Florida · Coverage Guide

Florida health plans for families and employers.

ACA plans through HealthCare.gov, employer group coverage from level-funded to ICHRA, and Florida Medicaid context — all under one FLOIR-regulated platform with broker support from Miami to Orlando to Tampa.

ACA-compliant plans Group plans for employers No-cost consultation
Marketplace
HealthCare.gov (federal marketplace)
Federally facilitated marketplace. www.healthcare.gov
Medicaid program
Florida Medicaid (Statewide Medicaid Managed Care / SMMC)
Administered by Florida Agency for Health Care Administration (AHCA). ahca.myflorida.com/medicaid
Carrier regulator
Florida Office of Insurance Regulation (OIR)
Licenses carriers and brokers and reviews rate filings. www.floir.com
Uninsured rate
15.5%
Florida non-elderly uninsured rate 2023 ACS, U.S. Census Bureau) National average ~7.6%.
What Benefitra covers in Florida

Four pillars. One platform.

Benefitra is the parent platform for benefits brokerage, HR SaaS, marketing, and decision-support tools. Florida employers can adopt one pillar or stack them.

Insurance

Health, dental, vision, life, disability. Individual, family, group.

Funding strategies →

Employee Benefits

Seven funding paths: fully-insured, level-funded, self-funded, ICHRA, PEO-integrated, captive, Taft-Hartley.

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Marketing & SEO

Lead-engine and rankings for growing employers. Page-2-to-page-1 in months.

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Business Tools / SaaS

586 free calculators: ACA, COBRA, ROI, valuation, projector.

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Coverage options in Florida

Affordable, compliant, and built for the way you actually buy.

Florida health plans give consumers and employers more options for dependable health insurance coverage. These options match different budgets and needs.

Individual and family plans. Florida uses the federally facilitated marketplace at HealthCare.gov — Florida does not operate its own state-based exchange. Plans are ACA-compliant qualified health plans regulated by the Florida Office of Insurance Regulation (FLOIR). Florida consistently has one of the highest marketplace enrollment counts in the country (about 4.2 million Floridians enrolled for plan year 2025), driven by a large self-employed and gig-economy population.

Qualified health plans and subsidies. Marketplace plans cover the federal essential health benefits. Most Florida enrollees qualify for premium tax credits, and many also qualify for cost-sharing reductions on silver plans. Open enrollment runs Nov 1 – Jan 15. Special enrollment periods apply to qualifying life events. Florida has not expanded Medicaid, which leaves a coverage gap and pushes more low-income working adults onto the marketplace with subsidies.

Florida Medicaid context. Florida Medicaid is administered by the Florida Agency for Health Care Administration (AHCA) through the Statewide Medicaid Managed Care (SMMC) program. Florida has not expanded Medicaid under the ACA: parents qualify only up to roughly 31% FPL, and childless non-disabled adults do not qualify regardless of income. Pregnant women qualify up to 191% FPL and children up to 215% FPL through Florida KidCare. The 2023 ACS uninsured rate stands at 15.5%.

Pairing a plan with an HSA. HSA-eligible high-deductible Florida health plans let employees pay eligible medical expenses with pre-tax dollars, with 2026 contribution limits at $4,400 individual / $8,750 family per IRS Rev. Proc. 2025-19. Supplemental plans (accident, dental, vision, disability) cover gaps the primary medical plan doesn't.

Employer group plans in Florida. Florida employers with 1 or more employees can offer small-group health insurance year-round (Florida guarantees small-group access at 1+ employees, more generous than the federal 2+ standard). Mid-market employers across the Miami, Orlando, and Tampa Bay metros use level-funded, self-funded, or ICHRA designs to control renewals — Florida's hurricane-zone risk-pool dynamics and seasonal workforce make funding-fit a year-round conversation. Benefitra's Funding-Fit Discovery models the math across all seven arrangements.

Individuals

Individual & family plans

ACA-compliant plans with essential health benefits, network access, and subsidy eligibility based on income.

Employers

Group health insurance

Small-business and mid-market plans, level-funded and self-funded options, premium-stability strategies.

Public programs

Medicaid & Medicare

State-administered Medicaid for eligible Florida residents; Medicare access by age or disability.

What Florida clients say

Real outcomes, real Florida employers.

Sam built a benefits plan that protected our Florida margins through a tough renewal cycle. He stayed involved through implementation.

— Florida employer, hospitality

Our seasonal workforce made fully-insured a poor fit. A level-funded design with ICHRA for the off-season crew saved us six figures.

— Central Florida operator

Sam matched our Florida family to a plan that fit our budget and kept our doctors. Smooth, no surprises.

— Tampa-area family plan member
Frequently asked questions

Florida health insurance — answered.

Marketplace, Medicaid, group plans, and ICHRA. Common Florida-specific questions for families and employers.

Where do Floridians enroll in ACA health plans in 2026?
Floridians enroll through HealthCare.gov, the federally facilitated marketplace. Florida does not operate its own state-based exchange. About 4.2 million Floridians enrolled for plan year 2025 — one of the highest marketplace enrollment counts in the country. Open enrollment runs Nov 1 – Jan 15, with special enrollment for qualifying life events.
Did Florida expand Medicaid?
No. As of 2026, Florida has not adopted the ACA Medicaid expansion. Parents qualify only up to roughly 31% FPL, and childless non-disabled adults do not qualify regardless of income. Pregnant women qualify up to 191% FPL and children up to 215% FPL through Florida KidCare. The non-expansion gap is one reason Florida has such high marketplace subsidized-enrollment counts — many low-income workers route to HealthCare.gov instead of Medicaid.
Who regulates Florida health insurance carriers?
The Florida Office of Insurance Regulation (FLOIR) licenses carriers and reviews rate filings. Producers and brokers are licensed by the Florida Department of Financial Services Division of Insurance Agent and Agency Services. Complaints, license verification, and rate filings flow through FLOIR and the Department of Financial Services.
Can a Florida small business offer group health insurance?
Yes. Florida guarantees small-group access at 1 or more employees — more generous than the federal 2-employee minimum. Group plans guarantee issue regardless of medical history. Small businesses with fewer than 25 FTEs may qualify for the federal Small Business Health Care Tax Credit. Florida employers in seasonal industries (hospitality, agriculture, tourism) often use level-funded or ICHRA designs to handle workforce fluctuations.
What is ICHRA and is it allowed in Florida?
ICHRA (Individual Coverage Health Reimbursement Arrangement) lets Florida employers reimburse employees tax-free for individual ACA plans bought on HealthCare.gov. ICHRA is federally permitted and fully available in Florida. It is often used by Florida employers with distributed or seasonal workforces who want a defined-contribution benefits budget — Florida's hurricane-zone risk dynamics also make a portable ICHRA plan attractive to employees.

Find your Florida funding fit in five minutes.

Answer twelve short questions. We grade your fit across the seven funding arrangements — fully-insured, level-funded, self-funded, captive, ICHRA, PEO-integrated, and Taft-Hartley.

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