Small Business – Health Insurance in Texas

Finding the right group health plan for your business can be downright intimidating: sorting through lists of insurance companies and plans for ongoing monitoring and re-verification of money and totals for deductibles and co-pays, meaning the plan limitations and exclusions; deciphering a dictionary’s worth of insurance-speak. Just to feel like a person of high school freshman again.

Texas insurance law allows a wide range of plans and health care packages. All group health insurance has its limits and find the right plan for the health of employees at the right price can be difficult.

In Texas, the term “small employer” is an insurance designation reserved for the two companies with 50 employees. The law provides some added protections to these businesses, including an annual ceiling of 15 per cent rate increases because of health factors, a guarantee of performance that carriers cannot arbitrarily stop coverage, a cooperative purchasing and provision for giving their small employers to purchase weight negotiate lower rates.

For employees of small businesses in Dallas, Houston and Texas, the law provides several ways to maintain benefits after leaving a job and the limits of the waiting period before pre-existing conditions are covered.

Small Business Coverage

Eligible employees are defined as those who usually work at least 30 hours per week are not classified as temporary, part-time or seasonal, and are not already covered by another group of health. A business’ owners count total for the employee.

If your Company has 60 total employees, it may still qualify if six of part-time workers and four have coverage through another source, such as a spouse.

If you decide to offer a health plan to your employees, you must also make available to all your eligible employees and their dependents.

Coverage is available under a small employer health insurance plan if at least 75 percent of a small employer, eligible employees chooses to be covered. Carriers must always “round up” when calculating the percentage. For example, a company of five people with only three employees wanting to participate satisfies a requirement of 75 percent by district.

However, in the case of a company with only two eligible employees, the law requires a stake to 100 percent. The husband and wife working in a company should be considered as two employees. None of the employees eligible to cover as depend on another.

If you provide a health plan, a regulation and a federal law called COBRA (Consolidated Omnibus Budget Reconciliation Act) allow employees to maintain benefits for a period of time after termination of employment. It is your legal responsibility to inform employees of their rights to continue coverage. Former employees who choose to continue their coverage under COBRA or continuation of the state must pay the full cost of the plan. You are not obliged to contribute to their premiums, even if you have already paid a part. Ask your operator for more details about your liability for former employees.