How to compare group health plans for your company

Start with the census, not with a product name

A useful comparison begins with four facts about the company:

1. Who is on the roster, and where they work. Ages, family-tier elections, and work locations determine which market you sit in and which products can be issued. In most states a fully insured small-group plan is for employers with 1 to 50 employees. California, New York, and Vermont use 1 to 100. Colorado moved to 1 to 50 on January 1, 2026. See group coverage for 2, 5, or 10 employees and multi-state workforces.
2. What you offer today, if anything, and when it renews. A renewal is the natural time to compare a current plan with alternatives. If you do not have a plan yet, the baseline is "no group coverage" rather than a renewal quote.
3. How much the company intends to contribute. The employer share toward employee-only coverage, and toward dependents, is part of the design. Official surveys, summarized on the cost of small-business health insurance, show that employees at smaller firms often pay a larger share of the family premium. That is a choice you can set.
4. Whether you are, or are about to become, an applicable large employer. A company with 50 or more full-time employees, including full-time equivalents, in the prior year is generally an ALE for the current year. That changes the compliance questions you bring to the comparison. See the employer coverage requirement and mid-size pages.

Without those four items, a side-by-side of brochures is not a comparison. It is a stack of products that may or may not be available to you.

Compare the structure first, then the network design

Group plan options fall into a few structures. Compare across structures before you compare two PPO quotes inside the same one.

• A fully insured small-group plan is a group policy. The employer pays a premium and the carrier takes the claims risk. In the small-group market those plans are often labeled by metal tier — Bronze, Silver, Gold, or Platinum — which is an actuarial-value target, not a quality rating. HealthCare.gov states that metal categories have nothing to do with quality of care.
• SHOP is the ACA's Small Business Health Options Program. It is one path to a fully insured small-group plan, and it is generally the path to the Small Business Health Care Tax Credit for eligible employers.
• A level-funded plan typically combines expected claims, administration, and stop-loss into a fixed monthly amount. A self-funded plan is the employer's arrangement for paying covered claims, usually with stop-loss. These designs fit some groups as headcount and claims history support them; they are not "better" in the abstract. See level-funded vs. fully insured on that page.
• An ICHRA or a QSEHRA is a defined-contribution reimbursement. The company sets an allowance; employees obtain individual coverage (or, in a QSEHRA, pay qualifying medical expenses) and are reimbursed tax-free up to the amount offered, when the rules are met. The two arrangements have different eligibility tests. Use ICHRA vs QSEHRA when that is the comparison you need.
• Some employers obtain coverage through a PEO. That is a different legal and administrative structure from a plan the company sponsors itself. See PEO health insurance.

Inside a group medical plan, compare the network design. A group PPO generally pays a higher share of costs in-network and also covers out-of-network care, usually at a higher cost, without a referral. A group HMO generally covers care from doctors who work for or contract with the HMO, except in an emergency, and may require employees to live or work in a service area. A group EPO or POS plan sits between those designs. An HSA-qualified HDHP is a cost-sharing design that can be paired with a health savings account when it meets the IRS definition.

HealthCare.gov's plan-comparison guidance is the right frame: look at the network, the premium, the deductible and out-of-pocket maximum, and how prescriptions are covered, rather than at a label or a ranking.

What to put on the same page for every option

Once two or more options can actually be issued for your census, compare them on a single sheet using the same columns:

• Total premium and employer contribution, for employee-only and for family (or other) tiers. A lower premium with a much larger employee share is not automatically a lower-cost plan for the people who enroll. Official averages for those shares are on the cost page.
• Deductible, coinsurance, and out-of-pocket maximum, for in-network care. KFF's 2026 survey found an average single deductible of $2,624 at smaller firms among workers in a plan with a general annual deductible. Use that only as context, not as a target.
• Provider network. Ask whether the doctors and hospitals your employees already use participate. For Florida employers, start with the check-your-network guide and the Florida carrier pages, including Florida Blue, UnitedHealthcare, AvMed, and the Florida Blue vs UnitedHealthcare comparison. Those pages describe products; they are not a statement that Ares is appointed with every carrier or that any carrier endorses Ares.
• Prescription coverage and any referral rules.
• Eligibility, waiting periods, and who can enroll, including owners, partners, and family members, which matter in very small groups and in family businesses and LLCs.
• Compliance and tax treatment, including Section 125 payroll, any ALE implications, and whether a design is generally the path to the Small Business Health Care Tax Credit (SHOP, with the rules on that credit page).
• Administration. Who handles enrollment, notices, and questions during the year.

Do not compare a fully insured premium to an HRA allowance as if they were the same number. They are different structures. Put the employer's monthly outlay, the employee's remaining premium or reimbursement, and the network access on the same row so the difference is visible.

Carriers are compared inside a market, not as a national ranking

Which issuers sell fully insured small-group coverage is a matter of state filings, not of a national "best companies" list. Ares will not publish a ranked list of insurers and will not describe a carrier as "the best."

In Florida, the Department of Financial Services' 2026 Small Group Market Carrier List names the marketers that advised the Office of Insurance Regulation they are offering ACA small-group plans effective on or after January 1, 2026. The indemnity/PPO list is Blue Cross Blue Shield of Florida d/b/a Florida Blue, National Health Insurance Company, and UnitedHealthcare Insurance Company. The HMO list is Av-Med, Inc.; BeHealthy Florida, Inc. (TruLi for Health); Capital Health Plan, Inc.; Florida Health Care Plan, Inc.; Health Options, Inc. d/b/a Florida Blue; Neighborhood Health Partnership, Inc.; and UnitedHealthcare of Florida, Inc. County-level on- and off-SHOP availability is on the Florida OIR tables. Aetna, Cigna, and other national brands that appear on our carriers hub are discussed there with state-by-state availability; a page about a carrier is not a claim that the carrier sells a Florida fully insured small-group product unless an official filing says so.

In other states, start with the state insurance department or the SHOP or state small-business marketplace, and with the state pages in this update. Our agents are licensed in all 50 states; product availability is still local.

How a comparison with Ares is run

You send a roster, the states where people work, what you offer today, and your renewal date if you have one. We confirm the market you sit in, compare the structures that actually apply, and put the two or three that fit on one recommendation, including contribution and the payroll pieces. We help you implement the design you choose, and we stay on the file for the next renewal.