Group health benefits

Choosing to offer health benefits is one of the biggest decisions your business will make. Let us help simplify the process so you can get the most from your investment.

Which best describes your business?

Make managing your group health benefits easier with ADPIA

  • Online benefits management tools1
  • Automated enrollment and deduction management
  • Employer / Employee Contact Centers
  • Open Enrollment / Renewal Support
  • Integration with your ADP Payroll

Like the health benefits you already offer? Keep the same plan and same price with no coverage interruptions2…and enjoy the benefits of partnering with ADPIA.

Video: Switching to ADPIA® for Group Health Insurance

Offering group health is a big step. Let ADPIA help.

  • Offer benefits your employees deserve
  • Control what you spend by selecting a plan that fits your unique budget
  • Tax-free solutions for you and your employees
  • Online benefits management tools1

Let ADPIA help make group health a reality for your business. It’s easy to get started with knowledgeable, licensed agents and the convenience of one-stop insurance management.

Video: ADPIA®: Offering Group Health Insurance for the First Time
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Putting the pieces together:

How do you choose the right benefits? You need the right partner. Automatic Data Processing Insurance Agency, Inc. (ADPIA®), can help. Our licensed agents have the knowledge and experience to help you pick the right coverage to meet your employees' overall health and wellness needs, including:

Stay competitive

Employees want to work for companies with the best compensation and benefits. Offering a comprehensive employee benefits package makes it more likely you'll attract and retain top talent.


Increase productivity

A healthy workforce can be a more productive one. Group health insurance helps create a healthy environment through prevention and wellness.


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Enjoy lower rates

Business health insurance is typically more affordable than an individual policy. Businesses generally enjoy lower premiums because the more people in an employer health insurance plan, the lower the health insurance costs for everyone.


Healthier employees = a healthier bottom line

Typically available to a company of two or more employees and their families, there are several reasons why it makes good business sense to offer group health insurance.

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Insights, options and service

At ADPIA, we provide access to a wide range of group health insurance plans. We connect you with one of our carrier partners, while offering guidance and support.

We can also connect you to a carrier network with additional products like flexible spending accounts (FSA), health savings accounts (HSA) and health reimbursement arrangements (HRA).

Farmer in greenhouse ponders health insurance needs for her growing business

As your needs grow and change

As your company grows — and as industry regulations change — you may need to reassess your health insurance needs. We'll get to know your business and help you determine what coverage is right for your situation.

Common questions about group health insurance

What is group health insurance?

Group health insurance is an employee benefit provided by an employer that offers medical coverage to employees and sometimes their spouses, partners and/or legal dependents.

What's the difference between group health insurance and individual coverage?

If you have a business that employs two or more people, you're eligible to purchase group health insurance for your business. By pooling employees together, premiums for group health insurance plans can be less expensive than buying individual plans for your employees.

In addition, employer-paid premiums are generally tax-deductible. Your employees' contributions to their premiums can be paid with pre-tax dollars, which lowers your employees' taxable income as well as your payroll taxes.

Individual plan premiums are determined by individual risk (and may result in a higher cost) and individuals must reach 7.5% of their adjusted gross income in medical expenses in order to deduct any excess from their taxes.

What percentage of the group health insurance premium does an employer usually pay?

According to a Kaiser Family Foundation survey, small employers (3-199 employees) typically pay 86% of premiums for single-employee coverage and 66% of premiums for family coverage. Midsized firms (200-999 employees) pay 88% of single-employee premiums and 82% of family premiums. Large firms (1,000-4,999 workers) pay 89% of single employee premiums and 77% of family premiums.

What is the typical waiting period before employees become eligible for a new employer's group health insurance plan?

According to ACA, waiting time cannot exceed 90 days and some states have adopted a 60-day maximum waiting period.

How does the carrier determine a group's premium?

Health insurance companies use one of three methods to calculate your group health insurance premium: medical underwriting, adjusted or modified community rating, or rating bands. The process used depends on the rules in your state. Please contact a licensed ADPIA agent for more detailed information.

What coverage is included in group health insurance?

Employers have a choice to select the coverage and plans that are best suited for their business and employees. Group insurance plans can include a range of coverage, including but not limited to: medical, dental, vision, life, short-term and long-term disability, etc.

How does group health insurance benefit a small business owner?

Health insurance helps protect the personal health of the business owner and its employees, as well as the financial health of the business. Group health coverage can relieve some of the financial fears of getting sick and help employees to stay health. Today, health insurance can also be a top benefit factor in attracting and retaining talented workers.

What will happen if the employee has a pre-existing condition?

A carrier cannot deny coverage on the grounds of a pre-existing medical condition, depending on circumstances.

What group health insurance plan is right for my business?

Finding the plan that works best for both you and your employees is a matter of balancing your coverage and budget needs.

Some insurance plans provide copayment coverage for most routine needs: annual physicals or monitoring a health condition. Plans of this type cover doctors' visits and prescriptions with a known copayment. The premiums for these plans reflect this level of coverage.

Other insurance plans offer a higher deductible, which results in a lower premium, but have higher out-of-pocket costs until the deductible and any coinsurance requirements are met. This type of plan provides coverage for significant medical expenses and can work for people who don't anticipate frequent trips to the doctor.

What are the typical features of a group health insurance plan and how do they affect its price?

Plan deductible - The expenses a member must cover before the insurer covers expenses. The lower the plan deductible, the higher the premium.

Out-of-pocket limit - The maximum annual amount the insurer will require a member to contribute toward the cost of care. The lower the out-of-pocket limit, the higher the premium.

Coinsurance level - The percent of the allowed amounts for covered services that the insurer will pay after the deductible is met. Plans range 50% to 100%.

Copayment for services - The fixed dollar amount that's due when the covered service is provided. In most cases, this is the only cost that the member is responsible for paying – the plan covers the majority of the cost of services.

What is the minimum participation requirement necessary to offer group health insurance?

For a small business owner, it's important to understand the minimum participation requirements necessary for group plan eligibility. Though requirements vary by state, the following generally serve as an industry-standard regarding group health insurance plan participation:

A minimum of at least 75% of "net eligible" or 50% of "total eligible" employees participate in the health plan.

"Total eligible" employees are the sum of all eligible employees (full-time working>30hr/week).

"Net eligible" employees are the total eligible employees minus those eligible employees who have credible coverage through elsewhere (i.e., through a spouse, Medicare, etc.)

Why ADPIA? Here’s what our clients have to say…

9 out of 10

clients say that switching to ADPIA was easy.

4 out of 5

clients agree ADPIA has simplified their insurance administrative process compared to their previous agency or broker.

4 out of 5

clients prefer ADPIA over their previous agency or broker.

4 out of 5

ADPIA clients are more likely to recommend ADPIA than their previous agency or broker, to another small business.

Internal survey of 589 ADPIA® clients in 2022 that used another insurance agent or broker or dealt directly with the insurance company before coming to ADPIA.

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  1. To take advantage of Benefits Connector with Ease, clients must have a group health policy brokered through Automatic Data Processing Insurance Agency, Inc., and must be an ADP payroll client using RUN Powered by ADP® or ADP Workforce Now®, excludes Autopay clients and clients using ADP Workforce Now® Next Gen.  Certain optional features within the Ease application may require a fee.
  2. Restrictions apply and availability may vary depending on your carrier.