“When it came time to renew his company’s health plan last fall, Jerry Eledge found himself in a bind that many small-business owners know all too well.

On one hand, “it’s kind of a moral obligation” to offer insurance, said Mr. Eledge, who runs Community Quick Care, a growing chain of primary health care clinics in the Nashville area. And yet, premiums for his existing plan were going up 20 percent, while other group plans promised as much as a 50 percent increase, even as deductibles and co-pays were becoming less generous. “We found no really good alternatives for 2014 at all,” he said. “Before Gary came along, we weren’t sure what we were going to do.”