A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
Speak with a licensed insurance agent 866-553-3223
Speak with a licensed insurance agent 866-553-3223
A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Will you receive an ACA premium subsidy?
See if you're eligible for the Affordable Care Act's premium tax credits (premium subsidies), how subsidies are calculated, and why they are more robust through 2025.
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Federal poverty guidelines for 2025
The federal poverty level (FPL) - also referred to as the federal poverty guidelines – is used to determine eligibility for Medicaid and CHIP, and for premium subsidies and cost-sharing reductions in the health insurance marketplace.

group health insurance

infographic regarding group health insurance

What is group health insurance?

Group health insurance is coverage through an employer or other entity that offers coverage to all eligible individuals in the group. Before the Affordable Care Act, group health insurance coverage was more regulated than individual health insurance, although many of the law's provisions apply to both the individual and group markets.

Group health insurance includes both small groups and large groups, which have different regulations, as well as self-insured group coverage. In most states, "small-group" means up to 50 employees, although four states define small-group as up to 100 employees1 (Colorado uses the 100-employee threshold but will switch to the 50-employee threshold in 20262). If an employer has more employees than the state's definition of small-group and chooses to purchase coverage (as opposed to self-insuring), the plan will be purchased in the large-group market.

Read more about how group health insurance changed with the implementation of the Affordable Care Act, and how the rules differ for small-group, large-group, and self-insured coverage.

Footnotes

  1. "Market Rating Reforms — State Specific Rating Variations" CMS.gov. Accessed Oct. 8, 2024 
  2. "Colorado Senate Bill 73" BillTrack50. Enacted May 1, 2024 

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