Florida Health Insurance
Cost Per Employee Calculator
Compare fully insured, level-funded, self-funded, PEO, and MEWA health plan costs for your Florida business -- powered by real data from KFF, CMS, and state DOI filings.
Florida Small-Group Health Insurance at a Glance
Calculation Methodology
Base Premium Calculation: We start with the KFF 2025 national average single premium ($720/mo) and apply the Florida cost index (0.98) to get the state-adjusted base rate. Age adjustments use the CMS 3:1 federal age curve, and tier mix multipliers convert single rates to blended PEPM costs.
Funding Type Adjustments: Fully insured rates include carrier margin (15-20%) and risk charges. Level-funded rates remove 8-12% of carrier margin but add stop-loss premium. Self-funded rates are pure expected claims plus admin fees (typically $30-50 PEPM) and stop-loss. PEO rates reflect group purchasing power (typically 14% below direct market). MEWA rates are similar to PEO but with association-specific pool dynamics.
Trend Projections: 3-year projections use funding-type-specific trend rates: fully insured (8.0%), level-funded (5.0%), self-funded (4.8%), PEO (3.8%).
Limitations: This calculator provides estimates based on market averages. Actual premiums depend on your specific group's claims history, plan design, carrier underwriting, and negotiated rates. Use this as a comparison starting point, then request actual quotes.
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What Florida Employers Need to Know About Health Insurance Costs
Florida is one of the largest and most competitive health insurance markets in the nation, with a cost index of 0.98 -- almost exactly at the national average. The state's massive population and diverse geography create varying cost dynamics across regions.
Florida Blue (the state's BCBS plan) holds the largest market share, but competition from UnitedHealthcare, Aetna, Cigna, Oscar Health, and Ambetter gives employers meaningful choice. South Florida (Miami-Dade, Broward, Palm Beach) tends to have higher premiums than the rest of the state due to higher provider costs and utilization.
Florida has NOT expanded Medicaid, which means a larger uninsured population and potentially higher uncompensated care costs baked into provider rates. This is a key market dynamic that distinguishes Florida from most other large states.
The absence of a state income tax makes Florida attractive for employers and employees alike, and it affects total compensation calculations when comparing benefit packages. PEO arrangements are very popular in Florida -- the state has the largest concentration of PEO clients in the nation, driven by the state's favorable PEO regulatory environment.