Coverage
How a small business gets group health coverage
A small business with 1 to 25 employees can offer real group health coverage. There are three common routes: a small-group plan you arrange yourself, a plan through a broker, or a large-group plan you join through a PEO structure. They differ mostly in what you pay, what network you get, and how much administration lands on you.
This page walks through the three routes, what a group plan through a PEO actually includes, and why its pricing works differently.
No fee and no contact for the first result.
01
The three routes, in plain terms
Buy a small-group plan yourself. You go to a carrier and buy a plan for the group directly. It is the most direct route, and for some teams it is enough. The trade is that you are rated inside the small-group market, where the premium reflects your group's size, ages, and claims, and you run the enrollment and the paperwork yourself.
Work through a broker. A broker shops small-group plans for you and handles some of the legwork. You get expertise and a wider set of choices, and you stay inside that same small-group market, so the pricing and the renewals follow the same rules.
Join a large group through a PEO. Your team joins an existing large group that a professional employer organization sponsors. You get large-group pricing and a National Tier 1 PPO, and the payroll, filings, workers' compensation, and HR support run through the same structure. This is the route that changes the pricing math, because your team is no longer rated as a small group on its own.
| Small-group, yourself | Through a broker | Large group via PEO | |
|---|---|---|---|
| Who arranges it | You | A broker, for you | Our PEO partner sponsors the group |
| How it is rated | Small-group market: your team's size, ages, and claims | Small-group market, same rules | Large-group pricing, across a big pool |
| Network | Carrier's small-group network | Carrier's small-group network | National PPO |
| Back office | You run payroll, HR, and the filings | You run payroll, HR, and the filings | Handled through the structure |
| At renewal | Climbs with your group | Climbs with your group | Large-group terms |
02
What a group plan through a PEO includes
A PEO group plan is more than the health coverage. Through our PEO partner it covers:
- A National Tier 1 PPO for the team, in three tiers.
- Top-tier dental and vision.
- A retirement plan.
- Payroll, the tax filings, workers' compensation, and HR support, all run through the same structure.
We are not the plan provider. A separate, licensed provider runs the plan. We run the math and connect you.
The plan tiers and the flat fee are published in the open. See what a group plan includes and see pricing.
03
Why the pricing works differently
A small-group plan is rated within the small-group market, so the premium tracks your own team's size, ages, and claims history, and it tends to climb at renewal. A PEO puts your team inside a large group, where the plan is priced the way a big employer's is, across a much larger pool.
The fee for the PEO route is flat: a set amount per person per month that holds steady when you add a hire or give a raise, so it does not climb with your payroll. The trade association for professional employer organizations reports more than 500 such organizations serving over 230,000 client businesses and more than 4.5 million worksite employees, and finds that businesses using one are about 50 percent less likely to go out of business (NAPEO, 2026).
04
What it takes to qualify
Whether a PEO group plan fits comes down to the numbers. The math tends to work when:
- you have 1 to 25 W-2 employees,
- the business nets about $90,000 or more and the owner pays about $500 or more a month for coverage, and
- renewal cost, retention, payroll, or workers' compensation is part of the decision.
If you are a bit over 25, run it anyway and we will tell you where you stand. Final eligibility depends on the provider's review of your business, and the calculator is built to tell you early when a group plan is unlikely to help.
See your number
Your own figures decide which route wins. The calculator runs your 2026 numbers and shows your current path next to a group plan, before you give us a name.
05
How we calculate this, and our sources
The plan details come from our PEO partner's current group offering: a National Tier 1 PPO in three tiers, top-tier dental and vision, and a retirement plan. The industry figures come from the trade association for professional employer organizations (NAPEO, 2026). Your own result comes from the figures you enter, and the full report shows every line for your CPA to check.
This page reflects 2026 and is reviewed quarterly. See our full method.
06
Related reading
07
Frequently asked questions
How does a small business get group health coverage?
Three common ways: buy a small-group plan directly from a carrier, work through a broker who shops small-group plans, or join a large group through a PEO structure. The first two keep you in the small-group market; the PEO route puts your team in a large group with large-group pricing.
How many employees do I need for a group plan?
Even one, which can be just the owner. A small team of 1 to 25 fits the PEO route, and a business of one can qualify too. The calculator checks your specific situation.
Is a PEO cheaper than a small-group plan?
Sometimes yes, sometimes no. It depends on your team's size and ages, your state, and what you pay today. That is the point of running your own number rather than comparing brochures. The model will tell you when staying put is the better move.
What does a PEO group plan include?
A National Tier 1 PPO in three tiers, top-tier dental and vision, and a retirement plan, plus payroll, the filings, workers' compensation, and HR support through the same structure.
Does USA OPS sell the coverage?
No. We run the analysis, explain the fit, and connect qualified owners with our PEO partner. The partner provides the group plan and handles underwriting, enrollment, payroll, and service.
See your number