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Group health

A health plan you choose for your team, with you paying part of the premium.

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Last updated: 2026-10-26

Who it is for

Employers with 20 or more employees who want to offer health coverage, or want a second look at the plan they have.

How it works

  • You choose a plan, or a set of plans, for your team.
  • You decide what share of the premium you pay. Employees pay the rest through payroll.
  • New hires can wait up to 90 days before coverage starts, or less if you choose.
  • At 20 employees, federal COBRA generally applies to your plan. At 50 full-time employees, counting full-time equivalents, the federal employer rules on health coverage apply too.

What to bring to the call

  • A list of employees with their home ZIP codes.
  • A summary of your current plan and its renewal date, if you have one.
  • The monthly amount you could put toward each person’s coverage.
  • The states where your people work.

Where these facts come from

Questions owners ask

When can we start a group plan?

Through SHOP, the federal small business program, an employer can apply, pick a plan and enroll employees any time of year. Other plans have their own timelines.

How long can new hires wait for coverage?

A group health plan cannot apply a waiting period longer than 90 days.

Does COBRA apply to us?

Federal COBRA generally applies to group health plans of employers with 20 or more employees in the prior year.

Do we have to offer coverage?

Federal law requires it only of applicable large employers, which have 50 or more full-time employees, counting full-time equivalents, on average during the prior year. State rules can add other requirements.

Is there an alternative to a group plan?

A CHOICE Arrangement, once called an ICHRA. You set a monthly amount, and employees use it with an individual health plan of their own.

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