I will focus this synopsis on Texas under the current laws. Presently in Texas small groups defined as over two employees are offered guaranteed coverage from the insurance carriers who have agreed to participate in the small group markets. This is good for small groups since they know regardless of medical issues they can get coverage for the current employees and any new employee they add to their company.
Guaranteed issue does not mean the rates can’t be increased due to overall group medical issues. In fact the base rates, which are filed with the state, can actually be increased by up to 67% during the underwriting process. Every carrier uses their own underwriting process so it’s possible a rate up at one carrier will not generate a rate up or a rate up at the same level. Also each carrier has their own set of plan designs and that is another reason companies may choose between different insurance carriers.
The health plans range from low deductible, small co-payments, and low out of pocket maximum PPO plans, to HMO plans, to Health Savings Account eligible High Deductible plans with a variety of deductible levels. The variety of plans comes with a variety of base prices that allows companies to find something to fit their budget or when budget is less important, something that delivers a health care insurance product they want.
These health benefit plans offer full coverage including maternity. Among small groups, they can choose to also include some optional coverage such as invetro-fertilization and additional mental health coverage. All of these things make small group coverage pretty much like what you can have at big employers. This allows small employers to compete for employees in a competitive employment environment.
In addition to the health insurance small groups can get various forms of disability insurance, dental insurance, and life insurance which helps them compete with larger employees.
For help picking the right small group health insurance in Texas give us a call. We love working with small groups helping them find a plan that keeps costs down while delivering the coverage they need.
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