Texas Group Health Insurance | Best Small Business Health Insurance in Texas

Texas Group Health Insurance & Employee Benefit Plans

As an independent group insurance agent, we are not limited by the available options of one particular carrier or health care plan type.

In other words, we have a wider net of group coverage options we can offer than if you partnered with a single provider.

For more information about mandated health benefits that employers must offer as part of the Affordable Care Act, see this resource from the Texas Department of Insurance. You will find all non-medicare-related information here.

Call us today at the number at the top of the page to discuss our current group benefits options in Texas! We proudly serve the entire state and offer FREE estimates through our online request form to the right! No payment or obligation is required!

Texas Large Group Health Insurance Plans

Eighty-three percent of workers in Texas are employed by a business that offers health insurance, and 76 percent have a choice of more than one plan. Of the employer-sponsored plans, 61 percent are self-funded, which exempts those employers from complying with Texas’ requirement for coverage that exceeds the ACA essential benefits provisions. In a self-funded plan, an employer forgoes using an insurer and sets aside money to pay for employees’ medical care, usually in a trust and administered by a third party. The approach is more common in large companies, which can spread risk through a wider employee population. The 39 percent that are fully insured (meaning that the company purchases coverage from an insurance provider rather than paying the medical costs directly) must cover these services in addition to the ACA benefits:

  • Brain Injury
  • Diabetes Care
  • Durable Medical Equipment (prosthetic/orthotic devices)
  • Off-Label Prescription Drugs
  • Pediatric Services (reconstructive surgery for craniofacial abnormalities in children)
  • Prescription Drugs (oral anticancer medications)–
  • Reconstructive Surgery following mastectomy
  • Transplant Donor Coverage (for individual plans but not HMOs)

Although Texas’ large companies pay almost eighty percent of the single coverage premiums charged to their workers, the average employee still pays 8.7 percent of median income as their contribution. The ACA limits the share that employees can be required to pay to no more than 9.12 percent of their income. 

Texas Small Business Health Insurance Plans

Small businesses (with fifty or fewer employees) are exempt from the mandate to offer health insurance to their workers. Still, health insurance is usually the top-requested benefit, and many companies want to provide it to their workforce. The ACA created SHOP (Small Business Health Options Program), which offers helpful resources for companies that want to provide healthcare insurance for their workers. Companies can learn about the options for coverage, pricing, and how to access information about tax credits. Taylor Benefits Insurance can help your company navigate the regulations and be sure that you locate the support that’s available for you. Small companies must meet these criteria to be eligible for the administrative support tax credit:

  • Employ fewer than 25 full-time equivalent employees (not including family members of owners or seasonal workers)
  • Pay average annual salaries of $50,000 or less per employee
  • Pay at least 50 percent of full-time employees’ premium costs
  • Purchase a qualified plan

Texas Employee Benefits Plans and Employee Benefits Packages

Texas is unique in not requiring private employers to carry workers’ compensation insurance to protect employees who may be injured on the job. In addition, Texas also does not require paid or unpaid leave for illness or vacation.

However, many companies in Texas do provide a robust benefits package, with a third of workers enjoying dental care coverage, 21 percent having available vision insurance, and half having access to an Employee Assistance Program. An EAP can be simple or complex. Typically, an EAP offers a fast, confidential response to the employee in crisis. The problems addressed include substance abuse, stress, family conflict, personal financial concerns, and more. Usually, the employee can initiate contact online or by phone to start the process and does not need to use their insurance to gain access to help. If the issue requires more than a brief support period, the EAP will refer the employee to more comprehensive assistance resources.

Texas Small Business Health Insurance & The Affordable Care Act

The Affordable Care Act, also sometimes referred to as Obamacare, has changed the way that group benefits are administered. Understanding the challenges and opportunities of the new law is an important part of maximizing the value and cost efficiency of your business, which is where our experience comes in.

We’ve been working with small business owners to offer affordable, effective group benefits since well before the Affordable Care Act was put in place, and we’ve played an essential role in helping our clients adjust to the new regulations during its implementation.

We pride ourselves on being able to come up with a creative solution that works for both your employees and your bottom line.

At Taylor Benefits, we are able to craft health plans that are specifically tailored to the needs and expectations of your company and its employees. We do this by examining your current benefits offerings against the backdrop of other businesses in your industry, as well as the health coverage requirements dictated by current healthcare laws and the goals of your business.

For a better understanding of what benefits are important to employees, see this informational guide for consumers from the Texas Department of State Health Services.

Need a small business health insurance plan for your Texas-based business? Call us today to learn how you can offer a cost-saving benefits package that will have a positive effect on the success and growth of your business!

Get started right away with a FREE health plan cost estimate, or call us at the number at the top of the page to discuss your options!

Learn more about Texas employee benefits packages offered by Taylor Benefits.

Different Types of Texas Small Business Health Insurance Plans

The most common structures for health insurance plans are listed below. Investigate these options before choosing the most appropriate small business health insurance plan for your employees.

  • HMO Health Insurance Plans
  • PPO Health Insurance Plans
  • Indemnity Health Insurance Plans
  • HSA-Qualified Plan

Your needs and budget determine which structure to choose for your company. Review this brief overview of the top four types of health insurance plans:

1) PPO Health Insurance Plans

The PPO or “Preferred Provider Organization” health plan is increasingly the most preferred for employers and employees. This provider paradigm typically offers a widespread network of medical service providers that the subscriber has access to. Subscribers can also get care from providers not in the network, but generally, they will pay more if they do.

2) HMO Health Insurance Plans

Health Maintenance Organizations (HMOs) offer a lower-cost approach in many cases. The HMO has a group of service providers that the subscriber can use. In most cases, the subscriber has a primary care physician who is responsible for coordinating their overall care and making necessary referrals to specialists. HMO patients typically cannot use out-of-network doctors or hospitals except in an emergency. 

3) HSA-Qualified Health Insurance Plans

HSA-qualified plans are insurance plans with high deductibles that qualify for Health Savings Accounts (HSAs). HSAs are accounts that you fund with pre-tax dollars to pay for medical costs. Unlike similar funds like FSAs (Flexible Spending Accounts), the money can roll over from year to year if it isn’t needed. 

4) Indemnity Health Insurance Plans

Indemnity plans are traditional insurance policies that do not restrict the medical providers that a patient can seek care from. Typically, an indemnity plan pays a specific portion of the overall costs, with the subscriber paying the balance.

Tax Credit in Texas for Health Insurance

If you own a small business with fewer than 25 employees and pay lower-than-average wages, your company may be eligible for a tax credit if you provide health insurance to your workers and pay more than half the premium cost. 

Relevant Statistics

  • Over 80% of businesses in Texas offer some form of group health insurance coverage.
  • On average, Texas group health insurance plans cover approximately 92% of medical expenses.
  • More than 2 million employees and their dependents are covered by group health insurance in Texas.
  • The average monthly premium for Texas group health insurance is $336 per employee.
  • Approximately 95% of Texas group health insurance plans provide coverage for prescription medications.

General Facts

  • Texas group health insurance provides coverage for a group of people, such as employees of a company or members of an organization.
  • It helps protect individuals and their families from high medical costs by providing financial assistance for healthcare services.
  • Employers typically offer group health insurance plans to attract and retain talented employees.
  • Group health insurance plans in Texas must comply with state and federal regulations to ensure coverage meets certain standards.
  • Premiums for group health insurance are often lower compared to individual plans because the risk is spread across a larger pool of people.

What are the main benefits of the Texas Group Health Insurance plan for small businesses?
The main benefits of the Texas Group Health Insurance plan for small businesses include cost savings through group rates, access to a wider network of healthcare providers, improved employee retention and morale, and compliance with healthcare regulations.

How does Texas Group Health Insurance ensure the privacy and security of policyholders’ health information?
Texas Group Health Insurance ensures privacy and security by implementing strict data encryption protocols, limiting access to authorized personnel only, regularly updating security measures, and complying with HIPAA regulations.

How does Texas Group Health Insurance handle pre-existing conditions?

Texas Group Health Insurance cannot deny coverage or charge higher premiums for pre-existing conditions under the Affordable Care Act. They must provide coverage for all health conditions, regardless of when they were diagnosed.

Are you looking for group health insurance in Texas?

We provide insurance plans for individuals, dependents, and any size small business available with the leading Texas health insurance companies at affordable premiums. Consider the policies available from these leading insurers:

  • National General Benefits Solutions
  • UnitedHealthcare
  • Blue Cross and Blue Shield of Texas
  • Humana

Contact us today to get an instant quote for business group health plan costs.

Frequently Asked Questions About Small Business Health Insurance in Texas

Here are answers to common questions regarding Texas health insurance coverage.

Which Large Group Health Insurance Providers Are in Texas?

Taylor Benefits Insurance can connect you with some of the nation’s most reputable group health insurance providers. You can always count on us to find you a great deal on large group coverage plans.

We collaborate with the insurance providers listed below:

  • Blue Cross
  • State Farm
  • Coventry Corp. Group
  • HIP Insurance Group
  • Carefirst Inc. Group
  • UHC of California
  • Metropolitan Group
  • HCSC Group
  • Blue Shield
  • eHealthInsurance
  • Humana Group
  • Kaiser Foundation Group
  • Unitedhealth Group

How Do Small Business Group Health Insurance Plans Work in Texas?

Small companies in Texas can choose from several feasible options when deciding to offer healthcare coverage to their employees.

The first option is a standard insurance policy for small businesses. Employers and subscribers often share the cost of the premium for individual coverage and added dependents.

The Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is an excellent alternative for companies that don’t want the responsibility of sponsoring insurance plans. Instead, the company can establish these accounts that the workers use to pay for their costs if they purchase qualifying individual plans.

A Group Coverage Health Reimbursement plan combines group health insurance with a monthly allowance to cover deductibles, copays, and other expenses.

Self-funded health insurance plans are not widespread in small businesses due to the risk. With self-funding, the company pays directly for medical costs incurred by the workforce rather than buying insurance. It’s risky because a few catastrophic claims can eliminate the anticipated savings and result in tremendous liability.

A final option is to join in an Associate Health Plan (AHP), which is a cooperative between several small organizations buying insurance together to benefit from higher subscriber numbers.

What Are the Different Types of Health Benefits Offered in Texas?

Taylor Benefits Insurance Agency provides the following benefits packages to businesses and employees in Texas:

  • health coverage
  • dental coverage
  • vision insurance
  • Disability insurance, both short and long-term
  • 401k
  • retirement & pension
  • section 125 cafeteria
  • HSA
  • life insurance
  • long term care
  • ACA (Affordable Care Act) compliance

How Much Do Employers Pay for Health Insurance?

Among Texas employers that sponsor insurance, the average amount they pay for individual coverage is $5,520, which equals 79 percent of the employee premium cost. Large employers must ensure that the subscriber’s share isn’t more than 9.12 percent of their income. However, employers are not required to contribute toward dependent coverage costs.

What is the average cost of small business health insurance?

The average cost of small business health insurance depends on whether you’re looking at individual employee coverage or family coverage. Here’s a breakdown based on 2023 data:

  • Individual Coverage: The average annual cost for a small business to cover a single employee is around $6,584. Employers, on average, contribute $6,485, or 83% of this cost.
  • Family Coverage: The average annual cost for a small business to cover an employee’s family is $16,357. Employers contribute an average of $13,737, or 63% of this cost.

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

We’re ready to help! Call today: 800-903-6066