Group Insurance health plans provide coverage to a group of members, usually comprised of company employees or members of an organization.
Small businesses often have the option to provide health insurance for their employees through group plans. These plans can offer a range of benefits and coverage options, making it easier for small business owners to attract and retain top talent.
Plan types
HMO
Lower premiums, requires members to use in-network providers and get referrals from a primary care physician. Best for cost-conscious teams.
PPO
More flexibility to see any doctor without referrals. Higher premiums but greater choice of providers. Best for employees who value flexibility.
HDHP + HSA
Lower monthly premiums with a higher deductible. Paired with a tax-advantaged HSA account. Best for healthy, younger employees.
EPO
Hybrid of HMO and PPO — no referrals needed but must stay in-network. A middle-ground option for small teams on a budget.
How it works
Meet with an Ikhlas advisor at no cost. We’ll ask a few questions about your business size, budget, and coverage goals.
Provide basic employee information through a census form. This helps us accurately assess your team’s needs and identify the most suitable coverage options.
We shop the market across leading national insurers to find the best plans that fit your budget and your employees’ needs.
Once you select a plan, Ikhlas manages enrollment, compliance documentation, and employee onboarding materials.
Your team gets covered, and we stay available year-round for renewals, changes, and any questions that come up.
We review your coverage annually to ensure it still fits your team’s needs and budget.
Coverage included
Most ACA-compliant group plans include these essential health benefits:
Eligibility
Eligible for SHOP marketplace plans
Small group or large group depending on state
Large group market plans
Eligible — requirements vary by state
Typically 70% of eligible employees must enroll
Cost breakdown
Premiums are split between you (the employer) and your employees. Here’s a general overview of how contributions work:
| Who pays | Typical share | Tax treatment |
|---|---|---|
|
Employer (employee-only coverage) |
At least 50% (often 60–80%) |
Fully tax-deductible business expense |
|
Employee contribution |
Remaining 20–50% |
Deducted pre-tax via payroll |
|
Dependent/family add-on |
Usually employee’s responsibility |
Pre-tax payroll deduction |
Employers with fewer than 25 full-time employees may qualify for the Small Business Health Care Tax Credit — worth up to 50% of premium costs paid.
Group members receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders.
Plans usually require at least 70% participation in the plan to be valid.
Premiums are split between the organization and its members, and coverage may be extended to members’ families and/or other dependents for an extra cost.
Employers can enjoy favorable tax benefits for offering group health insurance to their employees.
Book a free consultation with one of our experts to discuss your Group plan. All of our services are free!
In most states, you need at least 2 full-time equivalent employees to qualify for a small group plan. Some states allow sole proprietors to enroll. Our advisors can confirm eligibility based on your state.
Part-time employees may be eligible depending on your plan’s rules. They typically must work a minimum number of hours per week (often 30 hours). Coverage for part-time staff is optional for most small employers.
When an employee leaves, they can continue coverage temporarily through COBRA (Consolidated Omnibus Budget Reconciliation Act) for up to 18 months — though they pay the full premium cost. They may also qualify for a special enrollment period on the individual marketplace.
Yes. Some group arrangements allow employers to offer multiple plan tiers so employees can choose what fits their needs and budget — for example, a lower-premium HMO alongside a more flexible PPO.
It is not required for businesses with fewer than 50 full-time equivalent employees. However, employers with 50 or more full-time equivalent employees are required under the ACA’s Employer Shared Responsibility provision to offer minimum essential coverage or face potential penalties.
Coverage typically starts on the first of the month following enrollment. Some plans may allow a waiting period of up to 90 days for new employees before coverage kicks in.
