Ares Benefit Group advises businesses of every size, from 2 employees to 500+. Small-business coverage, for companies with 2 to 50 employees, remains the core of the practice. This page is for companies with 51 or more employees — including firms in the 51–200 and 201+ ranges — that need a group health plan designed for a larger census.
In most states, a fully insured plan for a group of this size is issued in the large-group market. That market is defined by state insurance law, and it is not the same test as applicable large employer status under the Affordable Care Act. Both matter, and they can point to different numbers. The mid-size page walks through that distinction; this page focuses on how we help you fund and administer coverage once you are in, or entering, the large-group range.
We work with HR directors, finance leads, and owners. The first conversation is about the census, the states where people work, the current plan and contribution, the renewal date, and the compliance work that already applies. It is not a product pitch.
What “large group” means on this page
Two different rules use a number near 50, and they are easy to mix up.
The insurance market. Under federal law, a small employer is generally an employer that employed an average of one to 50 employees during the preceding calendar year, and a state may extend that definition to one to 100 employees. In a state that uses the federal default, a fully insured plan for 51 or more employees is typically a large-group policy. In a state that extends the small-group definition to 100, a company with 51 to 100 employees may still buy a small-group policy. Florida, where this firm is based, defines a small employer for a nongrandfathered plan as an employer that employed an average of at least one but not more than 50 employees during the preceding calendar year. California, New York, and Vermont still use an upper limit of 100. Colorado used 100 through 2025 and, beginning January 1, 2026, uses 50, with a transition period for certain groups that already had small-group coverage. See mid-size business health insurance for the state-by-state detail and the official sources.
Applicable large employer status. Separately, the IRS treats a company as an applicable large employer for a calendar year if it averaged at least 50 full-time employees, including full-time equivalents, during the prior calendar year. That status governs the employer shared-responsibility rules and certain information-reporting duties. It does not, by itself, decide whether a carrier issues a small-group or a large-group policy.
A company can be an applicable large employer and still be in the small-group insurance market in a state that counts small groups up to 100 employees. The reverse path also happens: a firm can be buying large-group coverage and still need a careful ALE calculation because part-time hours and related companies are part of the IRS math. We will run both questions against your roster and the states where people work.
Fully insured large-group coverage
A fully insured large-group policy is a familiar structure. The employer pays a premium to an insurance company. The insurer pays covered claims under that policy, and the employees use the carrier’s network and plan design.
Premiums, participation rules, and available plan designs vary by carrier and by state. In many states, a large-group premium can reflect the group’s own claims experience, along with the plan design and the census. That is a different pricing method from the tighter rating rules that apply to small-group policies under the Affordable Care Act. It is not a promise that a large-group policy will cost less, or more, than the plan you have today. The only number that matters is the quote on your census.
Plan design is also a discussion, not a catalog. Deductibles, out-of-pocket limits, copayments, provider networks, prescription tiers, and referral rules should be set against how your people actually use care and against the contribution you intend to make. We will not claim that one metal name, network type, or funding method is the right answer for every group of 51 or more.
A fully insured plan is the right answer for many companies in this size range. It is one of the structures we will put on the table when it can be issued, not the only one.
Other funding structures we compare
The right design is the one that fits the census, the cash-flow tolerance, the states involved, and the compliance work the company is prepared to run. Alongside a fully insured large-group policy, we will look at:
- A level-funded plan, when a contract can be issued. The company pays a fixed monthly amount that typically covers expected claims, administration, and stop-loss insurance. The arrangement is generally treated as a self-insured plan that uses stop-loss, not as a separate federal product category.
- A self-funded plan, in which the employer pays covered claims as they come in, usually through a third-party administrator, and buys stop-loss insurance to limit exposure above agreed attachment points.
- An ICHRA, in which the company contributes a set amount and employees enroll in individual coverage. Employers of any size may offer an ICHRA. For an applicable large employer, affordability and minimum-value testing have to be part of the design.
We do not treat any of these as automatically better. A written comparison on your census is the work. If a structure cannot be issued in your state, or cannot be issued for your headcount, we will say so.
Section 125 payroll administration, group life and disability, and voluntary benefits such as dental and vision should be designed alongside the medical plan, not added as an afterthought. If people work in more than one state, see benefits for a multi-state workforce.
Compliance that comes with this size
Many companies in the 51–200 and 201+ ranges are applicable large employers, or will be in the next calendar year. In general terms, an applicable large employer may offer affordable minimum essential coverage that provides minimum value to full-time employees and their dependents, or it may owe an employer shared-responsibility payment to the IRS. “Affordable” and “minimum value” have specific IRS meanings. Minimum value generally means the plan is designed to cover at least 60 percent of the total allowed cost of benefits expected to be incurred under the plan. Affordability can be tested using methods the IRS publishes, including safe harbors based on Form W-2 wages, rate of pay, or the federal poverty line.
Applicable large employers also have information-reporting duties, including Forms 1094-C and 1095-C. An employer that sponsors self-insured coverage has reporting duties as a provider of minimum essential coverage as well. Federal COBRA continuation rules generally apply to group health plans of employers with 20 or more employees, and some states have their own continuation rules. Employer-sponsored plans are also subject to ERISA duties that can include a plan document, a summary plan description, and, in some cases, an annual Form 5500 filing.
This page is a briefing, not a determination of your status and not legal or tax advice. Employee benefits consulting describes how we support renewal strategy, plan design, claims review, and this compliance work. If you are crossing the 50-employee line for the first time, start with the mid-size page as well.
How an engagement runs
- You send a roster (ages or dates of birth, dependent status, work locations, and hours or full-time status), the current plan and contribution, the renewal date, and the states where people work.
- We confirm how your company sits against the large-group market rules in those states and against the IRS applicable large employer test.
- We compare the structures that can actually be issued — fully insured, level-funded, self-funded, and, where it fits, an ICHRA — and we recommend one, with the contribution schedule and the notices and reporting that come with it.
- We help you implement: carrier or administrator setup, employee communications, enrollment, and the payroll pieces.
- We stay on the file for the next renewal, and we will run a benefits RFP or broker review when you want a structured comparison, including a change of broker of record if you decide to make one.
Our agents are licensed in all 50 states. The firm is based in Tampa and works with Tampa Bay employers as well as companies with people in other states.
Talk with an advisor: (813) 540-1299Frequently asked questions
Is a company with 51 employees automatically in the large-group insurance market?
Not always. In states that use the federal default, including Florida, a fully insured plan for 51 or more employees is typically a large-group policy. In California, New York, and Vermont, the small-group market still includes groups of up to 100 employees. Colorado changed its small-employer definition to 50 as of January 1, 2026, with a transition for some existing groups. We will check the state rules that apply to your census rather than assume a single national cutoff.
Does applicable large employer status mean we have to buy a large-group policy?
No. ALE status is an IRS test. It affects shared-responsibility rules and reporting. The market in which a fully insured policy is issued is a state insurance question. Some applicable large employers still buy small-group coverage in states that define small groups up to 100 employees. Others use a large-group policy, a level-funded or self-funded plan, or an ICHRA.
Do you only work with small businesses?
No. Small-business coverage is the core of the practice, and we also work with mid-size and large groups, including companies in the 51–200 and 201+ ranges. The proposal form uses those employee-count ranges.
Will a large-group plan cost less than our current small-group plan?
We will not say that on a website. Pricing depends on the census, the plan design, the funding method, the states involved, and the quote. We compare options on your data.
Can we keep a level-funded or self-funded design instead of a fully insured large-group policy?
Yes, when a contract can be issued and the design fits. We will compare those structures with fully insured coverage rather than treat fully insured as the only large-group answer.
Ready for a proposal?