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How Small-Business Group Health Works

From choosing a plan to enrolling your team

Michael Furman
Reviewed by Michael Furman, COO — 24 years in insurance · MDRT Top of the Table
NovaVida Group licensed team · Updated August 2026

Group health insurance lets a business offer coverage to its employees, sharing the premium between employer and worker. It’s guaranteed-issue — no employee can be turned down for their health — and it’s one of the most valued benefits you can offer.

The Four Steps

First, you pick one or more plans and decide how much of the premium to cover (most carriers require at least 50% of the employee-only premium). Second, you offer coverage to eligible employees — generally those working 30+ hours a week. Third, employees enroll and premiums are shared through payroll, often pre-tax. Fourth, coverage renews each year, when we re-shop it for you.

Why It Beats Sending Everyone to the Individual Market

Group coverage is guaranteed-issue, often has richer networks, and the employer contribution is a deductible business expense. It’s also a powerful recruiting and retention tool — benefits are consistently among the top reasons employees stay. If a traditional group plan isn’t the right fit, an ICHRA or QSEHRA can give you budget control instead.

Fast Facts

  • Available for businesses with as few as one eligible W-2 employee
  • Employer typically pays at least 50% of the employee premium
  • Guaranteed issue — no employee is denied for health
  • You can start a group plan any month of the year

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Quick answers

Frequently Asked

How many employees do I need to offer group health?

Most small-group plans are available with at least one eligible W-2 employee besides the owner. ICHRA and QSEHRA have no minimum, which makes them flexible for very small teams.