Health Insurance for 10 Employees in Texas (2026): What a Small Business Actually Pays

The short answer

A 10-employee Texas small business in 2026 typically pays the employer share of group health insurance at $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. Those totals use the going employer contribution in each metro ($315 to $350, $295 to $330, and $325 to $360 per enrolled employee) with all 10 people on the plan. Statewide, the full single premium averages $625 to $680 per employee per month, so the employer's half is about $313 to $340 per enrolled person.

Ten eligible employees with no waivers usually produce about 8 enrollments, which clears Texas carrier participation rules. On that census a Houston employer budget drops to about $2,520 to $2,800 per month. A healthy group on a level-funded plan often prices 15 to 30 percent below a comparable fully insured quote. Dental and vision add $31 to $45 per employee per month if you pay them, or $0 as voluntary benefits. A licensed broker costs the business $0. Quotes come back in about 48 hours. Setup takes 3 to 4 weeks. Kenly writes groups from 2 to 250+ employees statewide.

The tables below put a 5-employee group and a 20-employee group next to that 10-person budget, then compare fully insured and level-funded. Statewide context: Texas small business health insurance cost guide and the group health insurance cost breakdown.

What a 5-employee group costs

Five eligible employees sit in the published 5 to 9 band, which prices a step above a 10-person group because the pool is smaller. Houston's published 5 to 9 full single premium is $640 to $710 per employee per month. At a 50 percent employer contribution that is about $320 to $355 per enrolled employee, or $1,600 to $1,775 per month if all 5 enroll. San Antonio and Austin rows below use each metro's published employer contribution times 5. Actual 5 to 9 quotes in those cities can price a bit higher per head than the 10-employee rate.

Metro	Employer cost per enrolled employee / month	5 enrolled / month
Houston	$320 to $355 (5 to 9 band)	$1,600 to $1,775
San Antonio	$295 to $330	$1,475 to $1,650
Austin	$325 to $360	$1,625 to $1,800

With 5 eligible employees and no valid waivers, 4 must enroll to clear a 75 percent participation test. Valid waivers (a spouse's plan, Medicare, Tricare) come out of the denominator. This is also the band where level-funded quotes start to open up. Houston context: Houston employee benefits guide. Austin context: Austin employee benefits guide.

What a 10-employee group costs

Ten enrolled employees is the size most owners search, and it is where carrier competition gets real. The table is employer cost at the published contribution in each metro, employee-only medical, all 10 enrolled. Age mix, zip codes, plan design, and funding type still move the number.

Metro	Employer cost per enrolled employee	10 enrolled / month	8 enrolled / month
Houston	$315 to $350	$3,150 to $3,500	$2,520 to $2,800
San Antonio	$295 to $330	$2,950 to $3,320	$2,360 to $2,640
Austin	$325 to $360	$3,250 to $3,600	$2,600 to $2,880
Statewide (half of $625 to $680)	About $313 to $340	About $3,130 to $3,400	About $2,500 to $2,720

Annualize the 10-enrolled row and Houston is about $37,800 to $42,000 a year, San Antonio $35,400 to $39,840, and Austin $39,000 to $43,200. Medical only, employer share, employee-only tiers. Dependents and a richer plan push the check up. A younger census or a narrow network pulls it down.

Ten eligible and no waivers means 8 must enroll, not 10. The bill tracks enrolled heads. Valid waivers drop out of the math. Three employees on a spouse's plan leave a denominator of 7, and 6 enrollments clear 75 percent. The rule and waiver list: Texas 75 percent participation rule. San Antonio context: San Antonio small business benefits guide.

Employee-only dental plus vision runs $31 to $45 per employee per month if the company pays the full premium. For 10 people that is $310 to $450 a month. Offered as voluntary payroll-deducted benefits, employer cost is $0. Full 2026 tiers: Texas group dental and vision cost guide.

What a 20-employee group costs

A 20-employee group still sits in the published 10 to 24 band. There is no separate statewide 20-person rate. Per-employee employer cost stays in the same published ranges as the 10-employee table. The monthly check scales with enrolled heads.

Metro	Employer cost per enrolled employee	20 enrolled / month	15 enrolled / month (75%)
Houston	$315 to $350	$6,300 to $7,000	$4,725 to $5,250
San Antonio	$295 to $330	$5,900 to $6,600	$4,425 to $4,950
Austin	$325 to $360	$6,500 to $7,200	$4,875 to $5,400

Houston's published 10 to 24 full single premium is $615 to $680, which sits under the 5 to 9 band of $640 to $710. That is why a 10-person company and a 20-person company often see nearly the same per-employee rate, and why crossing from 9 employees into 10 does more for the unit price than adding the tenth paycheck. At 20 eligible and no waivers, 15 must enroll.

Fully insured vs level-funded

Fully insured is the structure behind the city tables above. 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. On a Houston 10-enrolled case at $3,150 to $3,500 fully insured, that is roughly $2,200 to $2,980 a month. 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 city tables	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

How published size bands work

Texas small-group pricing is not a smooth line. Carriers quote in bands, and 10 employees is the first band where the market is fully competitive. Houston's published single-premium bands, which sit close to the statewide $625 to $680 average, look like this:

Group size	Average monthly single premium (Houston)	What changes at this size
2 to 4 employees	$665 to $735	Smallest pools, standard ACA small-group rating, fewer level-funded options
5 to 9 employees	$640 to $710	Level-funded quotes open up
10 to 24 employees	$615 to $680	Full carrier competition, sharp level-funded pricing. This is the 10-employee and 20-employee band.
25 to 49 employees	$595 to $655	Stronger underwriting offers, composite rates become available

Four carriers write meaningful small-group business at 10 employees across Texas in 2026: BCBSTX (broadest PPO, the default when employees are spread across a metro or work in the field), UnitedHealthcare (strong PPO plus aggressive level-funded pricing), Aetna (level-funded options and a competitive fully insured menu for 5 to 50 groups), and Cigna (narrow-network plans priced under the big PPOs). Quote all four on one plan design. The spread between best and worst quote on the same 10-person census is regularly 15 percent or more.

Frequently asked questions

How much does health insurance cost for 10 employees in Texas in 2026?

The employer's 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, assuming all 10 enroll at the usual contribution. Statewide full single premiums average $625 to $680 per employee per month. If 8 of 10 enroll, use those per-employee figures times 8.

Is a 10-employee Texas business required to offer health insurance?

No. Texas does not require any employer to offer health insurance, and the federal ACA employer mandate only applies at 50 or more full-time equivalent employees. At 10 employees, offering coverage is a recruiting decision. If you do offer a group plan, carrier participation and contribution rules still apply.

How many of 10 eligible employees have to enroll?

Eight, if there are no valid waivers. Most Texas small-group carriers want about 75 percent participation after valid waivers are removed. Employees on a spouse's plan, Medicare, or Tricare drop out of the count. The employer also has to pay at least 50 percent of the employee-only premium. Details: 75 percent participation rule.

Does a 5-employee group cost half of a 10-employee group?

No. The 5 to 9 band prices higher per employee than the 10 to 24 band. A Houston 5-person group at 50 percent contribution with 5 enrolled is $1,600 to $1,775 a month, more than half of the Houston 10-enrolled range of $3,150 to $3,500.

Does a level-funded plan cost less at 10 employees?

For a healthy group, yes: 15 to 30 percent below a comparable fully insured quote is the range we see. On a Houston fully insured employer cost of $3,150 to $3,500, that is roughly $2,200 to $2,980 per month. Groups that do not underwrite well can price at or above fully insured, which is why both structures get quoted on the same census.

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 10-person 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, including 5-person shops, 10-person companies, and 20-person groups in the 10 to 24 band.