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Small Employers Seek Texas Health Insurance |
by Jordan FeRoss

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.

To help make it profitable when working with small companies, insurers will often require a certain percentage of employee participation before they’ll agree to cover the organization (usually 75% or greater). Depending on the frequently-changing regulations, there are not always minimum participation requirements before an insurer must cover small business and provide its employees with health insurance in Texas.

Or if the number of employees is low, require them to have total participation of 100%, no exceptions. If the small employer includes spouses and maybe a few others, then the spouses must each get separate health insurance coverage. There would be no dependent sharing for either spouse. This applies to health insurance in Texas as well.

When a small business has a small number of employees participating in a group health insurance plan in Texas, they are usually all required to have the exact same plan. Larger companies can offer employees choices as far as co-pays and deductibles, but the smaller business may have to require everyone to be on the exact same plan.

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.

The laws regarding health insurance for small businesses are detailed and complex. Health insurance in Texas must be offered to all eligible employees as dictated by the law. Because employees covered by health insurance are healthier and less financially stressed, employers should think of health insurance in Texas as an investment in their company’s fiscal health.

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Kalender
March 2010
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