Series
The Employer Market
The 1-to-50 market is five structurally distinct employer populations sharing a regulatory label. Below 10 lives, the actuarial math does not support level funded. Between 6 and 15, it begins to work for the right groups. Above 16, the choice between level funded and fully insured is genuine and deserves structural analysis. Professional services, skilled trades, service economy employers, and employers offering nothing each face a different version of the coverage problem.
LFP-04.01
The 1-to-50 Market: One Size Range, Multiple Economies, Completely Different Coverage Problems
Small group covers 1 to 50 employees in the regulatory definition and at least five structurally distinct markets in practice. Actuarial viability is determined by size. Coverage …
LFP-04.02
Below the Viable Threshold: The Solo S Corp and the 2-to-5 Life Group
The fastest-growing segment of small business formation is the one level funded cannot serve. Below approximately 10 lives, stop loss variance makes the economics unviable. A …
LFP-04.03
The 6-to-15 Sweet Spot: Where Level Funded Starts Working and Why
Somewhere between 6 and 15 employees, the actuarial math shifts. Stop loss pricing becomes proportionate rather than punitive, surplus return produces real dollar amounts, and the …
LFP-04.04
The 16-to-50 Employer: Enough Scale for Real Plan Design, Not Enough for Self-Funded Confidence
At 16 to 50 employees, both level funded and fully insured are viable, and the decision deserves structural analysis rather than first-year price comparison. KFF reports that 37 …
LFP-04.05
The High-Income Small Employer: Consulting Firms, Law Practices, and Financial Advisors Buying Coverage for Talent
Professional service firms compete for talent against organizations with comprehensive benefits platforms. For this segment, the level funded value proposition is not cost savings …
LFP-04.06
The Blue-Collar Small Employer: Construction, Landscaping, Skilled Trades, and Benefits as Retention
Skilled trades employers face a coverage calculus tied directly to a labor shortage: the contractor offering health coverage retains workers the one offering only wages cannot. The …
LFP-04.07
The Service Economy Employer: Restaurants, Salons, Home Health, and the Coverage Gap Below the ACA Mandate
Restaurants, salons, home health agencies, and retail employers operate on margins that make meaningful employee premium contribution economically infeasible for much of their …
LFP-04.08
When ICHRA Is the Right Answer for a Small Employer: The Honest Assessment
ICHRA reimbursement mechanics are not the question. Whether ICHRA is the right structural choice for a specific employer with a specific workforce in a specific geography is. The …
LFP-04.09
The Cost of Offering Nothing: What Happens to Small Employers Who Do Not Provide Coverage
Below 50 full-time equivalents, there is no ACA penalty for offering nothing, and many employers default to that position without calculating what the decision costs in turnover …