(FORTUNE Small Business) – Small businesses looking for the best new health plans are in for a dizzying experience. Rules, regulations, and offerings differ from state to state, city to city, and insurer to insurer. Most innovation takes place locally. Luckily "a growing number of states and communities around the country are trying to come up with answers," says Rick Curtis, president of the Institute for Health Policy Solutions in Washington, D.C. "It's clear that a priority for a lot of states and localities is to come up with health-care solutions for small employers."

Here are profiles of firms that have taken advantage of some of the country's most exciting programs promoted at the local level by nonprofits and government agencies. Don't fret if you aren't lucky enough to live in areas that offer the plans; over the next few years such offerings could spread fast.

CALIFORNIA For most of the 20 years Monika Stoltz, 60, has been in business, the employees at the three Duck's Nest preschools she runs in Berkeley have had 80% of their premiums covered by the company. But this year Duck's Nest's carrier stopped offering composite rates--one price quote for all employees, regardless of age--to businesses like hers. For younger employees, that brought lower premiums. But payments skyrocketed for a large chunk of Duck's Nest's workers, and the business faced an increase to $300 from $40 a worker.

Thanks to PacAdvantage, the nation's largest nonprofit Small-business health insurance purchasing pool, Duck's Nest found a more affordable option. The combined purchasing power of more than 9,000 small businesses enables PacAdvantage members to choose among plans from several carriers; benefits include dental, vision, chiropractic, and acupuncture coverage. PairedChoice, which debuted in January, provides a more limited number of choices and lower monthly premiums.

Stoltz chose PairedChoice. The company contributes $175 for every employee each month--the same amount it used to--but that amount now covers 100% of the cost of the plan. Employees who want lower co-pays and increased coverage can choose to pay the cost difference for a more expensive plan. "It's saving us money and giving our employees choices," says Melanie Traynor, Duck's Nest's office manager.

CONNECTICUT Tom Filomeno's health premiums have increased only 2% to 5% over the past two years. That's because Filomeno, president of a West Hartford, Conn., accounting firm, enrolled in CBIA Health Connections, established in 1995 by CBIA Service Corp. CBIA Health Connections is a statewide group-purchasing plan--a type of program that helps small businesses negotiate better rates by pooling together. It is available to members of the Connecticut Business & Industry Association, a not-for-profit trade association. Filomeno can choose among 38 plan options from five carriers, including Aetna and Oxford. While rates are comparable to those of traditional carriers (a requirement, thanks to Connecticut state law), cost savings come from the availability of so many managed-care options, including lower-cost plans to which Filomeno wouldn't normally have access. A plan for a 36-year-old single employee, for example, could cost anywhere from $178.17 to $458.59 for coverage. "Employers can benchmark what they want to pay [with a minimum contribution of 50% of the lowest-cost employee plan], and employees can save or spend depending on what they want," says Philip J. Vogel, senior vice president of CBIA Service Corp.

Another boon for small businesses: CBIA handles all the administrative support. Medical options, dental, long- and short-term disability insurance, and even COBRA are all consolidated onto one bill. For Filomeno, whose employee turnover rate is about 10% annually, that saves about $2,000 in administrative costs. Not surprisingly, the program's enrollment has jumped 20% over the past two years. Today 4,700 businesses participate.

MICHIGAN Before access health came along, Anne Woodring, 50, was unable to provide health benefits for her employees. "I'd listen to the stories they'd tell about when their last annual checkup was and cringe," says Woodring, who owns a Merry Maids housecleaning franchise in Muskegon, Mich. Woodring stopped cringing in 1999, when Muskegon County came up with a cost-sharing program called Access Health. Employers, employees, and the county all contribute to the $154 premium (employers and employees pay $48 each, and the county kicks in $58), compared with a typical 80-20 plan, which runs to $280 to $300 a month per employee.

The nonprofit Muskegon Community Health Project created Access Health to encourage small businesses to start providing health care. (To take advantage of the plan, a business must pay a median hourly wage of $11.50 or less and cannot have offered any coverage in the previous 12 months.) Other states, including Illinois and Florida, have created similar plans. And thanks to Access Health, Woodring's employees have had fully covered life-saving surgeries--including a tumor removal and a hysterectomy.

NEW MEXICO Otis Brown, a sole proprietor who owns an X-ray duplicating company in Albuquerque, can't get coverage from most insurers. That's one of the reasons he signed up with New Mexico's Health Insurance Alliance, a not-for-profit, private initiative to help insure the state's uninsured workers. It covers not only companies with as many as 50 eligible employees but also sole proprietors with a spouse or a dependent. Brown had knee surgery in 2002; conventional insurers would have charged $1,600 a month to cover him, along with his bum knee, and his wife. With the Alliance, however, the couple's coverage from Blue Cross costs just $768.

The Alliance offers other advantages. Most plans require 70% of a business's employees to enroll before they'll give a company the best rate; the Alliance requires only 50% participation. That means that employers usually don't need to contribute as much of their workers' costs in an attempt to persuade them to enroll. Brown, who just turned 60, faces an age-related premium increase this year. But, he says, "I'm still not paying as much as I could be, so I have to be happy."

NEW YORK Unlike many small businesses, AdTek Information Systems doesn't live in fear of its next health insurance hike. The Manhattan company, which develops banking software, has for three years been a client of HealthPass, a not-for-profit health insurance trust established in 1999 by the city of New York and the New York Business Group on Health. "We saved 15% over our previous carrier the first year," says Anna Rotondo, AdTek's office manager, "and we're still saving money."

Unlike most conventional plans, which require employers to pay a minimum percentage of the overall costs, Rotondo can choose how much the company contributes. Under its commercial carrier, AdTek, which footed 100% of its employees' premiums, paid $10,000 a month for insurance. With HealthPass, the monthly premium is $3,000. AdTek kicks in $325 per employee--which still covers 100% of some plans HealthPass offers--and employees can pay the difference out of their own pocket to upgrade, choosing among 28 benefit designs from five carriers with varying levels of coverage and cost. HealthPass also handles all administrative duties, offers free benefit consultations, and features a tax-advantaged plan that saves AdTek $5,000 annually. Membership in the plan, which is limited to small businesses that have fewer than 50 employees and are located in New York City and surrounding counties, has tripled over the past four years.