Most small employers think they have two options. There are more.
The owners we talk to usually believe the choice is “offer a group plan” or “offer nothing.” In practice there are at least four routes, and which one wins is a math question that depends on your team's ages, where they live, and what you can contribute each month.
The gap is real. AHRQ's Medical Expenditure Panel Survey found that 50.5% of private-sector establishments with fewer than 50 workers offered health insurance in 2024, compared with 97.4% of large establishments — and the small-firm offer rate was down from 61.6% in 2008. Average 2024 premiums were $8,486 for single coverage and $24,540 for family coverage.
Your four routes, in plain English
| What it is | Often best when | |
|---|---|---|
| Traditional group | One plan (or a few) you buy for the team | Your team skews older and your current rates are good |
| SHOP | Small Business Health Options Program, generally for 1–50 FTEs | You want a group plan and may qualify for a tax credit |
| QSEHRA | Tax-free reimbursement, generally for employers under 50 FT with no group plan | You want to help without running a group plan |
| ICHRA | Set an allowance; employees buy their own individual coverage | You want a cost you choose, not a renewal you receive |
Employer coverage and HRAs can generally begin throughout the year, which makes this a less seasonal decision than individual ACA enrollment. You do not have to wait for the fall.
The five questions we start with
- How many W-2 employees and full-time equivalents do you have?
- Where do your employees live and work?
- What are you trying to accomplish — recruiting, retention, tax efficiency, or coverage for yourself?
- What can you contribute monthly?
- Is there an existing group plan or reimbursement arrangement in place?
That is genuinely enough for us to tell you which of the four routes is worth pricing. It takes about twenty minutes.
20-minute benefits feasibility review
Traditional group, SHOP, QSEHRA, and ICHRA — priced against each other for your actual team. Free, no obligation.
Book a feasibility reviewOwner coverage is part of this too
A small-employer conversation is rarely only about employee health insurance. Depending on your situation it can also surface employer-paid life, short- and long-term disability, voluntary benefits, and — if you have a partner or a business worth protecting — key-person and buy-sell funding. We raise those when there is a reason to, not as a matter of course.
When the answer is “stay put”
Sometimes it is. If your team is mostly older and your current group rates are good, staying where you are can be the right call. We have told employers exactly that. Being independent is what makes it possible to say so — we represent many carriers rather than one, so we are not steering you toward a single company's shelf.