Group health insurance for Illinois employers

The employer base

The Census Bureau's Statistics of U.S. Businesses for 2022 (state detailed-size file, released April 10, 2025) counts 241,235 Illinois employer firms with fewer than 50 employees, out of 258,353 employer firms in the state, with 1,299,208 paid employees at those under-50 firms and 5,533,883 at all Illinois employer firms. Under-50 firms were 93.4% of Illinois employer firms in that file. Among the eight states in this update, only California, Texas, and New York have more under-50 employer firms.

What official surveys say about cost

MEPS-IC 2025 Table II.A.2 reports that 35.5% of private-sector establishments at Illinois firms with fewer than 50 employees offered health insurance, compared with 97.1% at firms of 50 or more (51.5% of all Illinois establishments). That under-50 offer rate is above the national 32.1% figure and is second only to New York (39.3%) in this eight-state set. At under-50 firms, average annual premiums were $9,865 for single coverage and $27,996 for family coverage, with average employee contributions of $2,112 (single) and $7,377 (family). National MEPS-IC 2025 under-50 averages were $9,034 for single coverage and $24,176 for family coverage, with a 32.1% offer rate at establishments of firms with fewer than 50 employees. Illinois under-50 family premiums sit toward the high end of this set, after New York. Those are statewide averages for enrolled employees at offering establishments, not a Chicago, Springfield, or Metro East quote. See the cost of small-business health insurance.

A company that is not an applicable large employer is generally not required to offer health coverage under the ACA employer shared-responsibility rules. Some smaller employers still choose to offer a plan, or to use an ICHRA or QSEHRA, and some may qualify for the Small Business Health Care Tax Credit when the IRS size, wage, and SHOP rules are met. The Illinois 2-to-50 small-employer line and the federal applicable-large-employer test are related but not identical; we will apply both counting methods to your roster before we describe the market you sit in.

Who sells small-group coverage

This update does not include a verified official 2026 Illinois small-group issuer list, so we will not invent one. The Illinois Department of Insurance is the official place to confirm licensed issuers. We will only compare products that can be issued for the Illinois counties and any other states on your roster. A national brand that sells small-group coverage in another state may not offer an Illinois fully insured small-group plan.

Continuation when someone leaves the plan

Federal COBRA generally applies to employers with 20 or more employees. An official Illinois continuation period was not confirmed end-to-end in the research for this file, so this page does not state a state-specific duration. We will confirm any Illinois continuation rule with the Department of Insurance at proposal time. See COBRA for employers.

How we help an Illinois employer