California group health insurance
California is one of four states where the small group market runs up to 100 employees rather than 50, so a company of 80 still buys small group cover with community-style rating rather than large-group underwriting.
Group plans are overseen by two regulators, the California Department of Insurance and the Department of Managed Health Care, and the state marketplace for employers is Covered California for Small Business.
A free matching service for employers, not a broker or insurer. We introduce you to a licensed broker and tell you who they are before anything is shared. No plan, tax or legal advice. How it works
What is different for California employers
- Small group runs from 1 to 100 employees.
- Most HMO plans are regulated by the DMHC; most PPO and EPO insurance by the CDI.
- Covered California for Small Business is the SHOP route to the federal tax credit.
- State mandates add benefits beyond the federal essential health benefits.
- Employers with staff in other states may need a multi-state approach.
- Brokers need a California license with accident and health authority.
California at a glance
| Item | California |
|---|---|
| Small group size Average employees, prior year | 1 to 100 |
| State SHOP marketplace For the federal small business credit | CCSB |
| Regulators Insurance and managed care | CDI, DMHC |
| National single premium, for reference KFF 2026 average, all states | $9,804 |
Sources: CDI information for small employers, Covered California for Small Business, healthinsurance.org and KFF 2026 Employer Health Benefits Survey. Read October 28, 2026. The KFF figure is a national average, not a California rate.
Two regulators, one market
California splits health plan oversight. Plans licensed under the Knox-Keene Act, which includes most HMOs and some PPOs, answer to the Department of Managed Health Care. Health insurance policies answer to the Department of Insurance. For an employer the practical point is where to complain if something goes wrong: your broker should tell you which regulator covers the plan you choose.
California also has one of the larger state-run small business marketplaces. Covered California for Small Business is the route to the federal small business tax credit here, so an employer that might qualify should ask a broker to quote it alongside plans bought outside the marketplace.
| Most HMO plans | Department of Managed Health Care (dmhc.ca.gov) |
|---|---|
| Health insurance policies (many PPO and EPO) | Department of Insurance (insurance.ca.gov) |
| Small business marketplace | Covered California for Small Business |
| Broker licenses | California Department of Insurance license lookup |
General information, not legal advice. Your broker will confirm which regulator covers a given plan.
Six questions for a California broker
Add the California points to the usual list.
Their license, in your state
A resident or non-resident producer license with accident and health authority wherever you have employees. You can check it on your state insurance department's site (the NAIC lists every department).
How they are paid
Commission from the carrier, a flat fee from you, or both. Federal rules require brokers to disclose expected pay of $1,000 or more for a group health plan in writing before you sign (DOL guidance, 2021).
Which carriers they can quote
Brokers can only place cover with carriers that have appointed them. Ask which carriers and funding types they will take your group to, and whether any are left out.
CCSB and the wider market
Whether they are certified to sell through Covered California for Small Business as well as directly with carriers, so you see both.
What happens after you sign
Who handles enrollment, adding and removing employees, billing errors and claim problems during the year, and how quickly they reply.
Compliance help
Whether they help with ACA reporting, Section 125 premium-only plans, COBRA or state continuation notices and plan documents, or expect your payroll provider or attorney to do it.
A California employer with 2 to 100 employees? We will find a licensed California broker who works with groups your size.
Find a licensed brokerSetting up a California group plan
Headcount check
Confirm you fall within the 1 to 100 small group definition on the state's counting method.
Quotes inside and outside CCSB
A broker can show marketplace and direct options together.
Applications
Employer and employee forms to the chosen carrier, with first premium.
Effective date and renewals
Plans can start on the first of a month; renewals usually arrive 60 or more days ahead.
Questions people ask
Is small group really up to 100 employees in California?
Yes. California kept the wider ACA definition, so employers with 1 to 100 employees buy in the small group market. See healthinsurance.org and the CDI small employer page.
What is Covered California for Small Business?
The state's SHOP marketplace for employers. Buying a qualified plan through it is generally required to claim the federal small business health care tax credit. A certified broker can enroll you at no extra charge.
Does California require employers to offer health insurance?
California has no general state rule requiring private employers to offer cover; the federal 50 full-time equivalent threshold applies. Some cities set their own health spending rules for certain employers, so ask a broker or attorney about your location.
Who do I complain to about a California group plan?
It depends on the plan type: the DMHC for most HMOs and Knox-Keene plans, the CDI for insurance policies. Your plan documents name the regulator.
Do you have offices in California?
No. We are a national matching service with no offices. We introduce you to a licensed California broker who works with employers like you.
Find a California group health 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 suits your business 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.