Group Health Insurance Broker
Group health cover for US employers, set up and run by a licensed broker.
Talk to a licensed group health insurance broker who works with businesses of your size, in your state. You get one name, with a license number you can check, before anyone has your details.
What applies at your headcount
Federal rules change at 20, 25, 50 and 100 employees. Pick your size to see which apply. Counts are usually averages over the prior year, and full-time equivalents are counted differently for different rules, so a broker or accountant should confirm yours.
Employees, including owners on payroll
| Rule or option | At this size | What it means |
|---|---|---|
| A group health plan is possible | Yes | Needs at least one employee who is not an owner or an owner's spouse, in most states. |
| Small group market rules | Yes | No health questions; premiums vary only by age, area, tobacco and plan (healthcare.gov). |
| SHOP Marketplace | Yes | For employers with 50 or fewer full-time equivalent employees (healthcare.gov). |
| Small business health care tax credit | PossiblyIf average wages qualify | Fewer than 25 FTEs, lower average wages, a SHOP plan and at least 50% of employee-only premiums paid (IRS). |
| Federal COBRA continuation | NoState law may apply | Group health plans of employers with 20 or more employees in the prior year (Department of Labor). |
| ACA employer rules and IRS reporting | No | Applicable large employers: 50 or more full-time and full-time equivalent employees (IRS). |
| QSEHRA reimbursement | Yes | For employers with fewer than 50 full-time employees that do not offer a group plan (IRS Notice 2017-67). |
The classic small group. You can buy a plan with no health questions, may qualify for the small business tax credit and SHOP, and federal COBRA does not apply yet (your state may have its own continuation law).
General information for employers, not insurance, tax or legal advice. A licensed broker can tell you what applies to your business.
What a group health insurance broker does for you
A broker is licensed by the state to sell and service health insurance, and in group health their client is the employer. Before the sale they find out what you want to spend and what your people need, get quotes from the carriers they are appointed with and set the options side by side. After it, they run enrollment, deal with billing and claim problems, keep track of compliance dates and start each renewal early.
For most small groups the broker is paid a commission by the carrier, built into the premium. Larger employers sometimes pay a flat fee instead. Either way, federal rules require brokers to tell you in writing what they expect to earn when it is $1,000 or more.
What a group benefits broker handles
- Small business health insurance broker
For teams of 2 to 50 setting up or reviewing a first plan.
- Employee benefits broker
Medical, dental, vision, life and disability, with the compliance work.
- Small group health insurance
How the small group market is rated and what carriers can ask.
- Level-funded health plans
Fixed monthly cost with a possible refund. Read the stop-loss terms.
- Self-funded health insurance
Paying claims directly, capped by stop-loss insurance.
- Group health insurance quotes
What a broker needs from you to go to market.
Four ways to fund employee health cover
Most small employers start fully insured. Level funding and ICHRAs are the options brokers are most often asked about now. In 2026, 38% of covered workers at smaller firms were in level-funded plans (KFF).
| Feature | Fully insured | Level-funded | Self-funded | ICHRA |
|---|---|---|---|---|
| Who carries the claims risk | The carrier | You, capped by stop-loss | You, capped by stop-loss | Each employee's own insurer |
| What you pay each month | A fixed premium | A fixed amount, refund possible | Claims as they arise, plus fees | A set allowance you choose |
| Health questions to price it | None in small group | Usually | Usually, or claims history | None |
| Claims reports for you | Rarely | Often | Yes | No |
| Main rules | State insurance law and the ACA | Federal ERISA, mostly | Federal ERISA, mostly | IRS and DOL HRA rules |
General comparison; programs vary. More on level-funded and self-funded plans. General information for employers, not insurance, tax or legal advice. A licensed broker can tell you what applies to your business.
Not sure which of these fits your team? A licensed broker can quote more than one side by side.
Find a licensed brokerYour plan year, worked back from the renewal date
A typical timetable for a small or mid-sized group. Start earlier if you want to change funding type or have staff in several states.
- 120 days before
Choose a broker
Appoint one with a broker of record letter if you are switching. Gather a census: dates of birth, ZIP codes, cover tier.
- 90 days before
Go to market
The broker asks carriers for quotes and, if you have a plan, gets your renewal. Larger groups send claims data.
- 60 days before
Decide
Plan or plans, funding type and how much you will contribute for employees and dependents.
- 45 days before
Open enrollment
Employees choose a plan or waive cover. Your broker supplies the materials and answers questions.
- 30 days before
Applications in
Employer application, enrollments, waivers and first premium go to the carrier.
- Renewal date
Plan year starts
Cards arrive; payroll deductions begin. New hires join after your waiting period, which federal law caps at 90 days.
Small employers can also join a SHOP plan without meeting the usual participation minimum if they apply between November 15 and December 15 (CMS).
The 2026 benchmarks a broker will use
National averages from the KFF Employer Health Benefits Survey, the standard yearly study of employer cover. Your own figures depend on your state, people and plan.
| Per year | Single | Family |
|---|---|---|
| Average total premium | $9,804 | $28,303 |
| Average worker contribution | $1,672 | $7,471 |
| Worker share of the premium | 18% | 27% |
| Worker contribution at smaller firms | n/a | $9,687 |
Source: KFF 2026 Employer Health Benefits Survey and its news release, published October 22, 2026, read October 28, 2026. Smaller firms: 10 to 199 workers.
| Deductibles and plan types | 2026 |
|---|---|
| Average single deductible | $1,955 |
| At smaller firms | $2,624 |
| At larger firms | $1,772 |
| Workers in PPO plans | 50% |
| Firms of 10+ offering health benefits | 67% |
Deductibles are for workers in plans with a general annual deductible. Same KFF source.
State rules, state by state
Insurance is regulated state by state, and the small group line is not the same everywhere. We match employers in every state except Washington; these eight have their own guides.
| State | Small group size | Employer marketplace | Regulator |
|---|---|---|---|
| California | 1 to 100 | Covered California for Small Business | CDI and DMHC |
| Texas | 1 to 50 | Federal SHOP (healthcare.gov) | Texas Department of Insurance |
| Florida | 1 to 50 | Federal SHOP (healthcare.gov) | OIR and DFS |
| New York | 1 to 100 | NY State of Health | Department of Financial Services |
| North Carolina | 1 to 50 | Federal SHOP (healthcare.gov) | NC Department of Insurance |
| Illinois | 1 to 50 | SHOP; ask a broker for the current route | Illinois Department of Insurance |
| Georgia | 1 to 50 | Georgia Access SHOP | Commissioner of Insurance |
| Colorado | Changed for 2026 | Connect for Health Colorado | Division of Insurance |
Each state guide names its sources. General information, not legal advice.
Questions employers ask
Short answers. A licensed broker can go into what applies to your business.
What does a group health insurance broker do?
A licensed broker gets quotes from the carriers they are appointed with, explains plan types and funding options, helps you set contributions, runs enrollment and then services the plan: adding and removing people, sorting billing and claim problems, and handling each renewal. Many also help with ACA reporting and required notices.
How much does it cost to use a group health insurance broker?
For most small employers, nothing directly: brokers are usually paid a commission by the carrier, and small group premiums are generally the same with or without a broker. Larger employers sometimes pay a fee instead. Brokers must disclose expected pay of $1,000 or more for a group health plan in writing.
Is a broker better than buying direct from a carrier?
A carrier can only show you its own plans. An independent broker can compare several carriers and funding types, and stays involved after the sale. You can also buy through the SHOP Marketplace with or without a broker.
How do I check a broker is licensed?
Every state insurance department has a license lookup; the NAIC links to all of them. Look for accident and health (or life and health) authority in each state where you have employees. We give you the broker's license number with their name.
Can I find a group health insurance broker near me?
Yes. Enter your ZIP code to be put in touch with a licensed broker who works with employers in your state (we do not currently cover Washington), whether they meet in person or online. Many brokers serve clients across a state or region.
How far ahead of renewal should I talk to a broker?
About three to four months before your plan year starts gives time for quotes, a decision and open enrollment. Less time limits your options, especially if you want to change funding type.
Do you sell insurance or give advice?
No. We are a free matching service, not a broker, agency or insurer, and hold no insurance license. We do not discuss rates for your business or recommend plans. General information for employers, not insurance, tax or legal advice. A licensed broker can tell you what applies to your business.
Ask for a licensed broker
Three short steps: where the business is, what you have now, and who to speak to. It takes about two minutes and asks nothing about anyone's health.
- Free for employers. The broker pays us a flat fee per introduction.
- One broker, named to you first, with their state license number.
- No advice from us. Plans, rates and tax questions go to the licensed broker.
We are a free matching service, not a broker or insurer, and we do not quote or recommend plans. We look for a licensed benefits broker who works with businesses like yours and tell you who it is; your enquiry goes to them only with your go-ahead.
Thanks, your enquiry is in.
- Within one business day we will email or call to tell you which licensed benefits broker we have found, with their license number.
- Your details reach that broker only if you say yes.
- The broker reviews your renewal or your options and talks you through them. Whether to work with them is your choice. No marketing from us, ever.