Tuesday, December 30, 2008

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.

Small employers qualify for some extra legal protection under state and federal laws. This includes dictating how much insurance companies can charge them and what type of coverage must be extended to them. In order for these smaller companies to benefit from the special health insurance statutes in Texas they do have to meet certain eligibility requirements. The total number of employees is not as important as how many employees are eligible for, or will be participating in the insurance program. The law requires that all eligible employees have health insurance offered to them 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.

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.

No matter what size the company is, it is against the law for any employer to require an employee to participate in a health insurance plan in Texas in order to keep their job. It is also illegal to disqualify an employee for insurance coverage due to their age, gender or health conditions 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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