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.