Texas state law defines a small business as any business with fewer than 50 employees. That applies regardless if those employees are part or full-time. But how does this affect group health insurance in Houston and beyond? Let’s take a look at Texas health insurance laws for employers and how they might affect your business.
What is Group Health Insurance?
In simple terms, group health insurance is a way for employers to purchase a single health insurance plan so employees don’t have to buy individual plans. It is typically more affordable than individual insurance.
Key Features:
- Single Policy
- Primas más bajas
- Contribuciones del empleador
- Guaranteed Coverage
- Dependent Coverage
Benefits of Group Health Insurance for Small Businesses
For small businesses, group health insurance is a key way to attract and keep your best employees. Without benefits, your team is likely to be less well-rounded and could very well be a constant revolving door of employees. But it doesn’t have to be.
Types of Group Health Insurance Plans
- Fully Insured Plans
- Planes con financiación a nivel
- Planes autofinanciados
- HMO/ PPO/ POS
A group health insurance broker can help you identify the best employer-sponsored plan for you in Texas. Get a free quote.
Legal Requirements for Group Health Insurance in Houston
- There is no state mandate for group health insurance.
- El Ley de Atención Médica Asequible (ACA) still affects small businesses in Texas.
- All employees who work more than 30 hours per week must be given access to health insurance, if you offer it at all.
- New employees must be given 31 days to enroll in health insurance. After that, you can have them wait until the next open enrollment period.
- Employees with special circumstances may be allowed to enroll during a special enrollment period after joining a business.
- You may allow up to 90 days after enrolling in a health insurance plan for coverage to start.
- Small-employer plans must include 10 types of health care services.
- Texas law doesn’t require workers’ compensation under small business plans.
- Federal COBRA law still applies to businesses with more than 20 employees.
How Small Businesses in Texas Are Affected
Small businesses in Texas interested in group health insurance must have at least 70% of their full-time employees enrolled in a health insurance plan, and you must contribute at least 25% to health insurance premiums.
Additionally, if you have under 50 employees, you don’t have to offer group health insurance in Texas. However, you may want to. By offering high-quality benefits, you may be in a better position to attract and retain talent your business needs.
You also may be set up for federal tax credits if you opt to provide group health insurance plans for your employees.
If you have over 50 employees, however, you are required to comply with the federal health care mandate. You could even face penalties if you don’t offer affordable, minimum-value coverage.
Professional Employer Organizations (PEOs) are becoming popular in Texas because they help small businesses access large group pricing and reduce administrative burden.
Frequently Asked Questions About Group Health Insurance in Texas
How Many Employees Are Required for Group Insurance?
In Texas, there is no state mandate for group or employer-sponsored health plans. Instead, you are subjected to the ACA, which mandates health insurance coverage for small businesses with over 50 employees.
Do I Have to Provide Health Insurance to All Employees?
The law requires you to provide and offer health insurance to all employees, even part-time employees, if you offer it at all. So, yes, you are required to provide health insurance to all employees.
Who Qualifies for Group Health Insurance in Houston?
Businesses with over 50 employees are required to provide group health insurance under federal law. Houston is subjected to federal law, not state law.
What does Small Business Group Health Insurance Cover?
- Preventative Care
- Doctor Visits Hospitalization
- Emergency Services
- Prescription Drugs
- Mental Health & Substance Use Services
- Maternity & Newborn Care
- Rehabilitation Services
- Lab Services
- Pediatric Services
- Optional or Add-on Coverage–Dental, vision, telemedicine, Health Savings Accounts (HSAs).
What is a Group Health Insurance Broker and why do I need one?
A group health insurance broker is an individual who finds, compares, and helps you enroll in health insurance plans for your employees. They are like a matchmaker between your business and the insurance plans available throughout Texas. They shop the network on your behalf and locate the best deals without you have to lift a finger. At PCIS, we can even help negotiate better rates and terms on your behalf. Want us to handle paperwork and compliance? We can help there too.
If you want to save time and money, stay compliant with local and federal laws, and get unbiased advice about which plan options make the most sense for you and your business, you should consider hiring us to be your group health insurance broker.
Why It’s Time to Hire a Group Health Insurance Broker in Houston
Navigating group health insurance is complex and challenging. If you’ve never set your business up for group health insurance, it can be even more challenging. But it doesn’t have to be. With rising healthcare costs and complex regulations, now is the perfect time to partner with a trusted group health insurance broker to explore coverage or optimize your existing plan. Working with a broker is one of the smartest moves you can make.
When you’re ready, reach out to us and get a free quote to get your business started on group health insurance. The sooner you give us a call, the better.
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