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Group Health Insurance
Premiums vary by State, Insurance Company, Plan Design, Age Demographics, and Industry.
Level-Funded
A hybrid model where employers pay a fixed monthly amount covering claims, admin, and stop-loss insurance with potential refunds if claims come in under budget. It offers the cost-control benefits of self-funding with the predictability of a fully insured plan. Ideal for small to mid-size businesses looking to save without taking on full financial risk.
Ideal for 2-200 Employees
From ~$350+/mo per Employee
Fully Insured
The traditional group health insurance model where the employer pays a fixed monthly premium to an insurance carrier, which assumes all financial risk for claims. Coverage, compliance, and claims management are handled entirely by the insurer. Best suited for small businesses that want simplicity and predictable costs with no claims exposure.
Ideal for 2-100 Employees
From ~$550+/mo per Employee
Self-Funded
The employer assumes direct financial responsibility for employee health claims rather than paying premiums to a carrier, typically pairing with stop-loss insurance to cap exposure. This model offers maximum flexibility, transparency into claims data, and significant cost savings when claims are well-managed. Best for large, financially stable organizations with the capacity to absorb claims variability.
Ideal for 250+ Employees
From ~$250+/mo per Employee
GAP Insurance
A supplemental plan that covers out-of-pocket costs left by primary health insurance — such as deductibles, copays, and coinsurance — helping employees avoid unexpected medical bills. It's typically offered alongside high-deductible health plans to bridge the financial gap for employees. Suitable for employers of any size who want to enhance benefits affordability without redesigning their core plan.
Ideal for Any Size Employer
From ~$20+/mo per Employee
Gap insurance is a supplemental add-on and must be paired with a primary health plan — it does not function as standalone coverage.
Minimum Essential Coverage (MEC)
A low-cost plan that satisfies the ACA's employer mandate by providing basic preventive care — such as annual exams, immunizations, and screenings — without comprehensive medical coverage. It protects employers from ACA penalties while offering employees access to essential preventive services at a minimal premium. Ideal for large employers with variable-hour or part-time workforces who need affordable, compliant coverage.
Ideal for 50+ Employees (ALEs)
From ~$50/mo per Employee
MEC does not replace major medical insurance. Employees should be aware this plan covers preventive services only and does not include hospital, specialist, or prescription coverage.
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Frequently Asked Questions
Common Questions Answered for your convenience.
What factors affect how much I'll pay for group health insurance?
The cost of a group health plan is influenced by several factors including your employees' average age, group size, industry, location, and the plan type you select. Carriers also consider claims history for level-funded and self-funded arrangements, which can work in your favor if your group is generally healthy. Working with a broker allows you to compare options across multiple carriers to find the most competitive rate for your specific group.
Am I required by law to offer health insurance to my employees?
Businesses with fewer than 50 full-time equivalent employees are not federally required to offer health insurance. However, Applicable Large Employers (ALEs) with 50 or more full-time equivalent employees must offer Minimum Essential Coverage (MEC) or face ACA penalties. Regardless of size, offering health benefits can significantly improve employee retention and recruitment.
Can employees add their family members to the plan?
Yes, most group health plans allow employees to add dependents such as a spouse and children, typically up to age 26. The additional premium for dependents is often shared between the employer and employee, though the split varies by company. Dependent coverage options and costs will differ depending on the plan type and carrier selected.
How many employees do I need to offer group health insurance?
Most carriers require a minimum of 2 full-time employees to qualify for a small group plan. Some states allow sole proprietors with no other employees to enroll. Requirements vary by carrier and state, so it's best to speak with a broker to confirm eligibility for your specific situation.
What's the difference between fully insured and self-funded plans?
With a fully insured plan, you pay a fixed premium to an insurance carrier who assumes all financial risk for claims. With a self-funded plan, your company pays employee claims directly, giving you more control and potential savings — but also more financial exposure. Most mid-to-large employers opt for self-funded or level-funded arrangements to reduce long-term costs.
How do I know which plan type is the right fit for my company?
The right plan depends on your company's size, budget, risk tolerance, and employee demographics. Smaller employers often benefit most from fully insured or level-funded plans, while larger organizations with stable cash flow may see significant savings through self-funded arrangements. A licensed benefits broker can analyze your group's specific needs and present a side-by-side comparison to help you make the most informed decision.