Group Health Insurance for Small Business
Small employers have more options than most realise. We compare traditional group plans, ICHRA reimbursement and level funded arrangements side by side, and explain honestly what each one commits you to before you sign anything.
Group products for every type of organisation
We research the group market on your behalf to find the arrangement that genuinely fits — whether you are a five-person shop, a growing mid-size company, or a large multi-state employer.
Small and medium groups
From two enrolled employees upwards. Fully insured and level funded plans, ICHRA, and add-on dental, vision and ancillary cover — sized so the contribution and participation rules actually work for a smaller headcount.
Large groups
At fifty or more full-time equivalents the ACA employer shared responsibility rules apply, and the maths changes. We help larger employers weigh self-funding elements, network design and multi-state workforces.
Employee benefits that we offer
Our aim is straightforward: the best benefits your budget allows, and employees who actually understand how to use them. Benefits nobody understands get wasted, so education is part of what we do rather than an afterthought.
Traditional group health plan
A full suite of medical benefits with the carrier carrying the claims risk. Predictable monthly cost, straightforward administration, and the usual starting point for most small employers.
ICHRA
Reimburse employees tax-free for individual cover they choose themselves. Sidesteps annual group rate hikes and participation requirements, and suits distributed teams or fluctuating headcount.
Level funded and self funded
A fixed monthly payment covering claims, admin and stop-loss cover. Healthy groups may see surplus returned, in exchange for taking on more variability and underwriting.
Dental, vision and ancillary
Standalone dental and vision, plus accident, critical illness and hospital indemnity cover as voluntary or employer-paid add-ons alongside the medical plan.
Group life and disability
Employer-paid or voluntary group term life and disability cover, usually issued with simplified underwriting so employees are not put through individual medical questions.
Minimum essential coverage
Preventive-focused plans that satisfy certain employer obligations at lower cost. Benefits are limited, so it matters that everyone understands what is excluded.
Compare the three main approaches
These are genuinely different arrangements rather than tiers of the same product. The right one depends on your headcount, your workforce’s health, and how much variability you can absorb.
| Feature | Traditional group plan | ICHRA | Level funded |
|---|---|---|---|
| How it works | You choose one plan (or a few) and the carrier covers claims. | You set a monthly allowance; employees buy their own individual cover. | Fixed monthly payment covering claims, admin and stop-loss protection. |
| Who carries the risk | The carrier | Neither — you fund a defined allowance only | Shared: you fund claims up to a point, stop-loss covers the rest |
| Cost predictability | High. Fixed premium for the plan year. | Very high. Your cost is exactly the allowance you set. | Moderate. Fixed payment, with surplus possibly refunded. |
| Employee choice | Limited to the plans you pick | Wide — each employee chooses from the individual market | Limited to the plans you pick |
| Underwriting | Usually none for small groups | None | Yes — health questionnaires normally required |
| Participation rules | Carrier minimums apply | None | Carrier minimums apply |
| Admin burden | Low | Moderate — reimbursement tracking and class rules | Moderate — more reporting |
| Often suits | Employers wanting simplicity and a familiar structure | Distributed teams, variable headcount, tight budget control | Healthy groups willing to trade certainty for potential savings |
Scroll sideways to compare all three →
We also help with the rest of it
Putting a plan in place is one thing; running it month to month is another. These are the pieces employers most often ask us for once the medical cover is sorted.
Section 125 cafeteria plan
Let employees pay their share of premiums pre-tax, which lowers payroll tax for you and take-home cost for them.
Online benefits administration
A portal for enrolment, changes and document access, so new starters and leavers do not become a paperwork exercise.
Compliance support
ACA reporting, employer mandate thresholds, notice requirements and COBRA — the obligations that catch employers out.
HR support line
Somewhere to send the awkward questions when you do not have a dedicated HR function of your own.
What you are actually required to do
Employers with fewer than 50 full-time equivalent employees are generally not required to offer health insurance. Many do anyway, because in a tight labour market benefits are often what decides whether someone accepts an offer or stays.
At 50 or more full-time equivalents the ACA employer shared responsibility provisions apply, along with annual reporting. Counting full-time equivalents is less obvious than it sounds — part-time hours aggregate — so it is worth confirming where you sit before assuming.
Carriers also set their own rules: a minimum share of the employee-only premium that you must fund, and a minimum proportion of eligible employees who must enrol. Both vary by carrier and state, and some relax participation requirements late in the year.
Common questions from employers
How many employees do I need to qualify for a group plan?
Most carriers will write a small group from two enrolled employees, subject to participation and contribution minimums. A sole proprietor with no employees generally cannot buy group cover and would look at individual Marketplace plans instead.
Am I legally required to offer health insurance?
Below 50 full-time equivalents, generally no. At 50 or more, the ACA employer shared responsibility rules apply. Because part-time hours aggregate into full-time equivalents, it is worth having the count checked rather than estimated.
How much do I have to contribute?
Carriers typically require the employer to fund a minimum share of the employee-only premium — often around half — and to hit a participation threshold. Exact requirements vary by carrier and state.
Can I offer different benefits to different employees?
You can vary by legitimate class, such as full-time versus part-time or by location, but not arbitrarily by individual. ICHRA has its own specific class rules that are worth walking through carefully before you design anything.
When can we start or change a plan?
Unlike individual cover, small group plans can generally begin in any month. Some carriers also relax participation requirements during a window late in the year, which can open options that were not available earlier.
Does using a broker cost us more?
No. Broker compensation is already built into the filed rates, so your premium is the same either way. What changes is that someone independent is comparing the market on your behalf each renewal.
Let us build your plan
Tell us your headcount, where your people are based, and roughly what you can commit each month. A licensed broker will compare traditional group, ICHRA and level funded options side by side, and tell you plainly which is worth your time.
All Solution Plus is a licensed insurance agency. We do not offer every plan available in your area. Group plan availability, rates, participation and contribution requirements, underwriting rules and employer obligations vary by state, carrier and group size. Level funded and self funded arrangements involve self-funding elements and carry different risks from fully insured plans. This page is general information and not legal, tax or employee benefits advice — please consult your own advisers regarding your obligations under the ACA, ERISA and applicable state law.