Georgia group health insurance
Group health insurance in Georgia is regulated by the Office of Commissioner of Insurance and Safety Fire, and the state uses the federal 50-employee small group line. Small group rules are set out in the state's insurance regulations, including Rule 120-2-10-.12.
Since November 2024 Georgia has run its own marketplace, Georgia Access, including a Small Business Health Options Program for employers, in place of healthcare.gov.
What Georgia employers should know
- The small group line is the federal 50 employees.
- The Commissioner of Insurance regulates insurers and licenses agents.
- Georgia Access runs the state SHOP for employers, not healthcare.gov.
- SHOP is the route to the federal small business tax credit.
- Carrier and network choice varies a lot between metro Atlanta and rural Georgia.
- Brokers selling SHOP plans need to be set up with Georgia Access.
Georgia at a glance
| Item | Georgia |
|---|---|
| Small group size Federal definition | 1 to 50 |
| Regulator Commissioner of Insurance and Safety Fire | OCI |
| Marketplace for employers State-run since November 2024 | Georgia Access |
| National family premium, for reference KFF 2026 average, all states | $28,303 |
Sources: oci.georgia.gov, Georgia Access SHOP, Ga. Comp. R. & Regs. 120-2-10-.12 and KFF 2026 Employer Health Benefits Survey. Read October 28, 2026. The KFF figure is a national average, not a Georgia rate.
Georgia Access and the tax credit
When Georgia moved to its own marketplace, the small business side moved too. Employers who want a SHOP plan now enroll through Georgia Access rather than healthcare.gov, and that matters for one reason in particular: buying a qualified plan through SHOP is generally required to claim the federal small business health care tax credit.
If you might qualify for the credit (fewer than 25 full-time equivalent employees, lower average wages and paying at least half of employee-only premiums), ask a broker to quote SHOP plans through Georgia Access alongside plans bought directly from carriers. Whether you qualify is a tax question for your accountant.
| Regulator and agent licensing | Office of Commissioner of Insurance |
|---|---|
| Small group rules | Ga. Comp. R. & Regs. 120-2-10-.12 |
| Marketplace for employers | Georgia Access SHOP |
| Federal small business credit | IRS, via a SHOP plan |
General information, not legal or tax advice.
Six questions for a Georgia broker
The standard list, with one Georgia question added.
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 Field Assistance Bulletin 2021-03).
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.
Georgia Access SHOP
Whether they can quote and enroll SHOP plans through Georgia Access 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 Georgia employer with 2 to 50 employees, or more? Talk to a licensed broker in your state who works with groups your size.
Find a licensed brokerSetting up a Georgia group plan
Headcount and credit check
Confirm your group size, and ask your accountant whether the SHOP tax credit might apply.
Quotes inside and outside SHOP
Georgia Access SHOP plans and direct carrier plans side by side.
Applications
Employer and employee forms and the first premium.
Renewals
Review two to three months before the plan year ends.
Atlanta and the rest of Georgia
Metro Atlanta has the widest choice of carriers and networks in the state. Outside it, around Savannah, Augusta, Macon, Columbus and in rural south Georgia, fewer carriers write small group business and networks can be built around one regional health system. Employers with sites in more than one region, or staff commuting from Alabama or South Carolina, should ask the broker to check the network where each person lives before choosing a plan.
Questions people ask
What counts as a small group in Georgia?
Georgia follows the federal 1 to 50 employee small group line. A broker will confirm how your headcount is counted.
Do Georgia employers still use healthcare.gov for SHOP?
No. Since November 2024 Georgia's SHOP runs through Georgia Access, the state marketplace.
Can a Georgia small business get the federal tax credit?
Possibly, if it has fewer than 25 full-time equivalent employees, lower average wages and pays at least 50% of employee-only premiums for a SHOP plan. See the IRS guidance and ask your tax adviser.
Who regulates group health insurance in Georgia?
The Office of Commissioner of Insurance and Safety Fire regulates insurers and licenses agents. Self-funded plans are mostly governed by federal ERISA law.
Find a Georgia 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 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.