What do I need before I can buy a small group health plan?
You need a business with at least one employee other than the owners and their spouses. Generally, employers with 1 to 50 employees can buy small group coverage through the Small Business Health Options Program (SHOP), and the count includes part time workers as full time equivalents.
- At least one employee other than the owners and their spouses.
- Generally 1 to 50 employees, counting each part time worker as a fraction of a full time employee.
- A list of your employees with their hours, so the quote fits your real group.
- A decision on how much of each employee's premium you will pay.
If you run the business alone, or only with your spouse, you cannot buy a group plan. You buy an individual plan instead, and our self-employed guide covers that. If you only want to help employees pay for plans they buy themselves, a CHOICE arrangement or a QSEHRA is another way.
How do I buy small business health insurance, step by step?
Count your employees, decide what you will pay, compare plans, confirm enough employees will join and then enroll through an insurance company or a registered agent. For SHOP plans you no longer apply on HealthCare.gov. Since 2018, enrollment goes through the insurer or a Marketplace registered agent or broker.
- Count your full time and full time equivalent employees. HealthCare.gov and our free calculator both do the math.
- Pick your contribution. You choose how much of the premium you pay, and the tax credit needs at least 50%.
- Compare plans and prices from several insurers. SHOP plans come in bronze, silver, gold and platinum levels, and you can add dental.
- Check participation. In most states at least 70% of your employees must accept the offer.
- Enroll through an insurer or a registered agent. Federal rules say coverage must start no later than the first of the next month when your group enrollment is received by the 15th.
- Pay the insurance company directly and plan for renewal. About 45 to 60 days before coverage ends, ask your insurer or agent which plans and prices you will be offered.
You pay premiums to the insurance company, not to HealthCare.gov. Changes during the year, such as adding a new hire, also go through your insurer or agent.
When can my small business coverage start?
You can buy group coverage any time of year. When your group enrollment is received by the 15th of a month, coverage must start no later than the first of the next month. If it is received after the 15th, the latest start is the first of the month after next.
| Your group enrollment is received | Coverage must start no later than |
|---|---|
| The 1st through the 15th of a month | The 1st of the next month |
| The 16th through the last day of a month | The 1st of the month after next |
| You prefer a later date | A date you choose within a quarter for which small group rates are available |
If your group cannot meet an insurer's participation or contribution rules, state law may let the insurer limit you to an annual enrollment period from November 15 to December 15.
A plan cannot make new employees wait more than 90 days before coverage can begin.
How many employees have to join the plan?
In most states at least 70% of your employees must accept your offer before the group can enroll. This is called the minimum participation rate. If it is 70% and all 10 of your employees count, at least 7 have to say yes.
HealthCare.gov's participation calculator asks for three numbers: employees who accept, employees who decline and have no other coverage, and employees who decline because they are covered elsewhere, such as on a spouse's plan, COBRA, Medicare or Medicaid. Ask your agent how each insurer counts that last group, because state rules differ.
How much of the premium do I have to pay?
There is no contribution requirement for SHOP coverage, so you choose how much of each employee's premium to pay. To qualify for the Small Business Health Care Tax Credit, you must pay at least 50% of the premium for all full time employees who enroll.
For a sense of what other employers do, KFF's 2026 survey of firms with 10 or more workers found that workers at smaller firms (10 to 199 workers) pay an average of 16% of the single premium and 37% of the family premium. Insurers and states can set their own minimum employer contribution, so confirm it before you pick a plan.
In most states you do not have to cover employees' dependents. Some states do require it.
Besides a group plan, how else can I help employees pay for coverage?
You can reimburse employees for the individual plans they buy, using a CHOICE arrangement (formerly called an ICHRA) or a QSEHRA. The table shows who can use each option.
| Option | Who can offer it | How it works |
|---|---|---|
| Small group plan, including SHOP | Generally employers with 1 to 50 employees | You offer one or more plans and pay part of the premium. Employees enroll in what you offer. |
| CHOICE arrangement (ICHRA) | Employers of any size with at least one employee other than the owners and their spouses | You set a tax free amount for employees to spend on an individual plan. There is no yearly limit on what you contribute. |
| QSEHRA | Generally employers with fewer than 50 full time employees that offer no group plan | You reimburse employees tax free, up to $6,450 for one person or $13,100 for a family in 2026. |
Our guide comparing the three goes through costs, tax effects and employee savings in detail. The Small Business Health Care Tax Credit is generally available only with SHOP coverage.
What does small business health insurance cost?
KFF's 2026 survey puts the average yearly premium at $9,804 for single coverage and $28,303 for family coverage. At firms with 10 to 199 workers the averages are $9,593 and $27,288. Your own price depends on your employees and the plan level, so a quote is the only way to know.
Our cost guide breaks down who pays what, how fast premiums have risen and ways to lower the bill.
How can a licensed agent help me buy small business health insurance?
An agent does the comparison work. We ask for a simple employee list and the amount you want to contribute, then show group plans from several carriers with the cost to you and to each employee. We help with enrollment and new hires, and we review your options before every renewal.
Use the buttons on this page to request a quote or call us. If you are the only person in the business, ask about an individual plan instead.
See our Small-Group Health plans
Real health benefits for a small team. We handle shopping, setup and renewals.Small business health insurance calculator: employee count and tax credit
Enter your full-time and part-time employees to see your full-time equivalent count, which rules apply to you and what the small business health care tax credit could be worth.We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Get group plan prices for your team
A licensed agent compares small group plans and CHOICE arrangements from several carriers and shows you the monthly cost for you and your employees. It costs you nothing.