If your business employs 2-50 people (including you), it may qualify for a special type of affordable small group health insurance. Employees’ current health conditions and medical histories will not affect eligibility or the cost of monthly premiums, to participate or renew for future coverage. The rates are merely based on employees’ age, gender, and zip code. There are no health questions to answer on the application. That could make a significant difference for some folks!
To be eligible, the business must be located in Texas, and the employer must not have provided group health insurance for at least 12 months prior to applying. A minimum of 30% of eligible employees must receive annual wages no greater than $32,670. At least 60% of eligible employees must participate in coverage. The employer must pay at least half of the monthly premium costs for covered employees, but can elect to pay 100%, if so desired. Covered employees must be United States citizens or nationals, or aliens who are lawfully present in Texas.
All eligible employees must work at least 30 hours/week. They may be a sole proprietor, a spouse, or a partner in the business. They must not be considered temporary, seasonal, or substitute workers. If an employee is covered by another group plan-such as a spouse’s health plan, he/she would be ineligible. Also if they choose not to be covered under the employer’s health plan, but instead are covered by Medicaid, Medicare, CHAMPUS, or another Federal program, they are ineligible. Additionally, coverage on a benefit plan from another country makes one ineligible.
An employer has the option to offer coverage to part-time employees, but these employees do not count as “eligible” for determining the employer’s status as a small business. Dependents of employees can be covered through their spouse, but the employer is not obligated to share any related additional cost for those dependents. The additional premium for dependents is the financial responsiblity of the employee only.
Several excellent major medical plans are available with deductibles from $500-$2,500. Benefits include coverage for: doctor office visits, maternity, hospital inpatient/outpatient/emergency room services, psychiatric services, and prescription drug copays. (Did you know that individual and family health insurance plans in Texas normally do not cover maternity?) A vision plan is also included at no charge.
Employees will receive their allowable benefits ONLY IF they use “In-Network” providers and facilities. It is important to see if your preferred doctor accepts this health plan, if you intend to continue your health services with him/her. Otherwise, you might have to find a new primary care physician or specialists.
For detailed information or to apply for coverage, contact AustinHealthPlans.com at (512) 535-3556 or send an e-mail to: firstname.lastname@example.org . This plan would be great for a married couple who own their own small business and are considering starting a family. The rates are very reasonable and you cannot be declined because of pre-existing conditions or poor health!