Health insurance is harder to get in cannabis because, according to a guest column published Oct. 30, 2026 by MJBizDaily, cannabis employers have faced unequal banking access, no normal federal tax deductions and limited access to traditional employee-benefit solutions. The column discusses two structures for employers: self-funded plans, which it says give employers access to their own claims data, and healthcare captives, which it describes as a cooperative purchasing and risk-management structure. Here is what the column says about each, and what to ask before you choose.
Disclosure: the MJBizDaily column is written by Scott Byrne, president of Blackwell Captive Solutions, which runs a healthcare captive for cannabis employers called Humboldt Health. It is opinion, not reporting, so read its descriptions as the view of a company that runs a captive. You can read the MJBizDaily guest column yourself.
Why is health insurance harder to get in cannabis?
Cannabis remains a controlled substance under federal law. The Texas cannabis insurance page from Mosaic Insurance Alliance is about commercial business insurance for cannabis companies, such as general liability and workers’ compensation, and it does not cover employee health plans.
Federal rules are changing in narrow steps. A final rule published April 28, 2026 placed some FDA-approved drug products containing marijuana in Schedule III. As of Oct. 30, 2026, no final rule moving all marijuana to Schedule III is reported, and Schedule III does not make marijuana federally legal. It remains a controlled substance.
Rules also differ by place and change often. The cannabis policy changes guide shows how to check the rules where you live or work. If you are in D.C., the DC cannabis employment protections act guide covers work rules there.
What is cannabis insurance?
Cannabis insurance is business coverage written for cannabis operations. The Mosaic Texas page lists general liability, product liability, property, crop, workers’ compensation and commercial auto coverage as types cannabis businesses buy. It also says brokers who specialize in cannabis insurance can help you find policies and terms. Employee health plans are a separate question, and the rest of this guide covers them.
What is a healthcare captive?
The column describes a healthcare captive as a cooperative purchasing and risk-management structure. Participating employers pool certain risks, keep responsibility for predictable day-to-day claims, and use insurance and the captive to protect against large, unpredictable claims. Each participating employer sets its own plan design, and the captive provides the risk-management framework.
| Question | Healthcare captive, as the column describes it |
|---|---|
| Who pays predictable, day-to-day claims | Participating employers, who keep responsibility for predictable claims |
| Protection against large, unpredictable claims | Insurance and the captive together |
| Plan design | Each participating employer sets its own, with the captive providing the risk-management framework |
The column does not define fully insured or self-funded plans. Confirm which structure your plan uses with HR, and ask your broker to explain the other structures in writing.
What does pooling mean, and what about large-claim protection?
According to the column, participating employers pool certain risks inside a healthcare captive. They keep responsibility for predictable day-to-day claims and use insurance and the captive to protect against large, unpredictable claims. The column does not define stop-loss insurance, so ask your broker how large-claim protection is set up in any plan you consider.
What is a self-funded plan?
The column describes self-funding as giving employers access to their own claims data. It names what that data can show: which conditions drive use, where employees get care and how pharmacy costs trend. Ask HR who can see it and how it is kept private. The column does not describe self-funded plans in more detail, so ask HR and your broker how your plan is funded.
How do plan design, deductibles and prescriptions affect what you pay?
Each employer sets its own plan design, including deductibles and out-of-pocket requirements. A deductible is the amount you pay for care before the plan starts sharing costs. The column also notes that prescription drugs are a significant share of employer health spending, so employers need visibility into pharmacy use, pricing and rebates. For you, that means checking how your prescriptions are covered, not just the premium.
What does the column say about behavioral health and virtual care?
The column says behavioral and mental health deserves particular attention in the cannabis workforce. It calls virtual care a starting point, not a full health plan. It also says the cheapest plan is not necessarily the best one. Ask your HR team what mental health and virtual care benefits include before you compare plans on price alone.
What should employees ask HR about their health plan?
- Is our plan fully insured, self-funded, or part of a healthcare captive?
- What are the deductible and out-of-pocket requirements for me and my family?
- How are prescriptions covered, and what will I pay for my regular medicines?
- What does behavioral health coverage include, and how do I find a provider in the network?
- Does the plan include virtual care, and what does it cover?
- Who can see claims data about employees, and how is it kept private?
- Does the plan have any cannabis-related exclusions?
- Which insurer or captive carries the risk, and can I check its license?
Write the answers down and compare them with your current plan before open enrollment.
What should employers ask a cannabis insurance broker?
California’s Department of Insurance says on its cannabis insurance page that it does not recommend or endorse any of the agents or brokers on its cannabis insurance list. It advises you to find out whether your agent or broker is licensed, to ask whether your business would be covered for a cannabis-related loss, and to watch for policies with cannabis or public policy exclusions.
- Which model fits: fully insured, self-funded or captive, and who carries the risk for predictable claims?
- What large-claim protection is included, and what is excluded?
- What claims data will we receive, how often, and in what format?
- Which plan design choices change premiums and employee out-of-pocket costs, and what does each option cost?
- Does the policy have cannabis or public policy exclusions?
- Is the broker licensed with the state?
- Can the captive put its own cost, savings, enrollment and outcome figures in writing?
- What behavioral health and pharmacy management support is included?
What are the trade-offs to weigh?
- Risk you keep. In a healthcare captive, participating employers keep responsibility for predictable day-to-day claims, according to the column. Ask how that affects the premiums and out-of-pocket costs you would see.
- No cost or savings data in the column. The MJBizDaily column does not show cost or savings figures for any captive, and it gives no enrollment numbers or outcomes. Ask any captive for its own written numbers before you assume a saving.
- Cheapest is not always best. The column makes this point, so compare coverage, not just premiums.
- Vendor view. The column is written by the head of a company that runs a captive. Weigh its arguments against the questions above.
To go further on reading a source that has a stake in its conclusions, see our industry funding and author conflicts (our research library) guide.
What if your employer’s plan does not fit your needs?
The USAGov guide to the Health Insurance Marketplace explains the options. Under the Affordable Care Act, insurers cannot refuse coverage based on sex or a pre-existing condition. To enroll, you must live in the United States, be a U.S. citizen or national (or be lawfully present), and not be incarcerated in prison or jail. Enrollment happens during the open enrollment period each year, or during a special enrollment period after a life event such as moving or having a baby. The guide also explains premiums, deductibles, coinsurance and copayments, so you can estimate what a plan may cost you per year.
How do you avoid health insurance scams?
The FTC warns that scammers follow the news, and that when health insurance is a big story, they get busy contacting people. Its advice is to stop, check it out, and do some research before you share your information. If you spot a scam, report it to the FTC online or by calling 1-877-FTC-HELP. Read the FTC health insurance scams page for more.
Next step: Ask HR for the plan’s structure and deductible this week, then take the broker questions above to any meeting about changing plans.
By HealthDataConsortium.org Research Team
