Columbus healthcare practices: bidding against hospital-system benefits on a practice budget
You provide care for a living — and struggle to afford coverage for your own team. Every nurse, tech, and front-desk hire, you're up against hospital-system packages, likely paying $810–$1,591/mo per employee for small group coverage while Franklin County's individual market runs $326–$743/mo for the same tiers in 2026.
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The benefits squeeze on Columbus's 4,901 healthcare employers
Franklin County's healthcare sector employs 122,824 private-sector workers across 4,901 establishments, at an average weekly wage of $1,151 (BLS Quarterly Census of Employment and Wages, 2024 Q2). Most of those establishments aren't hospital systems — they're medical groups, dental offices, behavioral health practices, and home-health agencies competing for the same nurses, hygienists, techs, and staff the systems recruit.
At healthcare wages, benefits carry outsized weight in whether staff stay — and turnover in a practice means lost production, not just a recruiting fee. A hospital system absorbs group premiums at scale; a 40-person practice feels every renewal in the operating budget. That's the brutal irony practice managers live with: an industry built on delivering care, priced out of covering its own people well.
Franklin County 2026: small group vs individual, same tier, same age
Lowest-cost plan on each market. Plan year 2026 on both sides. Figures are estimates.
| Tier / age | Small group | Individual | Difference |
|---|---|---|---|
| Bronze, age 27 | $810/mo | $326/mo | $484/mo |
| Silver, age 27 | $872/mo | $352/mo | $520/mo |
| Gold, age 27 | $933/mo | $436/mo | $498/mo |
| Bronze, age 50 | $1381/mo | $555/mo | $825/mo |
| Silver, age 50 | $1486/mo | $600/mo | $885/mo |
| Gold, age 50 | $1591/mo | $743/mo | $848/mo |
This gap is the mechanism behind an ICHRA (Individual Coverage HRA): instead of one group policy, the practice gives each employee a fixed tax-free monthly allowance to buy their own ACA marketplace plan. Same tax treatment as group insurance — but priced off Franklin County's far cheaper individual market.
Estimates from CMS Marketplace Public Use Files (individual) and Ideon (small group), plan year 2026, Franklin County OH. Both sides always the same plan year. Not a quote; actual costs depend on census and plan selection.
What that gap means for a 40-person practice
Illustration: a 40-person Columbus practice contributing $700/mo per employee spends about $336,000 a year on health benefits. At Franklin County's estimated 2026 per-employee difference of $484–$885/mo — capped by the $700 the practice actually contributes — a practice like that could see an estimated annual opportunity of roughly $232,000–$336,000, whether taken as budget relief or redirected into richer allowances that compete with hospital-system packages.
Illustrative estimate based on county-level 2026 market data — not a quote or guarantee. Actual results depend on your employee census, ages, family composition, plan design, and contribution strategy.
Our promise: we run your real census against real county rates, free. If the numbers don't work for your practice, we tell you to keep your group plan. About a third of the companies we analyze should.
Why a fixed-allowance model fits how practices actually run
Budget certainty
The allowance is a fixed line item you set — not a renewal letter a carrier sets. Practice managers plan the year on a number that doesn't move mid-cycle.
Plans that travel
Employees own their individual plans and keep them if they change jobs — a real retention message for nurses and techs weighing offers from hospital systems.
No participation cliffs
Group plans can collapse when they require a minimum share of eligible employees to enroll and too many staff decline — common where spousal coverage and part-time schedules are the norm. An ICHRA has no participation requirement.
Columbus healthcare practice FAQs
How much does health insurance cost for medical practice employees in Ohio?
In Franklin County for plan year 2026, the lowest-cost small group plan runs $810–$1,591 per employee per month depending on metal tier and age, while the lowest-cost individual-market plan for the same tier and age runs $326–$743. These are county-level estimates from CMS Marketplace Public Use Files and Ideon — what a specific practice pays depends on its census, ages, and plan design.
How can a dental office or medical practice afford employee benefits that compete with hospital systems?
Mid-size practices rarely win by buying the same kind of group policy a hospital system buys — the system's scale wins that fight. An alternative is redirecting the same benefit budget through an ICHRA (Individual Coverage HRA): a fixed tax-free monthly allowance each employee uses to buy their own ACA marketplace plan. In counties like Franklin, where 2026 individual plans run an estimated $484–$885/mo below comparable small group plans, that same budget may fund a richer allowance than the group premium it replaces.
Does an ICHRA work for medical and dental practices?
Yes — practices are often a strong fit. ICHRAs have no participation requirement, so part-time hygienists, per-diem nurses, or staff covered under a spouse's plan don't put the whole plan at risk the way they can with group coverage. The allowance is a fixed line item the practice sets, and employees keep their individual plans if they change jobs. Whether the economics work depends on the county: Franklin County's 2026 individual-vs-group gap is among the widest in the country, which is why the estimate is worth running here.
What happens to a healthcare practice group plan when employees decline coverage?
Traditional small group plans typically require a minimum share of eligible employees to enroll. In healthcare, where many nurses and techs are covered through a spouse or work part-time, practices can fall below that threshold and lose the plan entirely. An ICHRA has no participation requirement: each employee independently chooses whether to use the allowance, and the practice's plan doesn't depend on how many opt in.
How much could a 40-person Columbus medical practice save by switching from group coverage?
Illustratively: a 40-person practice contributing $700/mo per employee spends about $336,000 a year. At Franklin County's estimated 2026 per-employee difference of $484–$885/mo — capped by the $700 the practice actually contributes — the estimated annual opportunity runs roughly $232,000–$336,000. This is a county-level estimate, not a quote; actual results depend on the employee census, ages, family composition, plan design, and contribution strategy.
Methodology: Individual-market premiums are the lowest-cost plan by metal tier and age from the CMS Marketplace Public Use Files, plan year 2026. Small group premiums are the lowest-cost plan for the same tier, age, and county from Ideon. Both sides of every comparison use the same plan year (2026); figures are estimates and no individual employer outcome is implied. Healthcare industry statistics (NAICS 62 private employment, establishments, average weekly wage): BLS Quarterly Census of Employment and Wages, Franklin County OH, 2024 Q2.
Last updated: August 16, 2026 · Plan-year 2026 data, same year both markets. Sources: CMS Marketplace Public Use Files (individual market) · Ideon (small group) · BLS QCEW 2024 Q2 (employment).
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No contact info needed for the estimate. Free census analysis if you want the actual figure — and an honest 'keep your group plan' if that's the answer.
Employment context: BLS QCEW 2024 Q2, Franklin County OH. Rate data: CMS Marketplace PUF + Ideon, plan year 2026, same plan year on both sides.
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