is covered. Our telehealth guide lists what to ask.
Island by island.
San Juan Island
Friday Harbor employees use Peace Island Medical Center for primary care, imaging, emergency care and some specialty care. These examples establish locations, not plan participation. Confirm the hospital and its clinic in each proposed network.
Orcas and Lopez
Orcas employees usually start at the Eastsound clinic, which Island Health in Anacortes manages for the Orcas Island Health Care District. Lopez residents have a local clinic. Check those, plus the mainland hospitals people actually use.
What island employers ask.
Will employees pay more for care on the mainland?
It depends on the plan. Some include the mainland hospitals islanders use in network; others charge more or require referrals. We check the hospitals your employees actually use before recommending a plan.
Our staff only work May through September. Can we still offer coverage?
Yes, with clear eligibility rules. Think through when coverage starts and ends, continuation rights when it ends and how returning workers are treated. Our COBRA and Washington continuation page explains the continuation side.
Which rating area are the islands in?
San Juan County shares a rating area with Island, Skagit, Snohomish and Whatcom counties. Rates come from your principal business address. Networks still vary by carrier inside that area.
The full package, locally.
Employee Benefits
Group medical, dental, vision, life and disability, level-funded and voluntary coverage.
Explore benefits →Business Services
COBRA, ACA compliance and pre-tax accounts, plus an enrollment platform at no added cost from us. Administrator fees may apply.
Explore services →Life Insurance
Term, whole life, final expense and key person coverage for owners and partners.
Explore life →Other areas we serve nearby.
Bellingham
Whatcom County employers checking care near home, specialists and changing work schedules.
See Bellingham →Ferndale
Cherry Point contractors and north Whatcom employers with crews that change size.
See Ferndale →Anacortes
Refinery, shipyard and marine employers on Fidalgo Island.
See Anacortes →Whidbey Island
Oak Harbor, Coupeville and Langley, with Navy households and island care.
See Whidbey Island →Stanwood & Camano
Two counties, one community, with care split between Skagit and Everett systems.
See Stanwood & Camano →All Washington areas
Every city we serve, plus the small group rating area for each county.
See all areas →Quote your island group.
Send a census with each employee's home island. We will check the island clinics and mainland hospitals before recommending anything.