Group Health Insurance Cost Calculator

According to the Kaiser Family Foundation (KFF) 2023 Employer Health Benefits Survey, the average annual premium for employer-sponsored health insurance was $8,435 for single coverage and $23,968 for family coverage. Employers paid an average of 83 percent of single premiums and 73 percent of family premiums.

The ACA requires that applicable large employers (50 or more full-time equivalent employees) offer affordable coverage where the employee contribution for self-only coverage does not exceed a set percentage of the employee's household income. For 2024, the affordability threshold is 8.39 percent of household income. Small employers have more flexibility but must contribute to meet insurer minimums (typically 50 percent of the employee premium).

Yes. Employer contributions to group health insurance are generally 100 percent deductible as a business expense under IRC Section 106. Employee contributions made through a cafeteria plan (Section 125) reduce taxable wages, benefiting both employer and employee by reducing FICA taxes.

A fully insured plan pays a fixed monthly premium to an insurance company, which bears the risk. A self-insured (self-funded) plan has the employer pay claims directly, retaining risk but saving on insurer profit and state premium taxes. Most large employers self-insure; most small employers purchase fully insured plans. Stop-loss insurance is typically purchased to cap per-claim or aggregate annual exposure.

Most states require a minimum of 2 employees to qualify for small group coverage. Some insurers require 5 to 10 employees. The ACA defines small group as employers with 1 to 50 employees. Groups of 1 (owner only) may use the individual market or QSEHRA. Groups of 51 or more are in the large group market and are not subject to ACA small group rating rules.