What are my options as a small employer?
Small employers have more choices than most people realize. Group plans can start with as few as two employees, and reimbursement arrangements like ICHRA and QSEHRA let you offer a tax-free benefit without picking one policy for everyone. Here is how the five main options compare.
| Option | Who it fits | How cost works | Admin effort |
|---|---|---|---|
| Fully insured group plan | Teams that want predictable costs and the simplest setup. | Fixed monthly premium per employee. The carrier carries all claim risk. | Low |
| Level-funded plan | Generally healthy teams, often 5 or more employees, who want a chance at savings. | Steady monthly payment covering expected claims, admin and stop-loss. Unused claim money may come back to you. | Low to moderate |
| Self-funded plan | Larger employers with the cash flow to absorb claim swings. | You pay claims as they happen, plus admin fees and stop-loss insurance. | High |
| ICHRA | Any size employer that wants a set budget and employees choosing their own plan. | You set a monthly allowance by employee class and reimburse individual premiums tax-free. | Low to moderate |
| QSEHRA | Employers with fewer than 50 full-time-equivalent employees and no group plan. | You set an allowance up to an annual IRS limit and reimburse individual coverage tax-free. | Low |
What does level-funded mean?
Level-funded sits between a traditional group plan and self-funding. Each month you pay the same amount. That payment covers three things: a fund for your team's expected claims, the plan's administration, and stop-loss insurance that protects you if a big claim comes in.
If your team's claims come in lower than expected, part of that unused claim money may come back to you at the end of the plan year. If claims run high, stop-loss coverage picks up the excess, so your monthly cost doesn't jump mid-year. It often works well for healthy teams that want some upside without taking on big risk.
How much does group health insurance cost?
There is no single price, because every quote is built from your team. The main drivers are:
- Team size. How many people enroll, and how many add spouses or children.
- Ages. Premiums are set partly by age, so the age mix of your team matters.
- Location. Prices and carrier networks vary by state and even by county.
- Plan design. Deductibles, copays, network type (HMO, PPO) and HSA eligibility all move the price.
- Your contribution. What share of the premium you pay shapes what it costs you and your employees.
The fastest way to know your number is a quote based on your actual census.
What compliance rules apply?
The ACA. Employers with 50 or more full-time-equivalent employees must offer affordable coverage that meets minimum value, or risk a penalty. Smaller employers don't have to offer coverage, but any plan they do offer must follow ACA rules, such as covering essential health benefits in the small-group market.
ERISA. Most private-sector health plans are governed by ERISA. In plain English, that means you need a written plan document, you must give employees a Summary Plan Description, and you have to run the plan in their best interest. Larger plans also file an annual Form 5500. Church and government plans are generally exempt.
We help you set up the paperwork correctly from day one. For legal or tax questions specific to your business, check with your attorney or CPA.
How do we get started?
- 1
We learn about your team
Headcount, current coverage, renewal date, budget.
- 2
We tell you what's possible
Which plan types fit (group, ICHRA, QSEHRA, level-funded) and what we'd shop.
- 3
You decide
No cost for the quote and no obligation.