How many employees do I need to qualify for small group health insurance?

Sometimes, small group health insurance can be more affordable than individual plans that offer the same benefits and coverage.

Generally, the Affordable Care Act (ACA) considers businesses with 1 to 50 employees eligible for small group health coverage.  However, if you are a sole proprietor, you will need to buy coverage as an individual.

To be eligible for small group coverage, your small business or non-profit organization must be operating as a full-time business. Your small business must also meet certain federal requirements, including:

  • A primary business address in the state where you’re buying coverage.
  • At least one employee enrolling in coverage who isn’t the owner, business partner, or spouse of the owner or business partner.
  • 1 to 50 full-time equivalent employees. To see if your mix of full-time and part-time employees equals between 1–50, use the full-time equivalent (FTE) employee calculator.

As a small business, you have the option to offer coverage based on a category of employees, such as only full-time or only management level employees.

To determine your premium, you will need to know the number of employees you wish to enroll, their names and dependents, along with birthdates.

Will my premiums be higher if I have employees with preexisting conditions?

When you choose an ACA plan, it does not allow premiums to be adjusted based on the health status of your employees. All employees and dependents can be added regardless of their medical conditions.

We’re here for you.

Talk to us about our different plan options for small group coverage to see what works best for your small business. Our Small Group Account specialists will help answer your questions and walk you through the process. Call us at 866-584-0171, Monday through Friday, 8 a.m. to 4:30 p.m. Or, email your questions to

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