Federal law extends certain protections to employers seeking to buy health insurance for themselves and their workers.  Massachusetts has enacted comprehensive reforms to expand small employer’s access to health insurance and to limit premium variation due to health status. Generally, small employers are those that employ 50 or fewer employees.  In Massachusetts employers, with 11 or more employees are encouraged to provide health insurance to employees,. The failure to do so may result in penalties.  Check with the Massachusetts Division of Insurance to be sure that you know which protections apply to your group.