Jordan FeRoss asked:


Employers offer group health plans as a part of the benefits package for their employees. Other groups that may offer these plans as well, such as churches, professional associations and similar groups. If you’re in a group that has health care insurance in Texas, then more than likely you can be covered in a group plan that is sponsored by your employer or organization. For small businesses in the state of Texas, they have special stipulations. There are some benefits that are authorized by the state that small businesses don’t need, but larger employers have to include in their health benefits package.

It is not mandatory that employers and other groups have to offer health care insurance in Texas. They don’t have to put money aside to pay for premiums. However, there are some health care insurance companies that mandate some employers to pay at least half of the premiums for their employees.

Here are a few descriptions of some Texas health insurance group plans:

? Small Employer - These health plans are used for businesses that have 50 or less employees that are qualified to get health insurance in Texas. The employees that qualify have to be working full-time and work at least or more than 30 hours a week. No other classifications (part-time, seasonal) are qualified for this plan. Also, the employee must not have additional health insurance elsewhere. There is usually an annual rate increase which comes with a cap of fifteen percent. By law, any employer or group in Texas that cancels one plan is responsible for putting their employees in another health care plan.

? Large Employer - In the state of Texas, large employers usually use the HMO health plan. Because of that, state law says the HMO must include a POS (point-of-service) elective. With larger employers, they can offer health care insurance in Texas to executives and other employees. No employee should be denied a health care due to a pre-existing condition.

? Self-Funded - These health care plans are managed by ERISA (Employee Retirement Income Security Act). This is for employers that want to pay the costs of health insurance for employees. There would be no HMO coverage. The self-funded insurance plan can be used in several states and are not required to adhere to the insurance laws of the state. The U.S. Department of Labor is responsible for overseeing this kind of health care insurance in Texas.

The majority of health plans for larger employers are self-funded. The Federal government doesn’t have a lot of requirements for this particular plan. However, these plans may offer a wider range of coverage than what we used to. This particular health care insurance in Texas also provides health coverage all across the board.

Employers and groups that use self-funded health care insurance in Texas may use subcontractors as the administrator of their insurance plan. The subcontractors as also known as third-party administrators, or TPAs. In order to legally act as a TPA with health insurance in Texas, they must have a state license. So, depending on what size company you work for will determine what kind of health insurance coverage you will get.