Coverage employees can use
Check doctors, hospitals, prescriptions, service areas, and referral rules.
- Independent Agency
- Multiple Carriers
- Licensed Advisors
- Ongoing Support
Benefits that fit your business
Start with what your business and employees need.
Whether you are offering coverage for the first time or reviewing an upcoming renewal, the decision involves more than choosing a monthly premium. The Assurance Network helps you compare available group options by cost, coverage, provider access, and how the plan may work for your team. Your business chooses whether to offer coverage and which option to select.
Costs for the business and team
Compare premiums, employer contributions, deductibles, copays, coinsurance, and out-of-pocket limits.
A plan that fits your goals
Consider your workforce, budget, locations, renewal date, and desired start date.
A clearer benefits conversation
Help your team understand the choices in front of them.
Health benefits affect real people and real budgets. The Assurance Network can help you compare plan details, employee costs, and provider access so you can make a decision with a clearer understanding of what each option means for your business.
A review for your situation
Whether you are starting, renewing, or rethinking coverage.
The right questions depend on where your business is today. The Assurance Network can help you identify what to compare and what information is needed next.
Offering benefits for the first time
Talk through employee eligibility, possible employer contributions, plan choices, timing, and the steps involved in presenting coverage to your team.
Preparing for a renewal
Review the renewal information alongside available alternatives. Compare premium changes, employee costs, benefits, prescriptions, and provider networks before deciding.
Supporting a team in different locations
Share where employees live and work so available plans, service areas, and provider networks can be checked for your group.
Your first call
Get a clear next step for your business.
Tell the Assurance Network whether you are starting a benefits program, reviewing a renewal, or exploring a change. We will ask about your employee count, work locations, timing, budget priorities, and what matters most to your team. You do not need to know the name of a plan or have employee information ready for this first conversation.
How the coverage works
Build your understanding before choosing a plan.
There is no single group plan that fits every employer. These are the core pieces to compare side by side.
Plan design
Review covered services and how the plan shares costs between the insurer and the member. The Summary of Benefits and Coverage (SBC) gives a standardized overview for comparison.
Provider network
Check whether employees’ doctors, hospitals, and pharmacies participate. Network size and out-of-network coverage vary by plan.
Premium contributions
Decide what the employer will contribute and what employees may pay through payroll, based on the available plan and applicable requirements.
Plan structures
Compare the way employees access care.
Plan labels are a useful starting point. The actual network, benefits, and rules are set out in the specific plan documents.
- H
HMO
Often uses a defined network and may require a primary care provider or referrals for certain specialist care. Rules differ by plan.
- P
PPO
Usually offers in-network and out-of-network coverage, with different cost-sharing for each. Out-of-network care can cost more.
- E
EPO
Typically covers care through its network, except for emergencies. Check the plan documents for referral and network rules.
- D
High-deductible plan options
Some plans have higher deductibles and lower premiums than other available designs. HSA contributions are permitted only when the coverage meets federal HSA eligibility rules.
Who may be eligible
Eligibility depends on the group and the plan.
Employer size, employee status, hours worked, location, participation, and carrier rules can all affect which coverage is available. The Small Business Health Options Program (SHOP), for example, generally serves employers with 1–50 full-time-equivalent employees, subject to eligibility requirements; some states may allow employers with up to 100 employees. Other group coverage may follow different state and carrier rules.
Employer size
Small-group definitions and plan availability can vary by state.
Employee eligibility
Plan documents and applicable rules define who can enroll and when.
Dependents
Some plans allow eligible dependents; enrollment terms and costs vary.
Work locations
Multi-state employees may affect service-area and network fit.
How the Assurance Network helps
Compare the tradeoffs before you commit.
The Assurance Network is an independent insurance agency. We help you review the group health options available for your business and understand how the differences may affect your budget and employees. Availability varies by location, carrier, and group eligibility.
Compare real plan details
Review available benefits, provider networks, prescription coverage, cost-sharing, and plan rules in plain language.
Understand the cost split
See the quoted premium and discuss how employer contributions and employee payroll costs could fit your budget.
Choose your next step
Ask questions and take time to decide. Your business makes the final choice; you are not pressured to select a plan on the first call.
What happens next
A clear process from conversation to enrollment.
The review starts with your goals. If you decide to explore coverage, the Assurance Network will explain what information is needed and how to provide it securely.
- 1Talk through your goalsShare your business location, approximate team size, timing, budget priorities, and renewal date if you have one.
- 2Gather what is neededIf you want quotes, learn what employee and business details the carrier requires and how to send them securely.
- 3Compare available optionsReview the quoted premiums, employer contributions, employee costs, benefits, networks, and plan rules.
- 4Prepare for enrollmentIf you choose to proceed, review eligibility, effective dates, enrollment materials, and the next steps for your employees.
Understand the costs
Look beyond the monthly premium.
A useful comparison considers what the business pays, what employees pay from each paycheck, and what a person may owe when using care. The lowest premium may not mean the lowest overall cost for every employee.
Monthly premiums
Review the total premium for employee-only and dependent coverage. Then decide how much the business will contribute and how the remaining share will be handled.
Costs when care is used
Compare deductibles, copayments, coinsurance, prescription costs, and the plan’s in-network out-of-pocket maximum. Check whether family limits differ from individual limits.
How the group is rated
For fully insured small-group plans subject to ACA rating rules, premiums may generally vary by age, location, family composition, and tobacco use where state law permits. An insurer generally cannot set these premiums based on employees’ health status or claims history. Rules differ for self-funded plans, and the actual price depends on the plan selected and the group’s rating details.
Choosing an arrangement
Group plans and other ways employers support health costs.
A traditional group health plan gives eligible employees access to coverage selected by the employer. Some employers also explore reimbursement arrangements, which follow different rules and do not work like a group insurance policy. The right path depends on workforce needs, budget, administration, tax treatment, and applicable requirements.
Fully insured group plan
An insurer assumes the covered claims risk under the policy. The employer pays premiums and follows the plan’s enrollment and payment terms.
Self-funded plan
The employer pays covered claims under the plan, often using a third-party administrator and sometimes stop-loss coverage. It involves different financial and administrative responsibilities.
HRA arrangement
An employer may reimburse eligible expenses under a formal health reimbursement arrangement, such as a QSEHRA or ICHRA, when requirements are met.
HSA-qualified plan
An eligible high-deductible health plan may be paired with a Health Savings Account. Not every plan with a high deductible qualifies; federal requirements apply.
Make an informed comparison
Questions to ask about every plan.
Plan names alone do not show how coverage will work day to day. Use these questions to compare the actual plan documents and employee experience.
Doctors and hospitals
Are employees’ current doctors, specialists, hospitals, and urgent care centers in network? Is out-of-network care covered, and what does it cost?
Prescription drugs
Are common medications on the formulary? Compare tiers, deductibles, pharmacy networks, mail-order terms, and any prior authorization requirements.
Access and referrals
Does the plan require employees to choose a primary care provider or obtain referrals? How does coverage work when traveling or living in another state?
Annual limits and exclusions
Review the deductible, out-of-pocket maximum, covered services, exclusions, and prior authorization rules in the plan materials. Most job-based plans cannot set annual or lifetime dollar limits on essential health benefits, though limits may apply to some services that are not essential health benefits.
Prepare for a review
What to gather before requesting options.
You can call before gathering documents. These details can help the Assurance Network understand your situation; carriers may request more information later to confirm eligibility and prepare quotes.
Business basics
Business name, address, industry, years in operation, and the states where employees live or work.
Workforce overview
Approximate number of employees and where they live or work. A carrier may later request an employee census through a secure process to prepare a quote.
Coverage goals
Target effective date, desired contribution approach, budget range, and the benefits your team values most.
Current coverage, if any
Renewal date, current plan summaries, and recent premium information can help frame a comparison.
Employer questions
Group health insurance FAQs.
Does every business have to offer health insurance?
No. Federal offer rules generally apply to an applicable large employer (ALE): an employer that averaged at least 50 full-time employees, counting full-time equivalents, during the prior calendar year. Full-time status for these rules generally means 30 hours of service per week or 130 hours in a month. FTEs are used to determine ALE status; the offer and payment rules generally apply to full-time employees. ALEs generally must offer minimum essential coverage that is affordable and provides minimum value to at least 95% of their full-time employees and offer it to their dependent children to avoid one type of employer shared responsibility payment; whether a payment applies depends on additional rules. Confirm your situation with a qualified tax or benefits professional.
How can the Assurance Network help my business?
The Assurance Network can discuss your goals, review group health options available for your location and group, compare plan features and costs, and explain the information and enrollment steps involved. Plan availability and the support available depend on the carrier, plan, and business circumstances.
What is the difference between group and individual health insurance?
With group coverage, an employer selects or sponsors coverage for eligible employees and may contribute toward the premium. Individual coverage is selected by a person or family for themselves. Availability, costs, enrollment rules, and financial assistance differ. A benefits professional can help compare the options that may be available.
Do I need an employee census before I call?
No. You can start with your approximate employee count, business location, timing, and priorities. If you want to request a quote, a carrier may require more detailed employee information later. Do not email Social Security numbers, medical histories, or other sensitive personal information; use the secure process provided for any information requested.
How much does group health insurance cost?
There is no single price. Premiums depend on factors such as the plan, location, covered group, and carrier rating rules. Employees may also have deductibles, copays, coinsurance, and other costs under the plan. A quote and plan materials are needed to review actual amounts.
Does the employer have to pay a set share of the premium?
There is no single contribution percentage that applies to every employer plan. SHOP eligibility includes other requirements, such as offering coverage to full-time employees and meeting the applicable participation rule; SHOP generally does not require an employer contribution just to offer coverage. To qualify for the federal Small Business Health Care Tax Credit, however, an eligible employer generally must pay at least 50% of employee-only premiums and meet the other tax-credit rules. Have a tax professional confirm eligibility.
Can employees add spouses or children?
Many employer plans offer dependent coverage, but who is eligible, when they can enroll, and how much it costs depend on the plan and applicable rules. Review the employer’s enrollment materials for the specific terms.
Can a small business get a tax credit?
Some eligible small employers may qualify for the federal Small Business Health Care Tax Credit. In general, the rules include fewer than 25 full-time-equivalent employees, average wages below an annually adjusted limit, an employer contribution of at least 50% of employee-only premiums, and qualifying SHOP coverage (with limited exceptions). The credit is generally available for no more than two consecutive tax years. Confirm current thresholds and eligibility with the IRS or a tax professional.
What is SHOP?
The Small Business Health Options Program (SHOP) helps eligible small employers offer group health and dental coverage. Federal SHOP eligibility generally includes 1–50 full-time-equivalent employees (with at least one full-time-equivalent employee other than an owner, the owner’s spouse, or certain family members or partners), offering coverage to all full-time employees, meeting the state’s participation rule, and having an office or worksite in the state. In most states, at least 70% of employees offered coverage must enroll or have other qualifying coverage; some states set a different rate, and the participation test is waived during November 15–December 15. Confirm current state requirements and availability before applying.
What should employees compare during enrollment?
Employees should check whether their doctors and medications are covered, what they will pay from each paycheck, and how deductibles, copays, coinsurance, and out-of-pocket limits work. They should also review dependent coverage, network rules, and enrollment deadlines in the employer’s materials.
What happens when an employee leaves the business?
Continuation rights and coverage end dates depend on the circumstances, employer size, plan type, and applicable federal or state law. Employers should coordinate with their plan administrator or benefits professional and provide any required notices.
Can employees in different states use the same plan?
Sometimes, but carrier availability, plan service areas, and provider networks vary. Share the states where employees live and work during the review so the available options can be checked.
Will the Assurance Network decide which plan is right for my business?
The Assurance Network can explain and compare the available options with you. Your business makes the final decision about whether to offer coverage and which plan to select.
Let’s find out what may work for your team.
Call the Assurance Network at 804-299-4075 to talk about your business, employee needs, and timing. You can start with questions; you do not have to arrive with a plan already chosen.
Plan availability, benefits, eligibility, rates, participation requirements, and enrollment rules vary by state, carrier, employer, and plan. Information on this page is general and does not replace official plan documents or tax, legal, or benefits advice. The Assurance Network does not offer every plan available in every area.
Helpful official resources: SHOP eligibility · IRS employer shared responsibility · CMS small-group premium rating rules · Limits on essential health benefits · IRS small-business tax credit · Summary of Benefits and Coverage
Looking for more employer coverage? See Small Group Life Insurance and Medicare for Groups.