Small-business group coverage
Do I have to offer my team health coverage?
Short answer: probably not. If your business has fewer than 50 full-time-equivalent employees, federal law does not require you to offer health coverage. Most small businesses sit well under that line. At 50 or more, the rules change and a coverage requirement kicks in. A few states add their own rules, so your exact situation depends on your size and where you operate.
So the honest question is not whether you have to. It is whether offering real coverage is worth it: what it costs you, what it costs your people, and what it does to your week. That is the part no one answers straight. So here it is.
No name, no email, no phone to see your result. No salesperson, no one calling you.
The short version
Under 50 full-time-equivalent employees, you are almost certainly not required to offer coverage. The real question is whether it is worth it. The rest of this page answers that.
You are not required to. Plenty of owners do it anyway. Here is why, and what stops them.
Two reasons owners offer coverage even when they do not have to. One, you cannot keep good people without it, and "we don't offer coverage" loses you the hire to the company that does. Two, you need coverage yourself, and putting it through the business is usually the better way to pay for it.
What stops most small owners is the same two things. The price: bought as a small group, the rate is age-banded, so it climbs every year and hits your most experienced people hardest. And the desk: payroll, filings, workers' comp, and HR all land on you, or you bolt on a service that charges a percentage of payroll and costs more every time you give a raise or add a head.
There is a version that fixes both. Real group coverage priced as one big group, on a flat fee per person that does not climb when you grow, with the back office off your desk. That is what the rest of this page is about.
How small-business group coverage actually works.
A 500-person company gets better coverage at a better price than a 10-person company can, because it buys as one large group instead of as one small one. The fix for a small business is to join a group like that instead of being rated as your own little pool. Your team goes onto one national PPO at a composite rate, set by the large group and not by each person's age, on one plan across every state they work in. The premium runs through your own payroll. Your people keep their doctors. And the owner can be on the plan too.
We are not the plan provider. A separate licensed provider runs the coverage. We run your numbers and connect you.
The believability clause
You do not build a group. You join one that already exists.
A 10-person company qualifies the same as a 200-person company, and so does a business of one.
What it actually fixes.
The rate is composite, set by the large group, so age stops setting the price and a small team is not punished for having experienced people. And the back-office fee is flat, per person, so it does not climb when you raise pay or add a head, unlike a percentage-of-payroll service that charges you more every time you grow.
Payroll and filings run without you. Workers' comp is pay-as-you-go, no big deposit and no year-end audit. A compliance question goes to someone whose job it is. HR support comes from a person you can actually reach. Even at break-even on cost, you move the entire back office off your desk and get your attention back for the business you actually run.
Running a team of 2 to 25? The full picture, including the percentage-PEO comparison and the flat fee, is on the page built for owners with a team →
What about ICHRA?
ICHRA changes who pays for an individual plan; a group plan changes what plan your people actually get, taking them off the age-rated individual market and onto one composite-rate national PPO, with the owner on it too. For some teams ICHRA is the right call, and the calculator will say so.
The honest, full read on ICHRA versus a group plan is on the team page →
The coverage a big company gets
Do not take our word for it. Run your own numbers.
Enter what you earn, your team if you have one, and what you spend on coverage and admin now. You get two numbers back, free, with no name, email, or phone. Your company's payroll costs, coverage plus admin today against the group plan and the fees you stop paying. And your own personal finances. It runs live on the real 2026 federal and state tax tables. If it does not beat what you run today, the screen says so.
No name, no email, no phone to see your result.
Want it in writing? The full CPA audit report, generated for your exact numbers, is yours to hand your accountant, built to be checked line by line.
You see your numbers before we see you. Your own CPA gets the final word.
The full CPA audit report we generate for your exact figures is built for your accountant to check line by line. We tell you when it does not fit, because we only earn when it does. This is not a loophole. It is an established structure big companies have used for decades, run through a NAPEO-member, ESAC-accredited provider on the Cigna national PPO, on the real 2026 tax tables. Your accountant can verify every figure.
In the news
The 2026 cost shock made national news.
When the 2026 subsidies ended, the squeeze on owners and the self-employed was covered across the major networks. The cost structure was always there. The news just put it on everyone's screen.
Millions face the ACA subsidy expiry
The quiet fallout from higher ACA premiums
How the end of ACA subsidies is squeezing owners
Premiums set to skyrocket Jan. 1
Millions of Americans in limbo
Health premiums set to soar
Unedited segments from each network's own coverage. USA OPS is not affiliated with or endorsed by these outlets.
Small-business coverage questions, answered straight.
Do small businesses have to offer health coverage to employees?
Most do not. If your business has fewer than 50 full-time-equivalent employees, federal law does not require you to offer health coverage, and most small businesses are under that line. At 50 or more full-time-equivalent employees, a coverage requirement applies. A few states add their own rules, so your exact obligation depends on your headcount and where you operate.
How does group health coverage work for a small business?
Instead of being rated as your own small pool, your business joins a large group that already exists. Your team goes onto one national PPO at a composite rate set by the large group, not by each person's age, on one plan across every state they work in, and the premium runs through your payroll. You join the group; you do not build it. A business of one qualifies the same as a larger company.
What is the difference between ICHRA and a small-business group plan?
ICHRA changes who pays for an individual plan. It does not change what plan your people can get; they are still buying in the age-rated individual market. A group plan takes them out of it, onto one composite-rate national PPO, the kind a big company offers, with the owner able to be on it too. For some teams ICHRA fits, and the free calculator says which.
How much does small-business group coverage cost?
Representative monthly rates on the Cigna national PPO run from about $589 for an HSA-qualified plan to $879 for a low-deductible plan, with a balanced plan around $732. The back office is a flat fee per person, $150 a month for the full stack or $75 for compliance only, and it does not climb when you raise pay or add a head. Your actual rate is set at enrollment, and your own number comes from the calculator.
Can the business owner be on the company’s group health plan?
Yes. Through the group plan the owner can be covered on the same plan as the team. This is one place a group plan differs from an ICHRA, where an owner with more than a 2 percent stake in an S-corp cannot be covered on a tax-advantaged basis by the company's own arrangement. Your CPA confirms the treatment for your situation.
Is it cheaper to offer a group plan or have employees buy their own coverage?
It depends on your team's ages, wages, and where they live, and the honest answer is that the free calculator shows which wins for you. As a rule, a composite group rate beats the age-rated individual market for a team with experienced or higher-wage people, and an individual-market approach can win for a young, lower-wage, or dispersed team.
Do I have to give my contact details to see my numbers?
No, not to see them. The calculator returns your company's payroll-cost number and your own personal-finances number with no name, email, or phone. Contact is asked only if you want the full CPA audit report sent to you and your accountant. No salesperson, no one calling you.
Not required. Often worth it. See your number.
Run the math free. No call, no email, no salesperson. If the structure does not beat what you run today, the screen tells you so and you owe us nothing, because we only make money when an owner we connect actually comes out ahead.
Your exact 2026 numbers, free. The full CPA audit report when you want it.