Small group & self-employed
Health coverage for Florida small businesses
Whether you have fifty employees, five, or none but yourself, there is a way to get health coverage that fits the business you actually run. We help South Florida owners compare the options, check that their doctors and prescriptions are covered, and enroll without guesswork.
Ways to cover your team
There is no single right answer. Which of these fits depends on your headcount, your budget, how much administration you want to carry, and whether your employees are already buying their own coverage.
Fully-insured small group
The traditional route. You choose a plan, the carrier prices it for your group, and premiums are fixed for the plan year. Simplest to administer and the easiest for employees to understand.
Level-funded
You pay a set monthly amount that covers claims, administration, and stop-loss insurance. If the group’s claims come in low, some of that money can come back at the end of the year. Carriers usually medically underwrite the group first.
ICHRA
Instead of buying a group plan, you give employees a tax-advantaged allowance to buy their own individual coverage. You set the budget by employee class. There is no company size limit.
QSEHRA
A smaller, simpler reimbursement arrangement for employers with fewer than 50 full-time equivalent employees who do not offer a group health plan. Annual contribution limits are set by the IRS.
Individual & family market
If you are self-employed with no W-2 staff, you buy through the individual market. Depending on household income, you may qualify for a premium tax credit that lowers what you pay each month.
Dental, vision & ancillary
Dental, vision, disability, and supplemental products can be added to any of the above, or offered on their own as a lower-cost benefit while you work up to medical coverage.
Are you an applicable large employer?
Whether you are legally required to offer coverage comes down to your full-time equivalent employee count, not your headcount. Part-time hours are added together and converted into FTEs, and the threshold is 50. Cross it and the ACA employer shared responsibility rules apply to you the following year.
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How this is calculated
Fifty is the number that changes what the law asks of an employer, and plenty of businesses do not know which side of it they are on, because part-time staff aggregate into the count. This applies the IRS rule exactly: heads for full-time, hours for everyone else.
Counting full-time employees
Anyone averaging at least 30 hours of service a week, or at least 130 hours of service in the calendar month, counts as one full-time employee.
one employee at 30+ hours a week = 1
Counting full-time equivalents
Add up the hours of everyone who is not full-time, counting no more than 120 hours for any one person, divide by 120, and round down to a whole number.
floor( total part-time hours in the month / 120 )
The annual test
For the real determination, do that sum for each of the twelve months of the prior calendar year, add the twelve totals together and divide by twelve. Fifty or above makes you an Applicable Large Employer for the current year.
( sum of the twelve monthly totals ) / 12 >= 50
Starting assumptions, and where each one comes from
| Assumption | Default | Source |
|---|---|---|
| Full-time threshold | 30 hours a week, or 130 a month | IRS, employer shared responsibility provisions |
| Part-time divisor | 120 hours | IRS: combine non-full-time hours, no more than 120 per person, divide by 120 |
| Applicable Large Employer threshold | 50 | IRS, averaged across the prior calendar year |
| Tax credit size limit | Fewer than 25 full-time equivalents | IRS, Small Business Health Care Tax Credit |
| Tax credit wage limit | $50,000 base, indexed since 2014 | IRS. Check the current year's adjusted figure before relying on it. |
Sources
- IRS — determining if an employer is an applicable large employer (2026)
- IRS — Small Business Health Care Tax Credit: who gets the credit (2026)
Important
This counts one month. The statutory test adds the full-time employees and the full-time equivalents for each of the twelve months of the prior calendar year and divides by twelve, so a business whose staffing moves through the year can land on the other side of 50 from what a single month suggests.
There is a seasonal exception. If your workforce goes above 50 for 120 days or fewer in the year, and the people above 50 during that stretch are seasonal workers, you are not treated as an Applicable Large Employer. This calculator does not apply that exception.
The tax credit flags are indicators, not a determination, and this does not calculate a credit amount. The wage threshold is adjusted for inflation each year, the coverage generally has to be bought through the SHOP Marketplace, and the credit can be claimed for no more than two consecutive years. Form 8941 and your accountant settle it.
This is not tax or legal advice, and controlled group and affiliated service group rules can combine separate businesses into one employer for this test.
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Common questions
We are just under 50. What should we watch?
The monthly average across the whole prior calendar year. Adding part-time hours or a few full-time hires can move you over, and the status applies to the following year. Track it monthly rather than once a year.
What happens if we are an Applicable Large Employer and do not offer coverage?
You may owe an employer shared responsibility payment if at least one full-time employee buys Marketplace coverage and receives a premium tax credit. You also have annual reporting on Forms 1094-C and 1095-C either way.
Do our related businesses count together?
They can. Businesses under common ownership may be combined into one employer for this test under the controlled group rules. A tax adviser should confirm how yours are treated.
Am I an Applicable Large Employer? v1.1.0 · bf4951c02f6a
How we work
We are an independent agency in Fort Lauderdale. That means we are not employed by a carrier and we are not tied to one company’s products.
We look at what you have first
Before quoting anything, we go through your current plan, what it costs you and your employees, and what has actually been used. Sometimes the answer is to keep what you have.
We check doctors and prescriptions
We look up your key providers and medications against each plan’s network and formulary before you enroll, so a network gap turns up in the comparison rather than at the pharmacy counter.
We work in English and Spanish
Calls, emails, and enrollment meetings can be handled in either language, for you and for your employees.
How we are paid. You do not pay us a separate fee. When you enroll, the insurance company pays us a commission that is already built into the plan’s premium — going through us does not raise your rate, and going direct does not lower it. We work with a number of carriers in Florida, but we do not offer every plan available in your area.
What to have ready
A quote comes back faster when we have these up front. Nothing here is required to start a conversation.
- A current employee census: date of birth, ZIP code, and whether each person is enrolling alone or with dependents
- Your current plan documents and the current monthly premium, if you have coverage today
- How much of the premium the business contributes for employees, and for dependents
- Any doctors, hospitals, or prescriptions your team needs kept in-network
- Your target effective date
Talk to an agent
Tell us about your business and we will lay out what is available to you, what each option would cost, and what the trade-offs are. No obligation to enroll.
Phone
Office
2881 E Oakland Park Blvd
Fort Lauderdale, FL 33306