There is no Florida price for group health insurance, and anyone who gives you one has made it up. What exists is a federal survey that publishes Florida averages and a Florida statute that says how a carrier may build your rate. The survey figures are real and are not about your business; the statute is. This post keeps them apart.
Read what the survey measured before you read what it says
The figures below come from the Medical Expenditure Panel Survey — Insurance Component, run by the federal Agency for Healthcare Research and Quality. Its Florida table is titled, in the workbook’s own first cell, “Table II. State of Florida, private-sector data by firm size, 2025.” The data year is 2025, the publication year 2026, and no newer Florida edition exists. Three qualifiers travel with every figure below, and none is a footnote you can drop.
The first is what the survey counts. MEPS samples at the establishment level — its technical notes state that “an establishment is generally a single physical location; a firm can consist of just a single establishment or multiple establishments” — and then classifies each establishment by the size of its parent firm. A Florida employer running four locations is four establishments belonging to one firm, so the unit being averaged is not a business.
The second is what the column is. The column heading reads “Less than 50 employees.” That is close to Florida’s statutory small-employer test and it is not the same test. Fla. Stat. § 627.6699(3)(v) additionally requires that the employer “has its principal place of business in this state” — a condition MEPS does not measure at all — and, under the grandfathered limb, treats an affiliated group as a single employer. The overlap is substantial. The sets are not the same set.
The third is the denominator. Every premium and contribution row below is measured “at establishments that offer health insurance.” These are averages among Florida employers who already offer coverage, not among Florida employers generally.
What MEPS-IC publishes for Florida small firms
Start with how common a Florida small-firm plan is. MEPS-IC reports that in 2025, 22.8% of Florida private-sector establishments at firms with fewer than 50 employees offered health insurance, with a standard error of 3.28%. Establishments classified by firm size; “less than 50 employees” is the survey’s column and not Florida’s statutory test; and unlike the rows that follow, this one is measured across all such establishments rather than only those that offer.
Then the premium rows. MEPS-IC puts the average total single premium at $9,742 per enrolled employee for 2025, with a standard error of 575.65 — measured at Florida establishments, classified by their parent firm’s size, in the “less than 50 employees” column that is not Florida’s statutory test, and only at those establishments that offer health insurance. For family coverage, the survey reports an average total family premium of $24,957 per enrolled employee in 2025, standard error 1,433.66, under all three of the same qualifiers.
Both are annual amounts. The survey’s own average, across all such establishments, for the whole year.
The employee side, and the number that does not exist
For single coverage, MEPS-IC reports an average total employee contribution of $2,500 per enrolled employee in 2025 at Florida establishments — again classified by firm size, again in the “less than 50 employees” column that is not Florida’s statutory test, again only where the establishment offers health insurance. Its standard error is 442.80, which is large against the estimate itself — the survey telling you not to treat the figure as precise.
The survey also reports that employees enrolled in single coverage at those establishments contributed 25.7% of the total premium in 2025, standard error 4.32%, under the same three qualifiers. The balance was carried by the employer.
Notice what that last sentence does not do. MEPS publishes the employee share and does not publish an employer share, in this table or anywhere else in the series. Any employer-side percentage attributed to this survey was produced by subtracting the published number from one hundred and handed back wearing the survey’s name — a computation wearing a citation. The remainder is real; the number attached to it is not, so it is not printed here.
MEPS also suppressed the plan-type breakouts of employee contribution for Florida small firms, so those figures are not available anywhere and the correct response is to stop looking rather than to find a lesser source.
Why none of this is a quote for your group
Every figure above is an average over a population you are not. It is not a rate, a benchmark or a budget, and it cannot be divided into a monthly number — MEPS publishes annual amounts, and the monthly version does not exist to be quoted. Your group’s actual premium is built from characteristics the survey never measured: the ages of your enrolled employees and dependents, family composition, tobacco use, the county your business sits in, the plan design you pick, and the carrier’s own filed factors. Two Florida businesses in the same county with the same headcount can be quoted differently, and neither will be quoted the survey average.
What Florida law actually lets a carrier use
Florida’s mechanism has a name. Fla. Stat. § 627.6699(6)(b)1. requires that “small employer carriers must use a modified community rating methodology in which the premium for each small employer is determined solely on the basis of the eligible employee’s and eligible dependent’s gender, age, family composition, tobacco use, or geographic area as determined under paragraph (5)(f) and in which the premium may be adjusted as permitted by this paragraph.”
The definition at § 627.6699(3)(n) says what modified community rating is meant to do: “a method used to develop carrier premiums which spreads financial risk across a large population; allows the use of separate rating factors for age, gender, family composition, tobacco usage, and geographic area … and allows adjustments for: claims experience, health status, or duration of coverage.”
Two structural points follow. First, the factors are not invented per quote — § 627.6699(6)(b)2. provides that they “may be developed by each carrier to reflect the carrier’s experience” and that “the factors used by carriers are subject to office review and approval.” They are filed and approved. Second, the permitted claims-experience adjustments are group-level only: § 627.6699(6)(b)5. states that adjustments for claims experience, health status or duration of coverage “may not be charged to individual employees or dependents” and “must be applied uniformly to the rates charged for all employees and dependents of the small employer,” within statutory limits on how far the result may deviate from the carrier’s approved rate. No individual on your census gets their own loading.
Florida also restricts averaging. Under § 627.6699(6)(b)7., carriers “may not use a composite rating methodology to rate a small employer with fewer than 10 employees,” where composite rating means “a rating methodology that averages the impact of the rating factors for age and gender in the premiums charged to all of the employees of a small employer.”
Gender is in Florida’s list and is not in the federal one
This is the part of Florida’s rating law an employer should know about and should not be given a tidy answer about, because there is not one on this record.
Florida’s Employee Health Care Access Act was enacted in 1992, before the Affordable Care Act, and was last amended in 2020. Its rating provision names gender among the characteristics a modified community rating may use — at § 627.6699(3)(n), at § 627.6699(6)(b)1., at § 627.6699(6)(b)2. and in the composite-rating definition at § 627.6699(6)(b)7. Florida’s post-ACA accommodation is one sentence at the end of § 627.6699(6)(b)1.: “A small employer carrier is not required to use gender as a rating factor for a nongrandfathered health plan.” Read it exactly — that is a permission to stop, not a prohibition on using it.
The federal rule reads differently. 45 CFR § 147.102(a)(1), last amended June 18, 2018, permits a small-group rate to vary only by whether the coverage is individual or family, by rating area, by age and by tobacco use. Gender does not appear in the list. And (a)(2) closes it: “The rate must not vary with respect to the particular plan or coverage involved by any other factor not described in paragraph (a)(1) of this section.” Section 147.102(h) also states that the section “does not apply to grandfathered health plans.”
Both texts are real, both are quotable, and this record does not resolve them against each other; no court decision, bulletin or regulatory guidance on the question was sought or is held here. The practical move is not to guess which instrument controls but to ask the carrier which factors it actually applies to your group.
Sixty-seven counties, sixty-seven rating areas
Florida’s geography rule is concrete. Fla. Stat. § 627.6699(5)(f) provides: “The boundaries of geographic areas used by a small employer carrier must coincide with county lines. A carrier may not apply different geographic rating factors to the rates of small employers located within the same county.”
CMS’s Florida Geographic Rating Areas table matches that exactly — 67 rating areas over 67 counties, one county per area, numbered alphabetically by county name. The table’s three-digit zip code column is empty in every row, which is the structural fact that matters: no Florida county is split between rating areas. This is the maximum-granularity option, applied uniformly: no county was carved out for being unusual, and none grouped with a neighbor for being similar.
Federally, 45 CFR 147.102(a)(1)(ii)(B) decides which of those areas applies to a group: “In the small group market, using the group policyholder’s principal business address,” with fallbacks for network plans whose service area does not include that address. So a Florida employer headquartered in one county with staff scattered across four is rated on the county of its principal business address, not on where its employees sleep.
Do not merge that with Florida’s eligibility test: 45 CFR § 147.102(a)(1)(ii)(B)’s “principal business address” decides which rating area applies, while § 627.6699(3)(v)’s “principal place of business in this state” decides whether the employer is a Florida small employer at all. Two entirely different jobs.
One date, stated plainly: the CMS table carries “Page Last Modified: 09/10/2024” and states no effective plan year anywhere on the page. It was searched for one; there is none to report, so none is claimed here.
What the county rule looks like on the ground
The structure behaves differently in different Florida markets, and every difference is about boundaries rather than prices.
In Jacksonville the municipal boundary is the county boundary — the Florida Constitution preserves a provision of the Constitution of 1885 authorizing a municipal corporation known as the City of Jacksonville “extending territorially throughout the present limits of Duval County.” Because § 627.6699(5)(f) forbids different geographic factors inside one county, there is no county line anywhere inside the city, and a Jacksonville employer’s rating geography changes only when it opens a worksite outside it.
In Miami, the opposite arrangement produces the same result. Miami-Dade is the only Florida county whose home-rule charter the Constitution preserves by name, and every incorporated municipality inside it shares one rating geography, while crossing into Broward moves an employer into a different one.
Regional structures do not survive the county rule. The South Florida Regional Transportation Authority’s area served is “Miami-Dade, Broward, and Palm Beach Counties” (§ 343.52(1)) and the Central Florida Expressway Authority spans Orange, Seminole, Lake, Brevard and Osceola (§ 348.753(3)) — each of which is its own rating area.
Tampa shows two Florida concepts keyed to the same county behaving differently. Rating geography may not vary inside a county under § 627.6699(5)(f), while a carrier’s “established geographic area” is defined at § 627.6699(3)(h) as the county or counties, or any portion of a county or counties, in which it provides or arranges care — so a Hillsborough employer can face a network reaching only part of its county while its geographic rating factor stays uniform across all of it. And in Key West, Monroe County is an island chain with no land neighbor, so an employer there has no adjoining county to move into without leaving the Keys. That is a statement about boundaries only: nothing on this record says whether a Monroe County premium is higher, lower or the same as anywhere else.
What can move the number once you are in the plan
Two provisions bound the timing. Fla. Stat. § 627.6699(6)(b)3. provides that “small employer carriers may not modify the rate for a small employer for 12 months from the initial issue date or renewal date, unless the composition of the group changes or benefits are changed.” The single exception in § 627.6699(6)(b)3. lets a carrier modify the rate one time within those 12 months for an employer enrolling under a previously issued group policy with a common anniversary date, and only on disclosure of the first renewal date and the possibility of an increase “in a clear and conspicuous manner.” Section 627.6699(6)(c) keeps older business on the same standard as new: for plans issued before January 1, 1994 and renewed on or after January 1, 1995, “renewal rates must be based on the same modified community rating standard applied to new business.”
That is the Florida cost answer: not a number for your group, but a set of rules you can hold a quote against.
The bottom line
There is no Florida price for group health insurance, and the published survey averages are not one. What Florida does give you is a rating mechanism you can read: modified community rating, county-level geography, and a filed set of factors your carrier has to justify to the Office of Insurance Regulation.
Frequently asked questions
What does the government actually publish about group health premiums in Florida?
The federal Medical Expenditure Panel Survey — Insurance Component, run by AHRQ, publishes a Florida table by firm size. Its 2025 data year, published in 2026, reports an average total single premium of $9,742 per enrolled employee and an average total family premium of $24,957 per enrolled employee. Three qualifiers travel with both figures and change what they mean. MEPS samples establishments — generally a single physical location — and then classifies each by the size of its parent firm, so a Florida employer with four locations is several establishments belonging to one firm. The “less than 50 employees” column is close to but not the same as Florida’s statutory small-employer test, which additionally requires a principal place of business in this state. And every premium row is measured at establishments that offer health insurance, which is a denominator rather than a population.
How much of the premium do employees pay in Florida?
For single coverage, MEPS-IC reports an average total employee contribution of $2,500 per enrolled employee in 2025 at Florida establishments with fewer than 50 employees that offer health insurance, and reports that employees enrolled in single coverage at those establishments contributed 25.7% of the total premium. The balance of the premium was carried by the employer. MEPS publishes the employee share and does not publish an employer share, so any employer-side percentage you see attributed to this survey has been computed by someone rather than measured. The employee-contribution figure also carries a large standard error relative to its size — $442.80 against $2,500 — so it should not be read as precise.
Does my county change what my group pays in Florida?
County is the unit Florida uses, and the rule runs in both directions. Fla. Stat. § 627.6699(5)(f) provides that “the boundaries of geographic areas used by a small employer carrier must coincide with county lines” and that “a carrier may not apply different geographic rating factors to the rates of small employers located within the same county.” CMS’s published Florida rating-area table maps 67 rating areas onto 67 counties, one county per area, with no three-digit zip code populated in any row — so no Florida county is split. Federally, 45 CFR 147.102(a)(1)(ii)(B) sets the small-group rating area from the group policyholder’s principal business address rather than from where each employee lives. Nothing here says whether any particular county is priced higher or lower than another; this is structure, not a price.
Can a Florida carrier rate my group on how healthy my employees are?
Florida’s mechanism is modified community rating. Fla. Stat. § 627.6699(6)(b)1. requires that “small employer carriers must use a modified community rating methodology in which the premium for each small employer is determined solely on the basis of the eligible employee’s and eligible dependent’s gender, age, family composition, tobacco use, or geographic area as determined under paragraph (5)(f).” The statute then permits bounded adjustments: § 627.6699(6)(b)5. provides that “any adjustments in rates for claims experience, health status, or duration of coverage may not be charged to individual employees or dependents,” must be applied uniformly across all of the small employer’s employees and dependents, and may not push the rate beyond a statutory limit from the carrier’s approved rate. Federally, 45 CFR 147.102(a)(1) permits variation only by individual-or-family, rating area, age and tobacco use, and (a)(2) forbids variation by any other factor.
Can my Florida group’s rate change in the middle of the plan year?
Fla. Stat. § 627.6699(6)(b)3. provides that “small employer carriers may not modify the rate for a small employer for 12 months from the initial issue date or renewal date, unless the composition of the group changes or benefits are changed.” The same subparagraph carries one exception: a carrier may modify the rate one time within the 12 months after the initial issue date for a small employer enrolling under a previously issued group policy with a common anniversary date for all employers covered under it, if the carrier discloses the date of the first renewal and the possibility of an increase in a clear and conspicuous manner, and demonstrates to the Office that administrative efficiencies are achieved and reflected in the rates. Read together, the rule and its exception mean a mid-term change is usually a group-composition or benefit change rather than a repricing.
Why do I keep seeing a monthly per-employee cost for Florida group health?
Because someone divided an annual figure. MEPS-IC publishes annual amounts per enrolled employee, and there is no monthly Florida figure in the survey to quote. Converting one is arithmetic performed on a survey estimate and then presented as if the survey had published it, which is exactly the move that turns a sound citation into a fabricated number. The same objection applies to rounding either published figure to a softer one, and to comparing the single and family figures as a ratio or a multiple. The figures may be read side by side as the survey states them; they may not be recombined.
About the author
Nate Jones, CPCU, is the founder of Wexford Insurance and Wexford Health Insurance, an independent agency placing small-business group benefits in 9 states. He reads Florida small-group rate structures with employers — the permitted rating characteristics, the county rule, and the difference between a survey average and a quote. Start with the Wexford Health Insurance quote form.