Archive for October, 2011

Affordable Health Plans for Small Employers (Texas only)

// October 21st, 2011 // Comments Off on Affordable Health Plans for Small Employers (Texas only) // General Benefits Information

HEALTHY TEXAS – Affordable health insurance for small businesses

HealthyTexas is a new set of employer based insurance plans offered by United Health Care and Celtic Insurance. They were designed to assist small business owners in offering more affordable health insurance for their employees and families. The plans are sponsored and partially funded by the State of Texas. They include all of the benefit requirements that are part of the 2010 federal health care reform.

In order to make the plans more affordable some of the standard guidelines that you may be familiar with have been slightly modified. Premium rates are determined by age, gender, and residential zip code. Unlike standard major medical plans there is no medical underwriting allowed for the HealthyTexas plans. Also, unlike standard major medical plans, the participation requirements drop from 75% of benefit eligible employees to 60%. This makes it a little easier for a group to get enough participation to qualify for the program.

What companies are eligible to enroll?
• Employee size between 2 and 50
• Have not provided group health insurance in the past 12 months
• Must be located in Texas and employees must all reside in Texas
• At least 30% of employees must receive wages at or below 300% of the federal poverty level which for 2011 is $32670
• Employer is still obligated to pay 50% of the employee’s cost
• Employer must offer dependent coverage but is not obligated to pay any of the cost for covering dependents
• Employees must be a US citizen or an alien lawfully present in the US.

What are some of the benefits of the plans?
• $25 copayment for most physician services
• 100% coverage for Preventative care as required by new federal healthcare reform law
• 80% coinsurance for hospitalization and surgery
• Network only savings
• Prescription drug plan $10/$25/$50 ($200 and $500 annual deductible)
• Optional coverage available: Dental, Life and Vision

Rosemarie Swaim- BenefitsMart LLC
817 565-8558
Or at

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