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Texas Group Health Insurance

The Texas group health insurance market has many insurance companies that have both strong networks and also offer comprehensive plans. Blue Cross and Blue Shield of Texas, UniCare, Humana, United Healthcare and many others offer coverage to Texas residents. Ok, so how are the rates determined for TX group health insurance? What things do you need to know when shopping for a group plan in Texas? Is it possible to find cheap Texas health insurance? Let’s take a look at these questions one by one:

How Texas Group Health Insurance Rates Are Determined

Texas insurance law allows insurance companies to use 5 criteria in determining rates for Texas group health insurance plans. These 5 criteria are:

1) Age of Employees
2) Gender of Employees
3) Size of the Group
4) Industry Classification of the Group (Business Code)
5) Geographic Area

The underwriting departments for insurance companies offering group health insurance in Texas can use some or all of these 5 criteria and must seek approval if they want to use any additional criteria. It is important to note that the insurance company must underwrite the same across the board with all companies. In other words, they cannot change their rating methodology from one employer group to the next.

The Difference Between Texas Group Health And Individual Health

You must know the fundamental difference between Texas group health insurance and Texas individual health insurance: the price. Group rates are about double the cost of a similar individual plan in TX because everyone is accepted onto the group health plan while on the individual plan side one must be somewhat healthy to be accepted.

The best way to find cheap Texas health insurance, whether group or individual, is to compare at least 2 or 3 insurance companies plans side by side. Choose big and trustworthy insurance companies with a strong reputation and then compare their quotes online against each other.

Use our free Texas quote finder to request free Texas health insurance quotes now!

Texas Group Health Insurance Qualifications

With the amount of small to medium sized businesses emerging today, policies on who qualifies for Texas group health insurance had to change.  Now if you have at least 2 employees or officers, your business can qualify for Texas group health insurance.  If you have at least 50-300 employees, your business is considered medium sized, and anything over 300 is considered a larger business.

Products offered to groups had to be modified to meet the needs and budget of the small to medium sized business.  This opened the door to agents who specialize in meeting the Texas group health insurance needs of these groups.  These plans have voluntary and supplemental options.

Keep reading for more valuable facts about group health insurance in Texas.

Texas Group Health Insurance Plans

Texas group health insurance plans are more comprehensive than individual plans being that it serves multiple people.  Many groups use managed plans like:

  • HMO’s – Health Maintenance Organizations – co-pays, premiums and PCP’s (primary care physicians).
  • PPO’s – Preferred Provider Organizations – Preferred provider network.
  • POS’s – Point of Service – Network of providers at a discount where patients pay up front and reimbursed for qualified fees.

Managed health care saves insurance companies a lot of money in what their review board considers to be unnecessary procedures or specialty visits.  Provider networks are health care services at an agreed upon range of rates.  Even though Point of Service plans offer more choices, they are partially self funded and patients pay a higher deductible.  Other Texas group health insurance benefits include:

  • Health Savings Accounts – Tax free to offset high deductibles and auxiliary charges such as lab work & x-rays, dental, and vision care.
  • Health Reimbursement Arrangements – Reimbursement on qualified visits and procedures. Higher deductibles are paid by employers, and employees are reimbursed for charges via third party arrangement. 

Texas Group Health Insurance Includes Retirement Benefits

Most Texas group health insurance benefits offered by large corporations include retirement benefits like pensions, IRA’s (Individual retirement accounts), and 401k’s.  The Employee Retirement System of Texas (ERS) administers retirement health benefits to Texans who have worked for the state and other big corporations of Texas.

Retirement enrollment period is 7 months and includes 90 days before your 65th birthday.  Then depending on your retirement plan, a percentage of your medical expenses are paid by your Medicare part B plan.  Disability benefits also fall in this category.     

How To Make Texas Group Health Insurance Affordable

Groups can make Texas Group Health Insurance affordable by implementing a plan of action.  Employees can save on premiums if the employer insists on a few things.

  • Determining the minimum health care needs as a group.
  • Modifying comprehensive coverage to only necessary coverage.
  • Agreeing to higher deductibles – Consumer driven plans and costs shifting.
  • HSA’s – Making sure your company is eligible to establish Health Savings Accounts to help offset high deductibles.
  • Implementing wellness plans among employees. 

Where To Get The Best Texas Group Health Insurance Rates

The best place to research the best rates is online.  Then as a group it is best to speak to an agent regarding your choices.  The agent may not be very receptive to your request to dissect your options and modify more comprehensive plans to save premiums.  This cuts into commission.  As an employer your concern however, is to get the best premiums for your employees.

Group plans have guaranteed acceptance; therefore, there is a high risk pool that has to be financed.  Employees pay into this high risk pool to offset the risk.  The risks are:

  • Smoking
  • Obesity
  • Age
  • Cancer
  • HIV
  • Diabetes
  • Heart Disease

These risks are taken into consideration when establishing rates for groups.  The likelihood of creating a claim based on the abovementioned risk factors as well as others is high.  Underwriters take into consideration the number of employees as well as the type of business along with other factors when establishing rates for groups.

Compare Texas Group Health Insurance Quotes

Another way to get the best rates on Texas group health insurance is to click on the quote tool at the top of the page where you will be directed to information on the best companies and rates for your business.

Compare Texas individual health insurance rates against Texas group health insurance rates.

Get started finding Texas health insurance now!

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