Average Cost of Small Business Health Insurance in Texas (2026): What a Small Business Actually Pays Per Employee

The short answer

A Texas small business in 2026 typically pays $625 to $680 per employee per month for the full single (employee-only) group health premium. That is the statewide sticker, not the employer's check. Most groups cover about half of the employee-only rate, so the employer share lands near $313 to $340 per enrolled employee per month. In the big metros the going employer contribution is $315 to $350 in Houston, $295 to $330 in San Antonio, and $325 to $360 in Austin.

Pages still quoting a $780 to $850 statewide average are outdated. The 2026 convention, matching Kenly's metro guides, is $625 to $680 for a full single premium. A 10-person company with everyone enrolled budgets about $3,150 to $3,500 per month in Houston, $2,950 to $3,320 in San Antonio, and $3,250 to $3,600 in Austin. A healthy group on a level-funded plan often prices 15 to 30 percent below a comparable fully insured quote. Employee-only dental plus vision adds $31 to $45 per employee per month if the company pays it, or $0 as a voluntary benefit. A licensed broker costs the business $0. Quotes return in about 48 hours. Setup takes 3 to 4 weeks. Kenly Insurance Advisors writes groups from 2 to 250+ employees statewide.

The tables below split sticker price from employer share, then break the statewide average into published size bands and metros. For the 5-employee, 10-employee, and 20-employee worked budgets, see health insurance for 10 employees in Texas.

What a Texas employer actually pays per employee

Full premium is the number carriers quote. The company bill is contribution percentage times enrolled heads. Metro guides publish the contribution employers actually use, and that is the better planning figure.

Metro	Employer cost per enrolled employee / month	10 enrolled / month	Full single premium (planning band)
Statewide	About $313 to $340 (half of $625 to $680)	About $3,130 to $3,400	$625 to $680
Houston	$315 to $350	$3,150 to $3,500	$630 to $705 metro; $615 to $680 in the 10 to 24 band
San Antonio	$295 to $330	$2,950 to $3,320	$590 to $665
Austin	$325 to $360	$3,250 to $3,600	$650 to $720

Houston sits on the statewide line. San Antonio prices under it. Austin prices over it, though a younger census often claws that back because Texas small-group rates are age-rated. City-level networks and carrier mix: Houston employee benefits guide, San Antonio small business benefits guide, and Austin employee benefits guide.

Average cost by group size

Texas small-group pricing is not a smooth line. Carriers quote in bands. Houston's published single-premium bands sit closest to the statewide $625 to $680 average. Austin runs a step above. San Antonio runs a step below. Houston's 10 to 24 band is $615 to $680, the same range as the statewide sticker.

Group size	Houston full single / month	San Antonio full single / month	Austin full single / month	What changes at this size
2 to 4 employees	$665 to $735	$625 to $695	$690 to $760	Smallest pools, standard ACA small-group rating, fewer level-funded options
5 to 9 employees	$640 to $710	$600 to $665	$660 to $730	Level-funded quotes open up
10 to 24 employees	$615 to $680	$575 to $640	$635 to $700	Full carrier competition, sharp level-funded pricing
25 to 49 employees	$595 to $655	$560 to $615	$610 to $670	Stronger underwriting offers, composite rates become available

Crossing from 9 employees into 10 does more for the unit price than adding the tenth paycheck, because that is the jump into the 10 to 24 band. A 10-person company and a 20-person company often see nearly the same per-employee rate. At 50 or more full-time equivalent employees the case leaves small-group pricing. Kenly still places those groups. The figures on this page are the 2 to 49 convention.

The contribution math most owners actually use

Carriers generally require the employer to pay at least 50 percent of the employee-only premium. That is a carrier rule, not a Texas statute. Most first-time groups start at that floor. Covering 70 percent or more buys higher enrollment and an easier participation test. No line on the quote moves the real budget more than this decision.

Participation is a separate test. Most Texas small-group carriers want about 75 percent of eligible employees to enroll after valid waivers come out of the denominator. A spouse's plan, Medicare, and Tricare are valid waivers. Ten eligible employees with no waivers usually produce about 8 enrollments, not 10 and not 5. The bill tracks enrolled heads. Details and the waiver list: Texas 75 percent participation rule.

Houston example, employee-only medical	Employer monthly cost
10 enrolled at $315 to $350 each	$3,150 to $3,500
8 enrolled (typical 75 percent, no waivers)	$2,520 to $2,800
Statewide half of $625 to $680, 10 enrolled	About $3,130 to $3,400

That is medical only. Add employer-paid dental and vision at $31 to $45 per employee and a 10-enrolled Houston case picks up $310 to $450 a month. Offered as voluntary payroll-deducted benefits, that layer costs the company $0. Full 2026 tiers: Texas group dental and vision cost guide.

Fully insured vs level-funded

Fully insured is the structure behind the averages on this page. The company pays a fixed premium. The carrier takes every claims dollar. It issues on a census with almost no health questions, and it fits groups that want a bill that never true-ups.

Level-funded looks like a premium on the invoice, but part of the payment funds the group's own claims account, with stop-loss capping the downside. If claims come in light, unused claims dollars come back at year end. Healthy Texas groups routinely price 15 to 30 percent below a comparable fully insured plan. The tradeoff is a short health questionnaire. Quote both on the same census. Level-funded usually opens in the 5 to 9 band and gets more competitive at 10 to 24. Full comparison: level-funded vs fully insured health insurance in Texas.

Feature	Fully insured	Level-funded
Monthly bill	Fixed premium	Fixed payment that budgets like a premium
Healthy-group pricing	Baseline in the tables above	Often 15 to 30 percent lower
Houston example, 10 enrolled	$3,150 to $3,500 per month	About $2,200 to $2,980 per month
Year-end surplus	Carrier keeps it	Unused claims dollars can come back
Underwriting	Community-rated, census only	Medical questionnaire
Best fit	Groups that want certainty, or a census that will not underwrite well	Healthy groups of 5 or more

What moves a group above or below the average

Five inputs do most of the work once headcount is set.

• Employee ages. Texas small-group premiums are age-rated per person. A 27-year-old and a 58-year-old on the same plan carry very different rates. Age mix is the largest single driver of where a census lands inside (or outside) the $625 to $680 band.
• Rating area. The same plan prices differently in Harris County than it does in Bexar, Travis, or Nueces. Coastal Bend employers often see a different winning carrier than the big metros, even when the statewide average is the planning number.
• Plan design. Deductible, out-of-pocket maximum, and network type move premiums fast. A focused network can price 10 to 20 percent below an open-access PPO. A $3,500 deductible plan beats a $1,000 deductible plan on premium every time.
• Carrier competition. Quote BCBSTX, UnitedHealthcare, Aetna, and Cigna on one design. The spread between best and worst quote on the same census is regularly 15 percent or more. A single-carrier quote leaves that money on the table.
• Participation and contribution. Higher participation gives carriers a better risk pool. Groups that contribute more see more employees enroll, which feeds the same loop. Spending a bit more per employee can lower the unit price.

Four carriers write meaningful small-group business across Texas in 2026. BCBSTX has the broadest PPO and is the default when employees are spread across a metro or work in the field. UnitedHealthcare pairs a strong PPO with aggressive level-funded pricing. Aetna brings level-funded options and a competitive fully insured menu for 5 to 50 groups. Cigna's narrow-network plans price under the big PPOs. Quote all four.

Frequently asked questions

What is the average cost of small business health insurance in Texas per employee per month in 2026?

The statewide full single premium averages $625 to $680 per employee per month. After a typical 50 percent employer contribution, the employer's share is about $313 to $340 per enrolled employee. Houston employers usually budget $315 to $350, San Antonio $295 to $330, and Austin $325 to $360. Older pages quoting $780 to $850 are outdated.

How much does a 10-person Texas company pay?

With all 10 enrolled, the employer share typically runs $3,150 to $3,500 per month in Houston, $2,950 to $3,320 in San Antonio, and $3,250 to $3,600 in Austin. If 8 of 10 enroll, use those per-employee figures times 8. Line-by-line 5, 10, and 20-employee tables: health insurance for 10 employees in Texas.

Do Texas small businesses have to pay 50 percent of the premium?

Texas law does not set a contribution minimum. Carriers do. Most Texas small-group carriers require the employer to cover at least 50 percent of the employee-only premium, and they want about 75 percent participation after valid waivers. Details: 75 percent participation rule.

Does a bigger group pay less per employee?

Yes, inside the small-group market. Houston's 2 to 4 band is $665 to $735 full single. The 10 to 24 band is $615 to $680. The 25 to 49 band is $595 to $655. The drop is real, but it is stepwise by band, not a smooth discount for every added head.

Does a level-funded plan cost less than fully insured?

For a healthy group, yes: 15 to 30 percent below a comparable fully insured quote is the range Kenly sees. On a Houston fully insured employer cost of $3,150 to $3,500 for 10 enrolled, that is roughly $2,200 to $2,980 per month. Groups that do not underwrite well can price at or above fully insured, so both structures get quoted.

How long does setup take, and what does a broker cost?

Quotes typically return in about 48 hours once the census is in. Setup from census to effective date takes 3 to 4 weeks, with coverage starting on the first of a month. A licensed benefits broker costs the business $0. Carriers pay the same commission whether the company goes direct or uses a broker. Kenly Insurance Advisors places groups from 2 to 250+ employees statewide.

Get a real number for your Texas group

The tables on this page are 2026 planning ranges, not a binder. A real number needs ages, zip codes, and dependent status. Send that census to clint@kenlyinsuranceadvisors.com and Kenly Insurance Advisors will return fully insured and level-funded options from BCBSTX, UnitedHealthcare, Aetna, and Cigna, usually within about 48 hours. Or start online with an instant quote, or book a free benefits review.

Broker services cost the business $0. Carriers pay Kenly Insurance Advisors. Coverage can be active in 3 to 4 weeks. The firm works with Texas employers from 2 to 250+ employees.