Alternatives to traditional group health insurance for Columbus employers
If your company has 25–250 employees and the group renewal keeps climbing, you have four real options — and each one is the wrong answer for somebody. Here's an honest look at all four, including the one where Franklin County's 2026 numbers are unusually favorable.
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The four options, honestly compared
Option 1
Stay fully-insured and shop carriers
Your broker re-quotes the renewal across the carriers writing small group in OH. It's the default move, and sometimes the right one.
Right fit
You want zero disruption, your renewal increase is modest, or you switched carriers recently and goodwill pricing is still in effect.
Wrong fit
As a long-term strategy: the typical outcome is single-digit relief in year one, then compounding increases after — you're shopping within the same small group risk pool that produced the renewal in the first place.
Option 2
Level-funded plan
A self-funded plan dressed like a fully-insured one: fixed monthly payments, a claims fund, stop-loss behind it, and a potential surplus refund in a good year.
Right fit
A young, healthy census that underwrites well — good years can genuinely cost less than fully-insured.
Wrong fit
A census with known conditions or an older age mix. If claims hit, the renewal can be re-rated sharply or high-cost individuals lasered — the savings are conditional on staying healthy, and you find out at renewal.
Option 3
Self-funding with stop-loss
The company pays its own claims, buys stop-loss insurance for catastrophic risk, and hires a TPA to administer. Real risk transfer to yourself, with real data transparency in return.
Right fit
Roughly 150+ employees, stable cash flow, and appetite for claims volatility — at that scale the law of large numbers starts working for you.
Wrong fit
Most companies under ~150 lives. One or two large claims can swing an entire year, and the fiduciary and administrative load is significant for a lean HR team.
Option 4
Individual Coverage HRA (ICHRA)
Instead of buying one group policy, the employer gives each employee a fixed, tax-free monthly allowance to buy their own ACA marketplace plan. The tax treatment mirrors group insurance; the employer's cost becomes a defined, predictable budget line. Whether it makes financial sense depends almost entirely on one number: the gap between small group and individual premiums in your county.
This is where Franklin County is unusual. For plan year 2026, comparing the lowest-cost plan at the same metal tier and age on each market, individual coverage runs an estimated $484–$885/mo per employee below small group — one of the widest gaps of any US county.
| Tier / age | Small group | Individual | Difference |
|---|---|---|---|
| Bronze, age 27 | $810/mo | $326/mo | $484/mo |
| Silver, age 27 | $872/mo | $352/mo | $520/mo |
| Gold, age 27 | $933/mo | $436/mo | $498/mo |
| Bronze, age 50 | $1381/mo | $555/mo | $825/mo |
| Silver, age 50 | $1486/mo | $600/mo | $885/mo |
| Gold, age 50 | $1591/mo | $743/mo | $848/mo |
Lowest-cost plan on each market, same tier and age, plan year 2026 on both sides. Estimates — see methodology below.
Right fit
Counties like this one, where the individual market is dramatically cheaper than small group. Companies like yours could see the same benefit budget go substantially further — actual results depend on your census and contribution design.
Wrong fit
Counties where the group/individual gap is small or negative — in much of the country an ICHRA saves little or nothing and just adds change management. The county data decides, not the concept.
No option above is a recommendation. All dollar figures are county-level 2026 estimates, not quotes, and no individual employer outcome is implied or guaranteed.
Why the county decides
Options 1–3 all reshuffle risk inside the same local group market — the outcome rides on your census. Option 4 is the only one whose economics are set by geography: ACA individual markets are priced county by county, and the spread against small group ranges from negative to enormous. Of 3,000+ counties analyzed for plan year 2026, Franklin County sits among the very strongest — an estimated 59.6% gap between the lowest-cost small group and individual bronze plans. The same strategy that's a non-event in most of the country may be worth a serious look for Columbus employers. That's why the evaluation starts with your county's numbers, not a brochure.
Group-alternative FAQs
What are the alternatives to group health insurance for a small business?
A Columbus-area company with 25–250 employees realistically has four: (1) stay fully-insured and shop carriers at renewal, (2) move to a level-funded plan, (3) self-fund with stop-loss insurance (usually 150+ employees), or (4) adopt an Individual Coverage HRA (ICHRA), where each employee buys their own ACA marketplace plan with a tax-free employer allowance. Which one fits depends on company size, employee health census, and — for ICHRA — the local gap between group and individual premiums.
Level funded vs ICHRA — which is better for my company?
They solve different problems. A level-funded plan can lower costs for a young, healthy census, but if claims come in, the renewal can be re-rated or individuals lasered, and the savings evaporate. An ICHRA's economics depend on the county, not the census: in Franklin County for plan year 2026, same-tier, same-age individual plans run an estimated $484–$885/mo per employee below the lowest-cost small group plan. Neither is universally better — a healthy census in a county with no group/individual gap favors level funding; Franklin County's unusually wide 2026 gap favors evaluating an ICHRA.
Is ICHRA worth it in Ohio?
It depends on the county. An ICHRA only creates room for savings where individual-market plans cost meaningfully less than small group coverage. Franklin County is one of the strongest such markets in the country for plan year 2026 — an estimated 59.6% gap at the bronze age-27 comparison — but other Ohio counties show smaller or no gaps, where an ICHRA may be the wrong move. Any evaluation should start with your county's numbers, not a national average.
When is self-funding a bad idea for a mid-size company?
Self-funding with stop-loss generally needs roughly 150+ employees for claims to be statistically stable; below that, one or two large claims can swing a whole year. It also brings fiduciary, administrative, and cash-flow obligations most 25–100 employee companies aren't staffed for. For those companies, the realistic choices are usually shopping carriers, level funding, or — where county economics support it — an ICHRA.
Does switching to an ICHRA mean worse coverage for employees?
Individual-market plans purchased through an ICHRA are ACA-compliant major medical coverage — the same regulatory floor as small group plans, with the same essential health benefits. Networks and plan designs differ plan by plan, so employees should compare options during enrollment. An ICHRA changes who picks the plan and how it's funded; it does not change the class of coverage, and no specific outcome or plan match is guaranteed.
Methodology: Individual-market premiums are the lowest-cost plan by metal tier and age from the CMS Marketplace Public Use Files, plan year 2026. Small group premiums are the lowest-cost plan for the same tier, age, and county from Ideon. Both sides of every comparison use the same plan year (2026); figures are estimates and no individual employer outcome is implied. Descriptions of level-funded, self-funded, and fully-insured mechanics are general market characterizations, not advice for any specific company.
Last updated: August 16, 2026 · Plan-year 2026 data, same year both markets. Sources: CMS Marketplace Public Use Files (individual market) · Ideon (small group) · BLS QCEW 2024 Q2 (employment).
30 seconds to your county estimate. One business day to your real number.
No contact info needed for the estimate. Free census analysis if you want the actual figure — and an honest 'keep your group plan' if that's the answer.
Rate data: CMS Marketplace PUF + Ideon, plan year 2026, same plan year on both sides. Estimates, not quotes.
See what your company could save
County-specific 2026 numbers, about 30 seconds, no contact info needed.
How many employees do you have?
See What My Company Could Save →30-second estimate. No contact info needed.