Small business & group health.

Small businesses in Arizona have three realistic ways to offer health benefits: traditional small-group coverage (2 to 50 full-time employees), a level-funded plan that can return money to you if your team stays healthy, or an ICHRA where you set a monthly dollar amount and employees buy their own plans. Apex Health Advisors is an independent agency, so we compare multiple carriers and plan types, run enrollment, and handle your renewal every year. Our help costs you nothing extra, because carrier commission is built into the premium whether or not you use a broker. Call 623-292-4360 for a group quote.

Do you even have to offer coverage in Arizona?

If you have under 50 full-time employees, no. Coverage is voluntary below that line, and a small group runs from 2 to 50 full-time-equivalent employees. The moment you cross 50 FTEs, the ACA employer mandate applies, and the penalties are real money: for 2026 the base penalty is $3,340 per full-time employee per year (after the first 30) if you do not offer qualifying coverage and someone gets a subsidy on the marketplace. If you are anywhere near that threshold, the FTE math matters more than most owners think. Seasonal and part-time hours add up and can push you over without you noticing.

Most of the businesses we work with offer coverage even though they do not have to, and the reason is simple: medical is the benefit employees expect and value most, ahead of almost everything else you could put in front of them. If you are trying to hire and keep good people, this is usually where the budget goes first.

Traditional small-group coverage

This is the classic setup. You pick a plan or a short menu of plans through a carrier, employees enroll, and the premium is fixed and predictable. Most carriers want at least 70% of eligible employees to enroll and require you to cover at least 50% of the employee-only premium. That 50% is the floor, not the goal. Plenty of employers go to 75% or 100% of the employee cost to stay competitive, then have the employee pick up dependents.

It is simple and it works. The catch in 2026 is price. Employer health costs are projected to climb 6 to 10% this year, the steepest jump in over a decade, and we have seen small-group renewals come in even higher than that. If you have been on a fully insured plan for years and just sign off on the renewal increase every spring, you are very likely overpaying.

Level-funded plans: where the refund lives

This is the structure most owners have never had walked through properly. With a level-funded plan you pay a fixed monthly amount, same feel as fully insured, but that payment splits into three buckets: a claims fund that pays your employees' actual medical bills, stop-loss insurance that protects you if one person has a catastrophic year, and administration. If your team does not use up the claims fund by year-end, some of it can come back to you. On a fully insured plan the carrier keeps that surplus. On a level-funded plan, you have a shot at getting it back.

Adoption has climbed for a reason: by 2023, roughly a third of small firms offering benefits were on a level-funded plan, up sharply from a few years earlier. They often run cheaper than fully insured for a healthy group, and because they are treated as self-funded under federal law, they skip most Arizona state insurance mandates and premium taxes, which can open up plan designs a fully insured carrier cannot sell here.

• Best fit: roughly 10 to 100 employees with a reasonably healthy, stable workforce.
• The classic mistake: a 10 to 15 person firm with a clean claims history staying fully insured because level-funded "sounds complicated." That company is often the single best refund candidate, and it hands the surplus to the carrier every year.
• Under 10 employees, ask about the stop-loss attachment points before you sign. With a tiny pool, one bad claim can drain the fund depending on how the contract is written.

ICHRA: pay an allowance, skip picking a plan

If you want to control your cost to the dollar and stop being the one who chooses a plan for everybody, this is the model. With an Individual Coverage HRA, you set a monthly allowance per employee. Each person shops for their own individual or marketplace plan, picks what fits their doctors and their family, and you reimburse them up to your cap. It is tax-free for you and for them, there is no cap on what you can contribute, and you can scale the allowance by age and family size.

Two things you have to get right. If you have 50 or more FTEs, you have to run an affordability calculation. For 2026, the employee's remaining cost for the benchmark Silver plan has to land under 9.96% of household income, and a flat allowance that works for a 28-year-old can come out "unaffordable" for a 58-year-old whose Silver premium is much higher. Second, you have to hold a real enrollment meeting. The number one ICHRA failure we see is an employee who does not realize they have to actively enroll in an individual plan before the effective date, and ends up with no coverage. We walk your team through it.

A simpler on-ramp if you have no plan today: QSEHRA

If you are under 50 employees and you do not currently offer any group plan, a QSEHRA can be the easy way in. You set a fixed monthly contribution within the IRS limits (for 2026, up to $6,450 single and $13,100 family), employees buy their own coverage and submit receipts, and there is no affordability testing to run. It is reimbursement-based like ICHRA, but with set caps and simpler rules. Just do not confuse the two. QSEHRA is only for employers with no group plan and has contribution limits; ICHRA has no limits and can run alongside a traditional plan for different classes of employees. Mixing them up causes real compliance headaches.

What we actually do for you (and what it costs)

The quote is the easy part. The value is everything around it. We compare carriers and plan types for your specific situation, check network adequacy against the ZIP codes where your employees actually live and work (a real issue in rural Arizona, where a cheap narrow-network plan can leave someone with no in-network primary care within 30 miles), run the enrollment, handle the paperwork, and manage your renewal every year so the spring increase does not blindside you.

The renewal is where it matters most. The right time to shop alternatives is 90 to 120 days before your plan anniversary. If you wait for the renewal letter to land, the window to underwrite a level-funded plan or stand up ICHRA administration for that year is usually already closed, and your leverage is gone. As for cost: working with us is free. Carrier commission is already baked into the premium whether or not you use a broker, so going direct does not save you a dime. You can put that built-in commission toward having an advocate in your corner, or you can let the carrier keep it.