Independent Texas brokers. National carrier access.
Group Health Coverage Your Team Values, at a Cost Your Business Can Plan Around. Group health insurance is employer-sponsored medical coverage for eligible employees and, when included, their dependents. Houston employers choose a funding arrangement, provider network, benefit design and contribution strategy. Compare total employer and employee costs, carrier eligibility and applicable compliance rules—not just the monthly premium.
How it works
Group health insurance is the plan your company sponsors for your employees and their families. We do the searching, the math and the paperwork, then bring you a recommendation you can act on.
First we take your headcount, your budget and what you want the plan to do for your people. That sets the target before anyone quotes a rate.
With that target set, we compare plans across our national carrier network. We are not tied to any single insurer, so what comes back to you is only what fits your company and your employees.
Once the plan is signed, setup is the start and not the finish. Renewals, plan changes and employee questions come back to us for the life of your plan.
Why PCIS
A group health decision is hard to reverse for a year. Four things decide whether that year goes well.
We are deeply rooted in Texas and our network spans the country. You get personal service with access to top-tier plans.
We answer to you, not to a single insurer. The only goal is the right coverage for your employees at the right price for your company.
The Affordable Care Act keeps changing. We track it so your plan stays within the regulations and you avoid costly fines.
A new hire, a mid-year change, a question about a claim: you have one dedicated resource for the life of the plan.
Compliance
Compliance depends on employer size, market, funding and plan status. Primary Care Insurance Solutions (PCIS) helps organize these checks; no review can guarantee that every compliance risk is eliminated.
An employer is generally an Applicable Large Employer (ALE) when it averaged at least 50 full-time employees, including full-time equivalents, during the prior calendar year. Related-employer and seasonal-worker rules can affect the calculation. ALE status determines whether the ACA employer shared-responsibility rules apply; it is not the same as Texas small-group insurance eligibility. Source: IRS, Determining if an employer is an applicable large employer.
Non-grandfathered individual and fully insured small-group policies generally must cover the ten essential-health-benefit categories, subject to applicable transitional relief. Large-group and self-funded plans do not have the same blanket requirement to cover all ten categories, although other ACA protections can apply. Confirm the market, funding arrangement and plan status before judging compliance. Source: Texas Department of Insurance, Small employer health insurance guide.
An employer averaging fewer than 50 full-time employees, including full-time equivalents, during the prior calendar year generally is not an ALE, subject to related-employer and other applicable counting rules. That does not remove all plan obligations. ACA small-group rating rules generally apply to non-grandfathered fully insured small-group policies, not every arrangement offered by an employer below 50. Self-funded and level-funded arrangements have different rules. Sources: IRS, Determining if an employer is an applicable large employer; Texas Department of Insurance, Small employer health insurance guide.
The right approach depends on your budget, group size and how much cost certainty you want. Use these guides to compare the main paths before you request quotes.
See what shapes a Houston employer’s premiums, including group size, employee ages, plan design, contribution strategy and carrier choices. Use these factors to prepare for a clearer quote conversation.
See moreA level-funded plan combines predictable monthly payments with claims-based funding and stop-loss protection. It may suit some Texas employers, but the trade-offs need careful comparison before a decision.
See moreAn Individual Coverage Health Reimbursement Arrangement lets an employer provide a defined allowance while employees choose individual coverage. Eligibility, employee classes and administration matter before you adopt one.
See moreSmall employers face different participation, contribution and plan-selection questions. Review the practical starting points for offering benefits, comparing carriers and preparing your employee census.
See moreCompare group health insurance costs in Houston, review level-funded health plans in Texas, understand ICHRA options for Houston employers, or start with small business health insurance in Houston.
We work with employers across Greater Houston, including Sugar Land, Katy, The Woodlands and Pearland, from our Houston office.
FAQ
An employer is generally an Applicable Large Employer (ALE) when it averaged at least 50 full-time employees, including full-time equivalents, during the prior calendar year. Related-employer and seasonal-worker rules can affect the calculation. ALE status determines whether the ACA employer shared-responsibility rules apply; it is not the same as Texas small-group insurance eligibility. Source: IRS, Determining if an employer is an applicable large employer.
An Applicable Large Employer may owe an employer shared-responsibility payment if it fails to offer the required coverage, or if an offer is unaffordable or does not provide minimum value, and a full-time employee receives a Marketplace premium tax credit. Different payment rules apply to the different failures. Liability depends on the coverage month, workforce and applicable year; confirm the calculation with legal or tax counsel. Source: IRS, Employer shared responsibility provisions.
Non-grandfathered individual and fully insured small-group policies generally must cover the ten essential-health-benefit categories, subject to applicable transitional relief. Large-group and self-funded plans do not have the same blanket requirement to cover all ten categories, although other ACA protections can apply. Confirm the market, funding arrangement and plan status before judging compliance. Source: Texas Department of Insurance, Small employer health insurance guide.
Start with the employer’s ALE calculation, the plan’s market and funding arrangement, and any grandfathered or transitional status. Then review applicable benefit protections, affordability, minimum value, eligibility, notices and reporting rather than treating essential health benefits or actuarial value as a universal compliance test. Primary Care Insurance Solutions (PCIS) can help organize the review; legal or tax counsel should confirm specific obligations. Sources: IRS, Employer shared responsibility provisions; Texas Department of Insurance, Small employer health insurance guide.
An employer averaging fewer than 50 full-time employees, including full-time equivalents, during the prior calendar year generally is not an ALE, subject to related-employer and other applicable counting rules. That does not remove all plan obligations. ACA small-group rating rules generally apply to non-grandfathered fully insured small-group policies, not every arrangement offered by an employer below 50. Self-funded and level-funded arrangements have different rules. Sources: IRS, Determining if an employer is an applicable large employer; Texas Department of Insurance, Small employer health insurance guide.
Reviews
Tell us your headcount and your renewal date. We will review your current coverage at no cost and bring you compliant options that fit.
