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Group Health Insurance

Small employers can choose whether to offer health insurance to their employees. Texas insurance law defines a small employer as a business with 2 to 50 employees, regardless of how many hours the employees work.

Businesses with fewer than 50 full-time equivalent employees don't have to pay a penalty for not providing health insurance. Federal law defines a full-time employee as one who works at least 30 hours during a typical week. The law counts each 120 hours worked in a month by part-time employees as one full-time equivalent employee.

If you provide health insurance

If you provide health insurance, you must offer it to all of your employees who work 30 hours or more each week. You must also offer coverage for their dependents. Business owners can enroll in their small-employer health plan if at least one of their employees also enrolls. The employee can’t be a business owner, partner, or family member.

You must give new employees at least 31 days from their start date to enroll in your health plan. If they don’t enroll during this period, you can require them to wait for the next open enrollment period to join. The open enrollment period is from November 1 through December 15 of each year. Some employees might have a special enrollment period if they have a life change, like getting married, having a baby, or adopting a child.

You can require employees to wait up to 90 days after they enroll in the health plan for their coverage to start. The insurance company may not charge a premium during this period.

The law doesn't require you to pay an employee’s health plan premiums. However, many insurance companies require employers to pay at least 50 percent of their employees’ premiums. You may pay a higher percentage if you choose. Insurance companies may raise premiums because of changes in health care costs or the age of your employees. They can’t raise premiums because of employees’ health.

We can help you:

  • understand the different plans, and how they work;
  • choose the right carrier to meet your needs;
  • consider factors other than cost;
  • understand the difference between worker’s compensation and health insurance.