Tuesday, December 30, 2008

How Texas Health Insurance Is Set Up For Small Employers

By Jordan FeRoss

For purposes of definition of health insurance in Texas, there is a difference between small employers and large employers according to state and federal mandates. For a small employer to be called just that, they will have to have no more than 50 employees that work full-time (actually 2 to 50 full-time employees). These employees that are defined as full-time must work at least 30 hours or more each week in order to qualify. That does not include temporary workers or seasonal workers.

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.

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.

Regardless of a company's size, it is never legal for an employer to coerce any employee into participating in health insurance in Texas. It is always the employee's choice and should not reflect negatively on that individual. And, no individual can be legally disqualified from any group plan or discriminated against because of their age, sex or any medical condition.

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. - 15485

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