Group Benefits Insurance

In Maryland, DC, and Virginia, you can offer small-group health insurance with as few as two enrolled employees (one employee and one owner counts). Group plans become available, more carrier-competitive, and more plan-design flexible as you grow toward 50 employees. At 50 full-time-equivalent employees, the Affordable Care Act’s Applicable Large Employer (ALE) mandate kicks in — you must offer affordable, minimum-value health coverage to full-time employees or face shared-responsibility penalties. We help small employers evaluate whether offering group medical, an ICHRA, or no employer-sponsored health is the right starting point.

Fully-insured is the traditional model — you pay a fixed premium to a carrier (CareFirst, Kaiser, UHC, etc.) and they bear all claims risk. Self-funded means you (the employer) pay claims directly out of a claims fund and buy stop-loss insurance to cap your exposure on high-claim individuals; used primarily by larger employers. Level-funded is the middle option that’s grown rapidly for small and mid-market employers — you pay a fixed monthly amount (like fully-insured) but the underlying structure is self-funded with stop-loss; if claims come in below the funded amount, you receive a refund at year-end. Level-funded is often the right answer for groups with 25+ healthy lives in our region — same predictability as fully-insured with potential premium savings of 10–25% in good claim years.

Individual Coverage HRA (ICHRA) is an arrangement where the employer reimburses employees tax-free for individual-market health insurance premiums and medical expenses, instead of offering a traditional group health plan. ICHRAs work especially well for: (1) small employers whose workforce is best served by choice (different employees, different plans), (2) employers with employees in multiple states or remote workforces, (3) employers who want a predictable cost structure (reimbursement caps are fixed by the employer), and (4) employers replacing an unaffordable group health plan with something more tax-efficient. They don’t work as well for: groups concentrated in one labor market where a group plan would be cheaper at scale, or groups with employees who would have trouble shopping the individual market. We model both before recommending.

If you hold a Service Contract Act (SCA) federal contract for services valued over $2,500, you’re required to pay specified prevailing wages and provide a specified fringe benefit rate (set by DOL Wage Determinations). The fringe benefit obligation can be paid in cash to employees or applied to bona fide benefits (health insurance, retirement contributions, paid leave above statutory minimums). Applying it to benefits — rather than cashing it out — provides material tax advantages, reduces employer payroll tax, and is more recruitment-effective. We design bona fide fringe benefit plans that satisfy DOL requirements and coordinate with your contract compliance officer. Similar principles apply to Davis-Bacon Act construction prevailing wages.

DC has the Universal Paid Leave Act — up to 12 weeks of paid family, parental, medical, and prenatal leave, funded by an employer payroll tax. No employee contribution. Administered by DC government. Maryland is phasing in FAMLI (Family and Medical Leave Insurance), with contributions beginning 2026 and benefits beginning later in 2026 — up to 12 weeks of paid leave funded by both employer and employee contributions. Virginia has no state-mandated paid family leave program; employers offering paid leave do so voluntarily or via private insurance. For multi-state employers, this creates a real coordination challenge — we help structure short-term disability, supplemental benefits, and PTO policies to work cleanly alongside whichever state programs apply.

• The largest cost is the premium itself, which varies by carrier, plan design, employee demographics, and employer contribution strategy. Rough DC-metro ranges for a 10-employee group with average demographics:
  • Group medical (employer pays 50%): $400–$900/month per employee
  • Dental: $25–$50/month per employee
  • Vision: $5–$10/month per employee
  • Short-term disability: $15–$40/month per employee
  • Long-term disability: $20–$45/month per employee
  • Group life ($25K-$50K): $3–$10/month per employee

  Total employer cost for a comprehensive employer-paid stack for 10 employees typically lands between $60,000 and $120,000 annually. Voluntary employee-paid options can add substantial benefits at zero employer cost. We model your specific situation and broker the placement at no additional cost to you — our compensation comes from the carriers as standard commissions.