When it comes to defining health insurance in Texas, the state and federal mandates that determine what a “small business” or a “large business” are important especially when it comes to setting insurance rates. According to these definitions a small employer may not have greater than 50 full-time employees. The government describes a full-time employee as one that works at least 30 hours per week. Seasonal or temporary employees are not included in these numbers.

With small employers, they are protected by some legal statutes. Some of them include coverage levels and increases in insurance rates. The thing with small employers is that with the health insurance law in Texas, they have to have the right amount of employees that are eligible for health insurance. It is not based on the number of total employees per say. With health insurance for small employers, it is mandatory that those eligible are offered health insurance coverage for themselves and their immediate families.

A health insurance carrier can mandate that at least three fourths of eligible employees from a small employer seek to get health coverage. With certain carriers, this can be part of how they will get their health care plan. Depending on the number of eligible employees, the law can mandate that not everyone has to participate. This can apply to health insurance in Texas.

Very small companies may be required to get buy-in from 100% of their employees regarding participation before an insurer agrees to work with them on a group plan or they may be forced to choose an individual or family plan for their health insurance in Texas. Because of the high costs of health insurance in Texas, it is best for employees to be covered under a company group plan rather than an individual plan. This can be difficult for small companies with very few employees.

Fewer employees at a small company also means fewer choices in the type of coverage for employee health insurance in Texas. To keep their costs down, insurers will often require everyone be covered by the same plan rather than offer multiple levels of coverage and allowing employees to choose. This is unlike larger companies who offer more options to employees regarding insurance plans.

However, whether it’s a small employer or a large one, it is against the law to force a new employee to get health insurance in Texas in order to stay employed there. It is also against the law to single out any employee that can get health care coverage due to how old they are, medical history status or pre-existing conditions that they may have.

Small businesses need to be mindful of the laws regarding health insurance in Texas. They must be sure to offer the proper health insurance for their eligible employees under the law. Having healthy employees is better for the employer in the long run and paying for health insurance will benefit them as well as the employees.