Providing health insurance coverage through a small business health plan often is more affordable than buying individual insurance coverage for yourself. Facts you should know for your insurance coverage needs:

• • At Least (1) Employee Needed to Qualify
  • Provided Coverage is Generally Guaranteed Issue
  • Contributions Must Be Made by You Towards Employee Premiums
  • You Have the Right to Shop for Coverage Throughout the Year

An average small business insurance plan provided by Texas Health Benefits, Inc. covering (5) people costs $1456 per month in Premiums. Average per person $291.

Learning the different types of coverage options available for health insurance is the best way to identify what plan is right for you and your organization. Below are common types of insurance plans that can be provided for your employee health benefits:

(HMO) Health Maintenance Organization: Plans provided for HMO insurance are affordable and comprehensive for the health coverage they can provide to you and your employees. The HMO Plans offer health coverage with relatively low out-of-pocket costs but most care must be performed in-network to avoid out-of-network costs.

• • Each Insured Member Must Select an In-Network Primary Care Physician
  • Referrals are Often Required to See a Specialist and Made by Your Primary Care Physician (PCP)
  • Your Out-of-Pocket Expenses are Normally Predictable and Often Limited to Low Annual Deductibles and Copayments for Doctor Visits, Other Covered Services.
  • Providers Vary in Numbers Given the Location of the HMO Network

(PPO) Preferred Provider Organization: PPO insurance plans often carry a higher premium than HMO but typically offer larger access to networks and provide your group members with more flexibility when selecting a care provider.

• • Your Insurance Members are Not Required to Choose a Primary Care Physician
  • They are Not Required to Seek a Referral to a Care Specialist from Their PCP
  • Members Have the Flexibility to Choose Any Doctor or Hospital Regardless of Provider Being Listed in the Plan’s Network – Costs May Vary or Increase Depending Upon Out-of-Network Care
  • Your Costs May Include for Out-of-Pocket Expenses: Annual Deductibles, Coinsurance and Copayments for Covered Services

(POS) Point of Service Plan: Hybrid plan that contains features of both HMO and PPO health plans. The Point of Service Plan typically is a midpoint in cost between HMO and PPO plans. The network for POS plans will vary by location.

• • Primary Care Physicians are Normally Required to be Selected by Members
  • Members are Normally Not Required to Seek a Referral to See a Specialist in POS Plan Benefits
  • Plan Allows for Flexibility for Members to User Provider Network for Some Services and Outside Network for Other Services
  • POS Out-of-Pocket Expenses are Typically Less When Members Stay in Network

Determine Your Needs for Your Business

You need to first be able to determine what needs your small business has for health insurance. Below, can help you get started:

• • Who Will Your Provide Coverage to at Your Business? Considerations must be made for not only the needs of your employees but also their dependents to find a plan suitable for your company’s community. Medical needs and financial needs of the group should be a part of this decision process.
  • What Percentage of Cost Sharing Can You Afford as a Business? Small business health insurance premiums are shared by both the employer and employee. You will need to determine what percentage as a business you will be willing to contribute for your employee health plans.
  • When Selecting Benefits What are Most Important for Your Employees and You? Inquiring about employee medical history is prohibited under federal privacy laws but it is still important to ask what types of benefits would be important to them. This is best practice to understand you are offering relevant benefits within your ability to provide necessary coverage.

Compare Your Health Insurance Options for Your Business

When you weigh the factors of your health insurance options there is much to consider. We believe at Texas Health Benefits, Inc there are 5 critical considerations you should focus on to find the solution to your health insurance needs.

• • Monthly Premium: How Much You and Your Employees Can Afford to Pay Monthly
  • Copayments, Deductibles and Coinsurance: Know What is Manageable for You and Your Employees When Receiving Medical Care in Regard to Out-of-Pocket Expenses
  • Provider Networks: Understand if You Have a Preferred Provider or Facility Already, They Will be Included in Your New Health Plan Selection
  • Coverage for Prescription Drugs: For Prescription Drug Price Comparisons Texas Health Benefits, Inc. Has the Ability to Help You Understand Costs for Certain Prescriptions
  • Add-On Coverages: If You Want to Add Vision or Dental Care to Your Plan THBI Can Ensure Your Employees are Fully Covered

• • The process to ensure your employees and their dependents are enrolled in your new health plan is where THBI excels in our relationship with our clients. Our agents will talk you through the entire process to make it seamless in your transition to the new selected coverage.
  • Premiums are dependent upon medical history of certain individuals within your group, but no employee will be declined coverage. When enrolling, be sure to answer any and all questions honestly to the best of your ability.