Medically reviewed by Jawad Arshad, MD, FACEP. Last reviewed: October 7, 2026.
Small business health insurance companies do not all sell to the same size of business or in the same states. Before you compare prices, find out which companies will quote a group like yours at all.
Key facts
- Anthem sells small business plans to businesses with 2 to 50 employees, and 2 to 100 employees in California, Colorado and New York (Anthem, 2026).
- Cigna says availability varies by location and plan type, and points groups of 2 to 50 employees to separate small group plans (Cigna Healthcare, 2026).
- HealthCare.gov SHOP serves employers with generally 1 to 50 employees, and enrollment can go through an agent or broker (HealthCare.gov, 2026).
- Average annual premiums were $9,325 for single coverage and $26,993 for family coverage in 2025 (KFF Employer Health Benefits Survey, 2025).
- Premiums paid through a Section 125 plan are exempt from income tax withholding and from the 7.65% FICA tax (IRS Publication 15-B, 2026).
What is the best group health insurance for employers?
The best group health insurance for an employer is the plan whose network, deductible and cost fit the people on your payroll. No single company wins in every county, because networks and prices change by location.
Small business health insurance companies fall into a few types. Knowing the type tells you what to expect before you ask for a quote.
Table: Types of small business health insurance companies
| Type | How you buy | What to check |
|---|---|---|
| National carrier (Anthem, Cigna and similar) | Usually through an agent or broker | Which states and group sizes the carrier sells to |
| Regional or state-based carrier | Broker or the carrier directly | Whether doctors and hospitals your team uses are in network |
| Level-funded carrier | Broker | Risk your business keeps, and whether it needs health questions |
| HealthCare.gov SHOP | Marketplace or an agent or broker (HealthCare.gov, 2026) | Whether SHOP is open in your state and how many employees count |
Our best small business health insurance guide covers plan quality. Our small business health insurance plans guide explains the five plan types that these companies sell.
Which small business health insurance companies sell to a group your size?
Anthem sells to businesses with 2 to 50 employees, Cigna points groups of 2 to 50 to separate small group plans, and SHOP covers generally 1 to 50 employees. Group size rules differ by company and by state, so check before you request quotes.
Anthem states that its plans are for businesses with 2 to 50 employees, and 2 to 100 in California, Colorado and New York, and 1 to 50 in Maine (Anthem, 2026). Anthem lists 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin (Anthem, 2026).
Table: Group size and quote route, from each company's own website (2026)
| Company | Group size stated | How to get a quote |
|---|---|---|
| Anthem | 2 to 50 employees (2 to 100 in CA, CO, NY; 1 to 50 in ME) | Contact an agent or broker, or use a state quoting link (Anthem, 2026) |
| Cigna Healthcare | Small group plans for 2 to 50 employees, listed separately | Ask to speak with a Cigna Healthcare representative (Cigna Healthcare, 2026) |
| HealthCare.gov SHOP | Generally 1 to 50 employees | SHOP portal or an agent or broker (HealthCare.gov, 2026) |
Does Cigna sell small business health insurance?
Cigna sells group coverage, but its main employer page describes plans for 25 to 99 employees and sends smaller groups to a separate small group page. Product availability varies by location and plan type (Cigna Healthcare, 2026).
Cigna also states that in most states it offers group insurance to employers with more than 50 full-time employees, and administrative services for self-funded plans with as few as 25 full-time employees (Cigna Healthcare, 2026). If your team has fewer than 25 people, ask a Cigna representative whether it sells a fully insured small group plan in your county.
How do I compare small business health insurance providers?
Compare small business health insurance providers by four things: network, deductible, total yearly cost to your company, and whether the company will renew without a large jump. Put every quote in one table before you decide.
Here is a worked example. The numbers are hypothetical, so you can see the math. A 12-person company gets quotes for employee-only coverage from three companies and plans to pay 65% of each premium.
| Company | Monthly premium per employee | Employer share (65%) | Employee share (35%) | Deductible | Company cost per year |
|---|---|---|---|---|---|
| Company A | $540 | $351.00 | $189.00 | $5,500 | $50,544 |
| Company B | $585 | $380.25 | $204.75 | $4,000 | $54,756 |
| Company C | $640 | $416.00 | $224.00 | $2,000 | $59,904 |
The company cost is the employer share times 12 employees times 12 months. Company C costs the business $9,360 more a year than Company A. Each employee pays $35 more a month, and in return the deductible falls by $3,500. Ask your team which trade they prefer before you choose.
Our group health insurance quotes checklist lists what each quote must show. Our small business health insurance quotes online guide explains how to request them.
Should I buy from the company directly or use a broker?
A broker can quote several companies in one request, while a company website shows only its own plans. Anthem tells small businesses to reach out to an agent or broker to get a quote (Anthem, 2026), and HealthCare.gov offers a local agent and broker search for SHOP (HealthCare.gov, 2026).
Ask any broker three questions: which companies do you quote in my county, how are you paid, and who helps my employees after enrollment. A broker who quotes only one company is a sales agent for that company.
Free. Results depend on your plan terms and IRS rules. Not legal or tax advice.
Can a Section 125 plan lower the cost whichever company I choose?
Yes. A Section 125 cafeteria plan lets employees pay their share of the premium before tax, so your business skips 7.65% FICA on those dollars. The carrier price does not change, but your payroll tax bill does.
IRS Publication 15-B (2026) describes a cafeteria plan as a written plan that lets employees choose between cash and qualified benefits such as health premiums. Using Company B from the table, each employee pays $204.75 a month. Assume a 12% federal bracket (IRS Revenue Procedure 2025-32, 2026).
| Monthly pre-tax premium per employee | Employer FICA saved (7.65%) | Employee FICA saved (7.65%) | Employee income tax saved (12%) |
|---|---|---|---|
| $204.75 | $15.66 | $15.66 | $24.57 |
| $457.00 | $34.96 | $34.96 | $54.84 |
| $700.00 | $53.55 | $53.55 | $84.00 |
At $204.75, the employer saves $15.66 per employee per month, which is below Summit's $35 per enrolled employee monthly fee. The saving matches the fee at about $457 a month of pre-tax contributions, because $35 divided by 7.65% is $457. Summit Health Benefits pays that fee out of the employer FICA savings, and its published planning range is $91 to $136 of employer FICA recapture and $56 to $101 net per enrolled employee per month once dental, vision and other pre-tax benefits are included (Summit Health Benefits, 2026). Run your own headcount in the calculator before you count on that range.
Employees come out ahead in every row, because their take-home pay rises. Read more in our Section 125 cafeteria plan guide and our guide to maximizing FICA tax savings.
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Frequently Asked Questions
What are the best small business health insurance companies?
Does Cigna offer small business health insurance?
How many employees does Anthem small business health insurance require?
What are the top small business health insurance providers?
Do I need a broker to buy small business health insurance?
Can employees pay their share of a company's group plan before tax?
Sources: Anthem, Small Business Health Insurance, employee counts and states served (2026); Cigna Healthcare, Employers and Small Business pages (2026); HealthCare.gov, SHOP for small businesses and employers (2026); KFF, 2025 Employer Health Benefits Survey (2025); IRS Publication 15-B, Employer's Tax Guide to Fringe Benefits (2026); IRS Revenue Procedure 2025-32, 2026 inflation adjustments (2025); Summit Health Benefits, plan pricing and FICA recapture ranges (2026).