There is exactly one figure this page will print as an Illinois cost, and it answers a narrower question than the title asks. The Agency for Healthcare Research and Quality runs the Medical Expenditure Panel Survey–Insurance Component, an annual survey of employers with the U.S. Census Bureau as its data collection agent, and its 2025 Illinois table reports an average total single premium of $9,865 per enrolled employee at private-sector establishments in firms with fewer than 50 employees that offer health insurance. That is a statistical average across a population. It is not a quote, not a starting point, and not a number any Illinois employer should carry into a budget.
The rest of this page is about why, and about what actually moves an Illinois rate.
What the figure is a figure of
The table it comes from is titled, in the workbook’s own first cell, Table II. State of Illinois, private-sector data by firm size, 2025. The column is headed Less than 50 employees
. The row is Average total single premium (in dollars) per enrolled employee at establishments that offer health insurance.
Two more rows from the same column are worth having in view. The survey reports that 35.5% of Illinois private-sector establishments in firms with fewer than 50 employees offered health insurance in 2025. And it reports an average total family premium of $27,996 per enrolled employee, at the same establishments, on the same basis.
Those three numbers are the entire published Illinois picture at this firm size from this source. They are not combined, differenced or converted anywhere on this site, and the two premium figures in particular are not set against each other — pairing them to suggest a family-versus-single relationship would be a computation, and computations on survey figures are how a published average turns into a fabricated one.
Qualifier one: the survey counts establishments and sizes firms
The unit being counted is the establishment — a particular workplace or physical location. The size band is a property of the firm: “the total number of employees for the entire firm as reported on the sample frame.”
Those are different objects, and the mismatch runs both ways. A single Illinois site belonging to a large multi-location company is not in the “Less than 50 employees”
column, however few people work at that site. A small Illinois firm’s one workplace is. So the column does not describe “Illinois businesses with under fifty employees,” and writing it that way substitutes a business count for a workplace count.
Qualifier two: that column is not the Illinois small-employer band
This is the sharpest of the three in Illinois, because the state’s statutory test is unusual.
The Illinois Health Insurance Portability and Accountability Act defines a small employer, at 215 ILCS 97/5, as an employer “who employed an average of at least 2 but not more than 50 employees on business days during the preceding calendar year and who employs at least 2 employees on the first day of the plan year.”
There is a floor of two, and it is tested at two separate moments.
The survey column has neither. “Less than 50 employees”
has no floor at all and no plan-year test. The two populations overlap heavily; they are not the same set. An Illinois employer reading the survey figure as “what Illinois small employers pay” is reading a number drawn from a group that includes businesses Illinois law does not treat as small employers at all.
Qualifier three: it only describes employers that already offer
The premium rows are explicitly measured “at establishments that offer health insurance.” The denominator excludes every establishment offering nothing. That is not an average across Illinois small employers generally — it is an average across the subset that already carries a plan, which is a self-selected group in every way that matters to a price.
The offer rate in the same column and the premium rows in that column are therefore not describing the same set of establishments, and neither set is the set Illinois law calls small employers.
How current it is, and what the agency says about its reliability
The data year is 2025; the workbook was published in July 2026. That lag is the survey’s stated rhythm — private-sector tables go up in July of the year after the data are collected, and the public-sector tables in November. A direct probe for a 2026 Illinois edition returned an HTTP 404 carrying an HTML error body, so 2025 is the newest edition and nothing on this page is compared against an older one.
On precision, the agency flags unreliable cells rather than hiding them. Its legend reads: a figure marked with an asterisk “does not meet standard of reliability or precision,”
and a cell shown as a double dash is an “estimate suppressed due to small number of observations in cell or high standard error.” None of the Illinois figures used here carries either mark, and each was read twice by independent parsers addressing the cells directly, which agreed exactly.
One real gap is worth naming. The agency publishes national sample counts but no Illinois-specific unweighted cell count, so the per-cell reliability flag is the only per-state reliability signal available. Its absence on these cells is meaningful; it is not the same as a published Illinois sample size.
What actually moves an Illinois group’s rate
Here the answer stops being a survey and becomes a rule, and the rule is short.
45 CFR 147.102(a)(1) permits the rate for small-group coverage to vary “only by determining the following”: whether the plan or coverage covers an individual or family; rating area; age; and tobacco use. Then paragraph (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.”
That closing clause does more work than the list above it. Everything absent from those four items is prohibited as a rating factor — the group’s claims history, any employee’s health status, gender, industry, how long the group has been covered. Age is permitted within a federally capped band; the ratio is a figure this site does not print.
Running underneath it is the single risk pool at 42 U.S.C. 18032(c)(2): an issuer “shall consider all enrollees in all health plans (other than grandfathered health plans) offered by such issuer in the small group market, including those enrollees who do not enroll in such plans through the Exchange, to be members of a single risk pool.” An Illinois group is priced inside a pool, not against its own experience.
Illinois draws its rating geography on counties
Rating area is the one permitted factor with a distinctly Illinois shape. CMS assigns all 102 Illinois counties across 13 rating areas, each county to exactly one area. The basis is counties alone: the table carries a three-digit-zip column, and that column is empty in all 102 rows. Federal rules allow a state to draw areas on counties, three-digit zip codes, or metropolitan and non-metropolitan statistical areas — Illinois chose counties, which is why the zip column is blank.
Which area applies is not a question about where employees live. 45 CFR 147.102(a)(1)(ii)(B) sets the small-group rating area from “the group policyholder’s principal business address,” meaning the principal business address registered with the state or, where none is registered or the registered one is not a substantial worksite, “the business address within the State where the greatest number of employees of such policyholder works.” Employee residence enters only through a narrow network-plan fallback the rule spells out.
Two Illinois consequences follow. Cook County is the only county in the state that forms an entire rating area by itself, so a business inside the Cook line and a business just across it sit in different rating areas without leaving the metropolitan region Illinois planning law defines as one. And the Illinois side of the St. Louis metro — Madison, St. Clair and Monroe — is exactly the membership of a single rating area, the one Illinois market where a statutory district boundary and a rating-area boundary coincide.
No source in this brand’s retrieval publishes a premium by rating area, so nothing here says any Illinois area is cheaper or more expensive than another. The structure is the fact; the ranking does not exist.
The Illinois rating statute that is still printed and no longer applies
If you search for how Illinois regulates small-group premiums, you will be handed the Small Employer Health Insurance Rating Act, 215 ILCS 93, and it will look like the answer. It contains a class-of-business system, an index rate defined as “the arithmetic mean of the applicable base premium rate and the corresponding highest premium rate,” a bounded corridor around that index rate, and a cap on renewal increases. Every one of those provisions is still printed, still readable, and still returned by search engines. Section 25 was amended as recently as 2023.
And none of it applies to current coverage. 215 ILCS 93/15(b) says so in the Act’s own applicability section:
“This Act shall not apply to any health benefit plan for a small employer that is delivered, issued, renewed, or continued in this State on or after January 1, 2022. However, if 42 U.S.C. 18032(c)(2) or any successor law is repealed, then this Act shall apply to each health benefit plan for a small employer that is delivered, issued, renewed, or continued in this State on or after the date that law ceases to apply to such plans.”
The Act is not repealed — it is dormant, with a snap-back condition. That condition is the repeal of the single-risk-pool rule, which is in force, so the condition is untriggered. The practical warning is unusual: an author can quote this statute accurately, cite it perfectly, and still publish something inapplicable to every compliant Illinois small-group plan issued since the start of 2022. When a proposal or an article explains an Illinois renewal increase in terms of classes of business and index rates, that is the statute talking, and the statute is switched off.
Why this page stops here
Everything above is either a measured survey figure with its qualifiers attached, or a rule with a citation. What this page deliberately does not do is turn one into the other.
The survey figure will not be divided into a monthly number, applied to a census, described as a going rate, or offered as a budget. The rating rules will not be converted into an estimate. Illinois publishes no small-group premium level by area, by county or by industry, and the figures its Department of Insurance does publish are per-carrier rate changes, which are a different quantity and are identified by carrier.
A real Illinois number comes from a rated proposal against your own business address, your own census and your own plan selection. Everything before that is context, and context that admits its limits is worth more than a figure that does not.
The bottom line
There is one authorized Illinois figure, it is a federal survey average rather than a quote, and it carries three qualifiers that change what it means. What sets an actual Illinois rate is a closed federal list of four factors — and your rating area follows your principal business address, not where anyone lives.
Frequently asked questions
What is the average cost of small-group health insurance in Illinois?
The Agency for Healthcare Research and Quality publishes one through its Medical Expenditure Panel Survey–Insurance Component. Its 2025 Illinois table reports an average total single premium of $9,865 per enrolled employee at private-sector establishments in firms with fewer than 50 employees that offer health insurance. Three things travel with that number and none of them is optional. It counts establishments, not businesses, and sizes them by the whole firm. Its “Less than 50 employees” column is not the Illinois statutory small-employer band. And it describes only establishments that already offer coverage. It is a survey average across a population, not a price for any employer, and this agency will not restate it per month, per employee or per group.
Does Illinois regulate what a carrier can charge a small group?
Not in the way the most-quoted Illinois statute suggests. The Small Employer Health Insurance Rating Act, 215 ILCS 93, contains a class-of-business and index-rate system — and 215 ILCS 93/15(b) states that the Act “shall not apply to any health benefit plan for a small employer that is delivered, issued, renewed, or continued in this State on or after January 1, 2022.” The Act is not repealed, so its machinery is still printed and still returned by search engines, and Section 25 was even amended in 2023 after it had stopped applying. It carries a revival condition tied to the repeal of 42 U.S.C. 18032(c)(2), which is in force, so the condition is untriggered. What governs an Illinois small-group rate today is 45 CFR 147.102 together with that single-risk-pool rule.
What can legally change the rate an Illinois small group is charged?
Four things, and nothing else. 45 CFR 147.102(a)(1) permits a rate to vary only by whether the plan covers an individual or a family, by rating area, by age, and by tobacco use. Paragraph (a)(2) closes the list: “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.” That closing clause is the whole answer. The group’s claims history is not on the list. No employee’s health status is on it. Neither gender, nor industry, nor how long the group has been covered. Age is permitted within a federally capped band, and this site does not print the ratio.
Does my county change what my Illinois group pays?
County determines your rating area, which is one of the four permitted factors — but no source in this brand’s retrieval publishes a premium figure by area, so nothing here says one Illinois area is cheaper or dearer than another. What is verified is the structure. CMS assigns all 102 Illinois counties across 13 rating areas, every county to exactly one area. The assignment is drawn on counties alone: the table’s three-digit-zip column exists and is empty in all 102 rows, so zip code plays no part. Cook County is the only county in the state that forms an entire rating area by itself, which means a Chicago-metro employer’s area depends entirely on which county its business address sits in.
Is the Illinois survey figure current, and how reliable is it?
The data year is 2025 and it was published in July 2026, which is the survey’s normal rhythm — private-sector state tables are posted in July of the year after the data are collected. A probe for a 2026 Illinois edition returned an HTTP 404 with an HTML error body, so 2025 is the newest edition available and this page compares it to nothing. On reliability, the agency flags any cell that “does not meet standard of reliability or precision” with an asterisk, and suppresses cells with too few observations. None of the Illinois figures used on this page carries that flag. Each was verified twice by independent parsers reading the workbook, which agreed exactly.
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 Illinois small-group rate structures for a living and spends most of a first cost conversation explaining which published figures do not describe the employer sitting across the table. Start with the Wexford Health Insurance quote form.