Group Health Insurance for Houston Employers
Renewal coming up? Compare the plan, the network and what your business and employees would pay.
For owners and HR teams at Houston businesses with 51-100 employees. We help compare plan options, employer and employee costs, and the rules that apply.
97%Retention
Client retention since PCIS was founded.
No cost to employers
Our brokerage services are paid through carrier commissions. Plan premiums and other plan costs still apply.
The basics
Compare the parts of your plan
Funding
Compare fully insured and level-funded plans with an individual coverage health reimbursement arrangement (ICHRA), where eligible.
Network
Check the exact plan's doctors and hospitals. Review whether out-of-network care is covered and what employees would pay.
Plan design
Compare deductibles, copays and out-of-pocket limits, plus the option to offer more than one plan.
Contribution
Decide how much of employee and dependent premiums the business would pay. Compare what employees would owe.
How it works
From your headcount to a plan comparison
Tell us about your business
Start with your headcount, budget, renewal date and priorities for employee coverage.
Compare available options
We compare available plans and explain costs, networks and trade-offs. Options depend on your group and location.
Get help after enrollment
We help with renewals, plan changes and employee questions after the plan starts.
Why PCIS
Why work with our Houston team?
Advice from a Houston team
We aren't tied to one insurer. We explain available options and the reasons for our recommendation.
Help with ACA requirements
We help organize the benefit, affordability and reporting checks that apply. Your legal or tax adviser should confirm your obligations.
Support after enrollment
Contact our Houston team about new hires, plan changes or claim questions.
Compliance
Check which rules apply
Employer size, the insurance market, funding and plan status affect your obligations. Start by separating the federal employer test from Texas insurance rules.
Are you an applicable large employer?
Generally, an employer is an applicable large employer (ALE) if it averaged at least 50 full-time employees, including full-time equivalents, in the prior calendar year. Related-employer and seasonal-worker rules can affect the count. This federal test is not the Texas small-employer definition.
IRS guidance on employer sizeEssential health benefits
Non-grandfathered individual and fully insured small-group policies generally must cover ten essential health benefit categories, subject to applicable transitional relief. Large-group and self-funded plans do not have the same blanket requirement. Other ACA protections can still apply.
TDI small-employer coverage guideTexas small-group rules are separate
Texas defines a small employer as a business with 2 to 50 employees, regardless of hours worked. That is not the federal ALE count. ACA small-group rating rules generally apply to non-grandfathered fully insured small-group policies. Self-funded and level-funded arrangements follow different rules.
General information, not tax or legal advice. No review can guarantee every compliance risk is removed.
Related services
Compare plan options and other benefits
Review funding options, then consider dental, vision, life and disability benefits.
Not sure which fits?
Compare funding options
Request a comparison of available fully insured, level-funded and ICHRA options. We review employer and employee costs, eligibility and trade-offs.
Get started
Get a group health quote
Tell us about your business. Next, upload an employee census or call us at 713-329-6944.
Houston office hours: Monday-Friday, 8:30 a.m.-4:30 p.m. CT.
FAQ
Group health questions
What are the ACA requirements for my business?
Start with the federal employer-size test. An average of at least 50 full-time employees, including full-time equivalents, in the prior calendar year generally makes you an ALE. Check related-employer and seasonal-worker rules too.
ALE status determines whether federal employer shared-responsibility rules apply. Texas small-group eligibility is a separate question.
What penalties could my business face for non-compliance?
An ALE may owe a payment if it fails to offer required coverage, or offers coverage that is unaffordable or lacks minimum value, and a full-time employee receives a Marketplace premium tax credit.
Different failures have different payment rules.
Liability depends on the coverage month, workforce and year. Ask legal or tax counsel to confirm the calculation.
Does my plan need to cover essential health benefits?
Check the plan's market, funding and status. For non-grandfathered individual and fully insured small-group policies, the general rule is to cover all ten categories, subject to applicable transitional relief.
Large-group and self-funded plans do not share that blanket requirement, although other ACA protections can apply.
How can I tell if my current group health insurance is ACA compliant?
Start with ALE status, the insurance market, funding, and any grandfathered or transitional status. Review applicable benefit protections, affordability, minimum value, eligibility, notices and reporting. Essential health benefits alone are not a universal compliance test. PCIS can help organize the review; legal or tax counsel should confirm specific obligations.
What if my company has fewer than 50 employees?
No automatic exemption follows from that headcount. Federal ALE status generally uses the prior year's average full-time employees plus full-time equivalents, with related-employer and other counting rules. Texas small-employer insurance eligibility uses a different test. Plan obligations can still apply even when the employer is not an ALE. Confirm the market, funding and plan status before deciding which requirements apply.