Top Cost Management Tips for Group Health Insurance for Small Businesses in Texas

Three women working on laptops at a wooden table while discussing group health insurance options.

Are you curious about how to save money on your group health insurance plan in Texas?

Of course you are!

Your business’s bottom line is why you’re in business.

There are several ways to reduce insurance costs and create a more stable health foundation for your employees. We’ve outlined those methods in the following post.

You’ll learn:

Both short-term cost management strategies, like exclusionary policies, and long-term policies, like tiered insurance programs, can radically reduce your insurance costs.

Dive into the details to learn proven cost management methods for your company.

Short-Term Cost Management Tips for Group Health Insurance Savings

Texas small business health insurance can be customized to reduce benefits for new hires.

Reducing benefits to new hires is the fastest way to stop overpaying for group health insurance.

Some ways you may do that include requiring increased cost-sharing for all health plan participants, consolidating vendors, and pooling insurance risks.

Other short-term cost management solutions include:

Adding charges for spousal coverage.

Adding “working spouse” provisions to health coverage plans and limiting an employee’s spouse’s access to a plan if they work for an employer offering health insurance can be great strategies to reduce costs. Working spouse provisions, also known as “spousal exclusion” and “spousal carve-out” policies, include one of the following forms:

-Working spouses are required to pay a premium surcharge for coverage through the employee’s enrollment if they decline their employer’s insurance.

-Exclusion of your employee’s spouse if they have similar coverage available through their employer.

-A requirement to first purchase health insurance through the spouse’s employer’s plan prior to purchasing it through your employee’s enrollment.

It’s best to examine what types of savings could be made before adopting any of these strategies. Keep in mind the legal nuances that accompany spousal exclusions in the process.

Offering high-deductible plans.

High-deductible plans are a big trend for employers seeking to manage group health insurance costs.

In 2020, the Kaiser Family Foundation ran a survey regarding health benefits. In it, they found that employees paid 17 percent of the premiums for single coverage and some 27 percent of the cost for family coverage. In the survey, employers also noted a shift in costs to employees via increased deductibles.

However, high deductibles must be balanced with the affordability requirements of the ACA. Yet, the research is in that employers continue to perceive high-deductible health plans as one of the most viable options for keeping medical costs under control.

The high-deductible health insurance trend started in 2011, and has increased since, according to KFF.

Offer and persuade employees to use telemedicine.

Virtual doctor appointments started during COVID-19 but stuck around after the pandemic. One of the greatest benefits of telemedicine is the cost. They are typically less expensive than a traditional office visit and much more convenient to people who are searching for after-hour care. Noticeably, though, more major health insurance carriers are offering telemedicine options along with their in-network providers.

Of course, it’s up to employers to educate employees regarding the effective use of telemedicine benefits. The big sell here is convenience. Employees who are parents or travel frequently are two demographics who greatly benefit from telemedicine.


Implementing upfront and short-term health insurance cost control strategies like high-deductible plans, removing spousal coverage, and encouraging telemedicine is one of the best methods to save on your group health insurance plans.

Long-Term Solutions for Group Health Insurance Savings

While short-term cost management solutions are important for your general group health insurance plan, long-term solutions save you significantly more in the long run. Here are a few simple long-term ways to reduce your insurance costs in Texas as a small business owner.

Create a strong employee wellness program.

Wellness programs are a great way to decenter your company from the responsibility of the health of your employees. Some 70 percent of healthcare spending is attributed to lifestyle and behavioral choices.

Naturally, employees are using this information to help employees improve their own health. Countless studies show that employers can use these programs to help contain or reduce health care costs, one study even showing a 25% reduction in health care costs.

However, not all wellness programs are created equal, so carefully analyze the costs, advantages, and level of employee interest and participation before you implement any changes.

For any wellness plan to be a success, employees must actively participate in them.

It could take some trial and error, but once employers land on a wellness program that is genuinely interesting to employees, the cost benefits can skyrocket.

To learn more about HIPAA rules surrounding wellness programs and their legality, check out The HIPAA Nondiscrimination Requirements article from the U.S. Department of Labor.

Use tiered health insurance plans.

Employers have long since differentiated premiums on types of coverage. However, what can be changed is the detail involved in structuring premiums. For example, employers can create tiers of premium rates instead of offering family coverage with a single premium regardless of the number of kiddos covered. Consider this strategy:

  • Employee only—individual coverage
  • Employee plus one—employee + spouse and a single child
  • Employee plus child or children without a spouse
  • Employee plus a partner spouse or children—Family Coverage

You can also expand tiers to require higher premiums for three or more children. There are a few other ways to do this, but it’s best to consult with a health insurance broker to learn more.

Bonus point: Some employers are looking into offering premiums based on employees’ salaries, which offsets the cost of high earners in the company.

Use health risk assessments.

Another way to manage health care costs is by using health risk assessments. This helps employers better understand what wellness programs would be beneficial to employees. Keeping employees informed about their health risks also motivates them to take action to reduce them. This, in turn, reduces healthcare costs for employers.

Additionally, those wellness programs we discussed earlier become easier to strategize and leverage as a cost management tool. Keep in mind certain legal constraints surround risk assessments, including the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA).

Understanding the policies surrounding health insurance coverage and risk assessments is essential for small businesses in Texas.


Tailored wellness programs, tiered premium plans, and health risk assessments are powerful solutions for reducing the long-term costs of your group health insurance plans. Investing in these strategies could very well pay off for your company.

Strategic Financial Resilience: Key Takeaways for Small Businesses in Texas & Beyond

Health insurance for businesses in Texas is a complicated business. The steps outlined above can place your business in a more strategic and healthy position for forward growth.

-Investing in wellness programs reduces costs over time.

-Restricting spousal coverage could be a fast and effective cost-reduction strategy.

-High deductible plans remain a powerful cost management tool.

Ultimately, however, you need to partner with the experts to build a strong, sturdy, and long-term cost-saving health insurance plan for your employees.

Connect with our team to learn powerful strategies to transform your health care costs today and long into the future.

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