Illinois group health insurance
Group health insurance in Illinois is regulated by the Illinois Department of Insurance, and the state uses the federal 50-employee small group line. Employers buy through a broker directly from carriers or through the SHOP Marketplace.
Illinois also has a rule most states do not: under the Consumer Coverage Disclosure Act, employers that offer group health coverage must give employees a written comparison of their plan against the state's essential health benefits, on request and at hire.
What Illinois employers should know
- The small group line is the federal 50 employees.
- The Department of Insurance regulates insurers and licenses producers.
- The Consumer Coverage Disclosure Act adds a written benefits comparison duty.
- Illinois moved to its own state-based exchange, Get Covered Illinois, for individual cover from the 2026 plan year.
- Chicago-area networks differ a lot from those downstate.
- Brokers need an Illinois producer license with accident and health authority.
Illinois at a glance
| Item | Illinois |
|---|---|
| Small group size Federal definition | 1 to 50 |
| Regulator Insurers and producer licensing | IDOI |
| Benefits comparison duty Consumer Coverage Disclosure Act | Yes |
| National single premium, for reference KFF 2026 average, all states | $9,804 |
Sources: Illinois Department of Insurance, Illinois Department of Labor on the Consumer Coverage Disclosure Act, healthcare.gov SHOP and KFF 2026 Employer Health Benefits Survey. Read October 28, 2026. The KFF figure is a national average, not an Illinois rate.
The benefits comparison Illinois requires
The Consumer Coverage Disclosure Act is enforced by the Illinois Department of Labor. It requires employers that offer group health coverage to employees in Illinois to provide a list of the state's essential health benefits and say whether the employer's plan covers each one. The comparison is due to new hires, to employees once a year, and to anyone who asks. The Department publishes a template.
Fully insured small group plans already cover the essential health benefits, so the comparison is mostly paperwork for them. It matters more for self-funded and level-funded plans, which can differ. A broker can usually prepare the comparison with you, but the duty is the employer's; check the current template and get legal advice if you are unsure how it applies.
| Regulator and producer licensing | Illinois Department of Insurance |
|---|---|
| Benefits comparison duty | Consumer Coverage Disclosure Act, Illinois Department of Labor |
| Marketplace for employers | SHOP via healthcare.gov |
| Federal small business credit | IRS, via a SHOP plan |
General information, not legal advice.
Six questions for an Illinois broker
The usual list, with an Illinois 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.
The disclosure comparison
Whether they will help you prepare the Consumer Coverage Disclosure Act comparison for the plan you choose, especially for a self-funded or level-funded plan.
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.
An Illinois employer, in Chicago or downstate? Talk to a licensed broker in your state who works with groups your size.
Find a licensed brokerSetting up an Illinois group plan
Headcount and locations
Group size, plus where employees live, including across state lines.
Quotes and networks
Plans compared side by side, with network checks for each location.
Applications
Employer and employee forms and the first premium.
Disclosure
Prepare the benefits comparison for new hires and annual notices.
Chicago and downstate
Most Illinois employers are in the Chicago metro, where many carriers compete and the major health systems sit in some networks and not others. Downstate, around Springfield, Peoria, Champaign and the Metro East near St. Louis, the choice of carriers and hospitals is narrower. If you have staff in both, or employees who live across the line in Indiana, Wisconsin or Missouri, ask the broker to check networks for each location before you choose. A plan built around one Chicago health system can be a poor fit for someone in Rockford.
Questions people ask
What is a small group for health insurance in Illinois?
Illinois follows the federal 1 to 50 employee small group line, counted on average employees in the prior year. A broker will confirm how your headcount is counted.
What is the Illinois Consumer Coverage Disclosure Act?
A state law, enforced by the Illinois Department of Labor, that requires employers offering group health coverage to give employees a comparison of their plan against the state's essential health benefits, at hire, yearly and on request.
Does Illinois have a state marketplace for small businesses?
Illinois launched its own state-based exchange, Get Covered Illinois, for individual coverage from the 2026 plan year. Employers should ask a broker about the current SHOP route and buying directly from carriers.
Who regulates group health insurance in Illinois?
The Illinois Department of Insurance regulates fully insured plans and licenses producers. Self-funded plans are mostly governed by federal ERISA law.
Find an Illinois 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.