Employer Health Insurance Laws by State 2025

State	Health Insurance Requirements for Small Businesses↓	Health Insurance Requirements for Large Businesses	Additional Employer Health Insurance Law Info
Hawaii	Required	Required	The annual penalty for not offering coverage is $2,000 for every full-time employee beyond the first 30.
Alabama	Not Required	Required
Alaska	Not Required	Required
Arizona	Not Required	Required
Arkansas	Not Required	Required	The annual penalty for not offering coverage is $2,000 for every full-time employee beyond the first 30.
California	Not Required	Required	The annual penalty for not offering coverage is $2,000 for every full-time employee beyond the first 30.
Colorado	Not Required	Required
Connecticut	Not Required	Required
Delaware	Not Required	Required
District of Columbia	Not Required	Required
Florida	Not Required	Required	The annual penalty for not offering coverage is $2,000 for every full-time employee beyond the first 30.
Georgia	Not Required	Required	The annual penalty for not offering coverage is $2,000 for every full-time employee beyond the first 30.
Idaho	Not Required	Required
Illinois	Not Required	Required
Indiana	Not Required	Required
Iowa	Not Required	Required
Kansas	Not Required	Required
Kentucky	Not Required	Required
Louisiana	Not Required	Required
Maine	Not Required	Required
Maryland	Not Required	Required
Massachusetts	Not Required	Required
Michigan	Not Required	Required
Minnesota	Not Required	Required
Mississippi	Not Required	Required
Missouri	Not Required	Required
Montana	Not Required	Required
Nebraska	Not Required	Required
Nevada	Not Required	Required
New Hampshire	Not Required	Required
New Jersey	Not Required	Required
New Mexico	Not Required	Required
New York	Not Required	Required
North Carolina	Not Required	Required
North Dakota	Not Required	Required
Ohio	Not Required	Required
Oklahoma	Not Required	Required
Oregon	Not Required	Required
Pennsylvania	Not Required	Required
Rhode Island	Not Required	Required
South Carolina	Not Required	Required
South Dakota	Not Required	Required
Tennessee	Not Required	Required
Texas	Not Required	Required
Utah	Not Required	Required
Vermont	Not Required	Required
Virginia	Not Required	Required
Washington	Not Required	Required
West Virginia	Not Required	Required
Wisconsin	Not Required	Required
Wyoming	Not Required	Required

Federal law requires all employers with 50 or more full-time equivalent employees (FTEs) to provide insurance with minimum essential coverage (MEC) that satisfies the Affordable Care Act’s (ACA) employer mandate.
A small business is defined as one with fewer than 50 full-time equivalent employees, while a large business has 50 or more.

Government and occupational safety organizations dictate the employer health insurance laws by state. That means that if you are looking for a guide to employer health insurance laws by state in 2022, you won’t find one. That doesn’t mean, however, that there aren’t regulations and guidelines that employers are mandated to follow.

US Government Affect on Health Insurance Laws

Employer health insurance laws follow something like a hierarchy of sorts and follow a specific chain of command.

The US Department of Labor and other work-related national governing committees set the standard for every employer in the country. State government laws follow this. Most states have their own occupational health and safety standards and laws to help govern employers and companies.

There are also even more localized government bodies on county and city levels that play a role in the effort to ensure the best and appropriate employer health insurance laws are in place. It is just important to be mindful that the U.S. government oversees and trumps all other laws and local agencies.

State Regulations and Laws Regarding Employer Health Insurance

Some states have taken more proactive measures regarding employer health insurance laws. Here is a look at some of the states that have chosen to employ some laws to help govern employer health insurance.

The state of Massachusetts mandates that employers with at least 11 employees and group insurance plans provide what is called minimum creditable coverage (MCC). This ensures both the employer and the employee have fair and adequate safeguards in place. If not, they must pay a Fair Share Contribution (FSC) of up to $295 per employee per year to the state.

Vermont employers that have more than four FTE employees (age 18 or older, working 30 or more hours) are required to offer health insurance coverage and employers are required to pay a portion of the cost.

Hawaii is another state with strong laws about employer-provided health insurance. All employers with one or more employees, whether full-time or part-time, permanent or temporary, are required to provide Prepaid Health Care Act coverage to their eligible employees in Hawaii unless the employees fall into an excluded category

On the other hand, some states do not require employers to provide health insurance. For example, Florida and North Carolina have no state laws requiring employers of any size of business to provide health insurance to their employees and their families.

Employer Health Insurance Laws by State 2025

US Government Affect on Health Insurance Laws

State Regulations and Laws Regarding Employer Health Insurance

Sources

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