Small business group health insurance, built around your team.

Do you even have to offer coverage?

Under 50 full-time employees, coverage is voluntary. At 50, the mandate kicks in and the math gets real.

If you have under 50 full-time employees, you are not required to offer coverage. A small group runs from 2 to 50 full-time-equivalent (FTE) employees. The moment you cross 50 FTEs, the ACA employer mandate applies, and the penalties are real money.

If you are anywhere near that line, the FTE count matters more than most owners think. Seasonal and part-time hours add up and can push you over without you noticing. Most of the businesses we work with offer coverage even though they do not have to, for a simple reason: medical is the benefit employees value most, ahead of almost anything else you could put in front of them. When you are trying to hire and keep good people, this is usually where the budget goes first.

Traditional small-group coverage

The classic setup: simple, predictable, and in 2026, very easy to overpay for.

You pick a plan or a short menu of plans through a carrier, employees enroll, and the premium is fixed and predictable. Most carriers want at least 70% of eligible employees to enroll and require you to cover at least 50% of the employee-only premium. That 50% is the floor, not the goal. Plenty of employers go to 75% or 100% of the employee cost to stay competitive, then have the employee pick up dependents.

It is simple and it works. The catch in 2026 is price. Employer health costs are projected to climb 6 to 10% this year, the steepest jump in over a decade, and we have seen small-group renewals come in even higher. If you have been on a fully insured plan for years and just sign off on the increase every spring, you are very likely overpaying.

If you sign off on the renewal increase every spring without shopping it, you are very likely overpaying.

Level-funded plans: where the refund lives

It feels like a fixed premium, but if your team stays healthy, some of the money can come back to you.

This is the structure most owners have never had walked through properly. With a level-funded plan you pay a fixed monthly amount, the same feel as fully insured, but that payment splits into three buckets: a claims fund that pays your employees' actual medical bills, stop-loss insurance that protects you if one person has a catastrophic year, and administration.

If your team does not use up the claims fund by year-end, some of it can come back to you. On a fully insured plan, the carrier keeps that surplus. On a level-funded plan, you have a shot at getting it back. Adoption has climbed sharply among small firms in recent years. These plans often run cheaper than fully insured for a healthy group, and because they are treated as self-funded under federal law, they skip most state insurance mandates and premium taxes, which can open up plan designs a fully insured carrier cannot sell.

• Best fit: roughly 10 to 100 employees with a reasonably healthy, stable workforce.
• The classic mistake: a 10- to 15-person firm with a clean claims history staying fully insured because nobody ever walked them through the alternative. That company is often the single best refund candidate, and it hands the surplus to the carrier every year.
• Under 10 employees: ask about the stop-loss attachment points (the dollar level where the stop-loss insurance starts paying) before you sign. With a tiny pool, one bad claim can drain the fund depending on how the contract is written.

ICHRA: pay an allowance, skip picking the plan

You fund a monthly allowance, employees buy their own individual coverage, and you reimburse tax-free against proof.

Instead of choosing one plan for everybody, you set an allowance and each employee picks their own individual policy. There is no federal minimum or maximum on what you contribute, you can set different amounts for different classes of employee, and whatever an employee does not claim stays with you. It is strongest for teams spread across several rating areas, groups with a wide age spread, and owners offering coverage for the first time.

One thing to know before you get attached to the idea: if your ICHRA counts as affordable, those employees can no longer claim a Marketplace premium tax credit. For a team that would otherwise receive substantial subsidies, that single rule can decide the whole question. We run that math per employee before you commit.

QSEHRA: a simpler on-ramp if you offer nothing today

Under 50 employees with no group plan today? This is often the easiest way in.

If you are under 50 employees and do not currently offer any group plan, a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) can be the easy way in. You set a fixed monthly contribution within the IRS limits, employees buy their own coverage and submit receipts, and there is no affordability testing to run. It is reimbursement-based like ICHRA, but with set caps and simpler rules.

Just do not confuse the two. QSEHRA is only for employers with no group plan and has contribution limits. ICHRA has no limits and can run alongside a traditional plan for different classes of employees. Mixing them up causes real compliance headaches, which is exactly the kind of thing we keep you out of.

What our team actually does for you (and what it costs)

The quote is the easy part. The value is everything around it, including a renewal that never blindsides you.

We compare carriers and plan types for your specific situation, check network adequacy against the ZIP codes where your employees actually live and work (a real issue in rural Arizona, where a cheap narrow-network plan can leave someone with no in-network primary care within 30 miles), run the enrollment, handle the paperwork, and manage your renewal every year so the spring increase does not blindside you.

The renewal is where it matters most. The right time to shop alternatives is 90 to 120 days before your plan anniversary. If you wait for the renewal letter to land, the window to underwrite a level-funded plan or stand up ICHRA administration for that year is usually already closed, and your leverage is gone.

As for cost: working with our team is free. Carrier commission is already baked into the premium whether or not you use a broker, so going direct does not lower your price. That commission is in your premium either way. You may as well have someone using it on your behalf. That is the same care we bring to every client, whether it is one household or a team of forty.

We do not stop at the quote. We stay your guide through enrollment, compliance, and every renewal after.