Frequently Asked Questions

Small Business Group Health Questions, Answered

From minimum employee counts to FICA stacking strategies — everything small business owners need to know about group health insurance.

What is group health insurance for small businesses?
Group health insurance is employer-sponsored coverage where the employer pays a portion of employee premiums and employees receive coverage at lower rates than individual policies. Plans are available from multiple carriers and can include medical, dental, vision, and supplemental options.
How many employees do I need to offer group health insurance?
Most carriers require a minimum of 2 eligible employees (including the owner). Groups with 2–50 employees fall under "small group" market rules. Some carriers offer group coverage for self-employed individuals. The ACA small business tax credit applies to groups with fewer than 25 full-time equivalent employees paying average wages under $62,000.
Is an employer required to offer health insurance?
Businesses with fewer than 50 full-time equivalent employees are NOT required by the ACA to offer health insurance. However, businesses with 50+ FTEs (Applicable Large Employers) must offer affordable minimum essential coverage or face penalties. Even if not required, offering health benefits is one of the most effective tools for attracting and retaining talent.
How much does group health insurance cost?
Costs vary by location, plan design, carrier, and employee demographics. Typically, employers contribute 50–80% of the employee premium (employee-only), with employees paying the remainder via payroll deduction. Dependent coverage is typically not required to be subsidized. We compare quotes from multiple carriers to find the best value for your group.
Can the Ignite Health FICA program combine with group health?
Absolutely — and this is one of the most powerful combinations available to small businesses. The Ignite Health FICA reduction program can be layered on top of existing or new group health benefits, turning your health insurance cost into additional payroll tax savings. Many of our business clients save more in FICA taxes than they spend on premiums.
What is the difference between HMO, PPO, and HDHP plans?
HMO plans require you to use network providers and get referrals for specialists — they tend to have lower premiums. PPO plans offer more flexibility to see any doctor without referrals — premiums are higher but out-of-pocket costs are more predictable. HDHPs (High Deductible Health Plans) have lower premiums but higher deductibles — they pair well with HSAs (Health Savings Accounts).
Can I include dental and vision in my group plan?
Yes — dental and vision plans can be bundled with or offered separately from medical coverage. We represent multiple dental and vision carriers and can build a comprehensive benefits package at multiple price points. Dental and vision benefits are among the most valued by employees.
How do I get started with group health coverage?
Start with a free employer consultation where we review your employee census, current benefits (if any), budget, and goals. We then shop multiple carriers and present your best options with side-by-side comparisons. Enrollment typically opens within 30–45 days of application.

Explore Related Services

FICA Tax Reduction

Stack FICA savings on top of your group health plan and save $40K–$80K+ per year.

Life Insurance & Annuities

Key person insurance and executive benefits to complete your business protection strategy.

Ancillary Benefits

Dental, vision, and supplemental benefits to round out your employee benefits package.

Related Articles

Dig deeper with these guides from our resource library.

Group Health Insurance for Small Businesses: The 2026 Complete Guide Read Article → Hidden Costs of Small Business Group Health Insurance — and 3 Ways to Reduce Them Read Article → Small Business Health Insurance in 2026: Group Health vs. Individual Plans — What Every Owner Needs to Know Read Article → Group Health Insurance Tax Benefits: What Small Business Owners Can Deduct in 2026 Read Article →

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