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Small employer health insurance guide

Some small employers in Texas offer health insurance to their employees.

Note: Texas insurance law defines a small employer as a business with two to 50 employees, regardless of how many hours the employees work.

If you provide health insurance, you must offer it to all 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.  

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. 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.

Learn more: How to shop smart for insurance

Paying premiums

The law doesn't require you to pay an employee’s health plan premiums. But your insurance company might require you to pay at least 50% of your employees’ premiums. You may pay a higher percentage if you want to.

Insurance companies may raise premiums because of changes in health care costs, the age of your employees, or employee tobacco use. They can’t raise premiums because of your employees’ health, though.

Coverage and benefits

Federal law requires small-employer plans to cover 10 types of health care services , called essential health benefits. Plans bought before March 23, 2010, and some plans bought before October 1, 2013, aren't required to cover the essential health benefits.

Texas also requires some plans to include certain benefits. Learn more on our Mandated health benefits page.

Insurance companies can’t deny or limit coverage to employees with preexisting conditions.

Workers' compensation insurance

Most employee health plans won’t pay for work-related injuries or illnesses. For that, you’ll need a separate workers’ compensation insurance policy.

Workers’ compensation insurance pays medical costs and some lost wages for employees who have work-related injuries or illnesses. It won’t pay for non-work-related injuries and illnesses or for routine health care.

Texas law doesn’t require you to have workers’ compensation insurance. But if you have it, you’ll be legally protected from some lawsuits and damage awards. For more information, read our  Workers' compensation insurance guide .

Learn more: Workers' compensation insurance guide .

Shopping for coverage

You can buy health insurance directly from an insurance company or agent.

Most insurance companies require at least 75% of your full-time employees to participate in your health plan. Employees who have other health coverage don’t count toward your participation percentage.

You can buy coverage at any time during the year. But if you don’t meet the 75% participation requirement, an insurance company can make you wait until the open enrollment period to buy coverage. The open enrollment period is from November 1 through January 15 each year.

Shopping tips

These tips can help you find the best value for your money:

How companies set premiums

Your employees’ health won’t affect your rates. Insurance companies can’t deny or limit coverage to employees with preexisting conditions.

Insurance companies consider the following factors when setting your premiums:

Keeping coverage after employees leave

Under state and federal law, most employees have the option to keep their coverage for a while after they leave their job. You must tell employees how they can keep their coverage.

Former employees who keep their coverage pay the full cost of the plan. You don’t have to pay anything toward their premiums.

The federal COBRA law applies to employers with 20 or more employees. The state continuation law applies to employers of any size.

Question? Call us at 800-252-3439.

Texas Health Insurance

Texas Department of Insurance (TDI) helps Texans make informed decisions about their health insurance. Learn how to find the right type of health insurance for you and your family. 

Need health insurance?

On this page, how health insurance helps, health insurance options, affordable health insurance, health marketplace: buying your own health insurance, related links.

Health insurance protects you before you get hurt or sick.  

If you get hurt or sick and need to go to the doctor, health insurance protects you from paying high medical bills.  

Health insurance is also called a health benefit plan. Health benefit plans cover preventative services like wellness visits, shots, and screening tests. These services help you stay healthy and avoid future health problems.

You can get health insurance through:  

If you own a small business with employees,  learn about small employer health insurance . 

Federal and State programs help people with limited or no money.  

Government health insurance and benefit programs have options for: 

Alternative health plans can help save money but may limit health coverage.  Learn more about alternative health plans .   

If you do not have health insurance, you can  contact your local community health center for assistance . 

These centers provide high quality, low-cost health care on a sliding fee scale to individuals and their families regardless of age, health, insurance, or immigration status. 

Insurance you buy from a company or the marketplace is individual insurance. It’s sold to individuals, not to members of a certain group.  

You can buy individual coverage through: 

Home » Blog » Business Insurance » The Texas Small Business Health Insurance Guide

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The Texas Small Business Health Insurance Guide

Interested in learning more about small business health insurance for Texas? Check out this guide with information on types and costs, plus where you can go to purchase health insurance.

Jesse Boyer

Merchant Maverick Contributor

health insurance plans for small business in texas

Small business health insurance in Texas doesn’t need to be daunting. With the flexibility of options available to employers and employees alike, it’s easy to incorporate coverage into your risk management plan.

In Texas, small businesses employ over 4.9 million Texans — 45.1% of the workforce. Many of those business industries are growing rapidly. Small business health insurance remains a decisive factor in attracting, retaining, and nurturing Texan talent as actions have been taken to broader its accessibility in recent years.

To understand the wide scope of health insurance for small businesses, check out our full guide here .

Keep reading about how health insurance for small business owners specifically works in Texas.

Table of Contents

Key Health Insurance Terms

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Health insurance refers to insurance policies that cover medical expenses. Small business health insurance is group insurance designed to meet the needs of a smaller organization that may not have a full HR department to organize health benefits. In Texas, small businesses utilize the government’s Small Business Health Options Program (SHOP) and purchase insurance through the federal health insurance website.

Health insurance protects people if they need medical care due to an illness or an injury. Preventative care such as routine check-ups and annual tests is usually covered, too. The amount of money a person might pay for a routine visit, surgery, or medical emergency will vary depending on the health plan.

In a perfect world, everyone would have health insurance. Illnesses and accidents are unavoidable as we journey through life. Even healthy people need regular visits with a doctor or coverage in case of an emergency.

According to Statista, Texas had the highest rate of uninsured Americans per state population in 2021. On a more positive note, that number is 16.1% as opposed to 19.1% in 2017, indicating that coverage for Texans is steadily expanding.

As you’re brushing up on health insurance, knowing these important terms will simplify the process:

Am I Legally Required To Provide Health Insurance In Texas?

If you are a small business owner with over 50 employees, you are legally required to offer insurance to your employees. If you are a small business owner with between two and 50 employees, offering health insurance is optional.

Even though you may not be  legally obligated to offer health insurance, offering health insurance can offer your business several benefits. In addition to your employees feeling happy, healthy, and comfortable working for you, you are eligible for tax credits and deductions if you pay at least 50% of employee premiums.

According to the Texas Government, “Texas insurance law defines a small employer as a business with two to 50 employees, regardless of how many hours the employees work.” Additionally, Texas law counts 120 hours done by part-time employees in a month as a full-time equivalent employee. Texas laws don’t require you to pay your employee’s premiums, although many insurance companies will require you to pay at least 50% of employee premiums.

Also, according to Texas law, if you offer health insurance to any employees, you must offer it to all employees who work 30 hours or more a week and all employees’ dependents.  You can make employees wait up to 90 days before they are eligible for health insurance benefits, and if employees don’t sign-up for insurance within a 31-day window, you can deny them insurance benefits until open enrollment.

Small businesses beware: if fewer than 75% of your employees participate in your health insurance program, most insurance companies will make you wait until open enrollment to begin your plan. Employees with individual health plans don’t count toward that percentage. Businesses with over 75% participation can enroll anytime.

Federal law requires small-employer plans to cover 10 types of essential health benefits. 

These benefits include:

An individual health insurance plan is a health insurance plan that an individual pays for and designs to fit their needs. One option for small businesses is to give employees a monthly sum and have the employee take control of where to purchase insurance. With the addition of the individual health marketplace, more people can invest in health insurance without the need to go through a group insurance plan. A group health insurance plan is where a group (namely, a company or business) buys insurance for members of that group at a reduced rate.

Health insurance is expensive and fluctuates with rising healthcare costs. For group health, premiums continue to rise, and employers require their employees to pay more for the financial burden.

Which Type Is A Good Fit For Your Business?

Group plans are great for businesses with a growing number of employees, especially those who might have families. The more people to cover, the more cost-effective a group plan will be. Also, you can negotiate rates if you have a young and healthy staff.

Small businesses looking for ways to save on health care may want to promote individual plans. With a defined contribution plan, tax-free money is given to an employee each month to spend on health insurance. More individualized care means that health money could be spent more efficiently.

Texans can access the federally-run marketplace at HealthCare.gov to see a list of insurance plans available in their state. As you start to shop, you will find that there are several specific health insurance plans for you to choose from. The main differences come down to:

Here is an overview of each major health insurance plan and what they mean for your small business.

Health Maintenance Organization (HMO)

An HMO is a type of health insurance plan with a network of doctors accepting your insurance. Your employees only have access to providers employed through the HMO and out-of-network care is often not covered (except in an emergency). The HMO provides a lower cost option to employees but lowers the choices of providers/hospitals where they can be treated.

The HMO plan is ideal for:

With an HMO, the insured must retain a Primary Care Physician and go through that doctor for referrals to specialists. That means this plan is not ideal for people who need care across a wider geographical area, such as people who travel. However, out-of-pocket expenses tend to be lower and more predictable.

Preferred Provider Organization (PPO)

A PPO is a type of health insurance plan where a network of doctors agrees to accept a set payment. Unlike the HMO, you aren’t limited to in-network provers, so you have access to any health provider you choose — out-of-network providers just cost more. You also do not need a referral for specialists. Since A PPO has the most choices, the premium costs are generally higher.

The PPO plan is ideal for:

The PPO plan is more choices for more money and with greater flexibility.

To learn about the other types of health insurance available, read our Ultimate Guide To Small Business Health Insurance .

How Do I Find Small Business Health Insurance In Texas?

Now that you understand your insurance obligations as a Texas small business owner and know how much health insurance will cost, where do you find health insurance?

Go to healthcare.gov and search for available plans in your area to see what’s available. According to healthinsurance.org, the participating insurance companies in Texas in 2023 include:

Note: Participants change yearly. Visit healthcare.gov for the most up-to-date information and providers.

The open enrollment period for coverage in 2023 was recently closed.

On November 1, open enrollment for individuals or companies with fewer than 75% of their employees will be available again. Open enrollment in Texas goes from November 1 to December 15 for businesses and up to January 15 for individuals.

Choosing the right plan for your business comes down to asking yourself the following questions: What kind of medical care do my employees need? How much money am I willing to put into health insurance? And, is choice or cost more important to my employees? 

In order to determine which policy will work best, decide how many of the upfront costs you are willing to contribute to your employee premiums and what kind of insurance options would be the best fit. Here are the biggest factors in health insurance costs:

Think about your employees, their ages, and their needs. With an outline of what best suits your employees, you’ll be able to sit down with an insurance agent or broker and determine how to get the best policies for the cost.

The cost of business insurance is always at the forefront of decisions as a business owner. The federal marketplace for small employers has categories of Bronze, Silver, and Gold plans. These plans are based on your employee’s age.

Here are some sample prices for ages, taken from the SHOP Marketplace data.

Prices are listed in order of bronze, silver, and gold plans, and rounded to the nearest dollar. This is the cost per employee, per month.

Choosing to insure the health of your employees is the right decision. Follow the steps to get insurance through the federal marketplace once you’re ready to buy a health insurance policy. Acquaint yourself with the terms of each insurance package and help employees understand their benefits, too.

It’s easier than ever to find a way to protect your health and the health of your employees with health insurance, so don’t be afraid to take the leap.

Even if you have just one employee and you want to insure them, we have a guide for health insurance for one employee. To learn more, check out our additional resources to help you understand health insurance for small businesses.

Health Insurance For Texas Small Business FAQs:

Small business health insurance is a type of health insurance employers can purchase that provides financial assistance to employees who need medical care for illnesses, injuries, and routine checkups.

You can get health insurance for your small business in Texas through healthcare.gov’s marketplace.

A small business has to provide health insurance in Texas when it has over 50 employees per federal law. Employees who work 30 hours a week or 120 hours a month are eligible for coverage.

In 2022, the penalty in Texas for not providing health insurance to qualified employees was $2,750 for the first 30 employees. Employers must cover 95% of their eligible employees, including their employees’ dependents.

The cost of providing small business health insurance to employees in Texas varies from $102 to $703, depending largely on their age and the policy type. Expect to pay an average of around $163 per employee.

The easiest ways to save on health insurance are paying your policy in full (if doing so provides a discount) and increasing your deductible, which is the money paid before insurance companies provide coverage.

You can find health insurance for your small business in Texas by going to healthcare.gov during the open enrollment period. It’s also possible to purchase plans directly from an insurance carrier or through a broker.

The types of business insurance you need for your small business in Texas will vary according to your specific business needs and risks. Generally, it’s best to start with general liability , workers’ comp , and commercial property insurance if you have a physical storefront, and then scale up from there.

Jesse Boyer

Latest posts by jesse boyer ( see all ).

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Sana Benefits - Texas Content

Sana

Texas Content

Small business health insurance in texas.

Small Business Health Insurance in Texas

Affordable. And built for Texas small businesses.

Everything may be bigger in Texas, but it doesn’t mean your health insurance costs have to be. Sana is based in Austin, Texas, and we offer comprehensive, flexible plans that fit most any budget. You’ll use Sana’s easy-to-use admin platform, your employees can see any doctor they want, and they’ll have access to free virtual doctors’ visits.

Sana plans in Texas

Sana vs. blue cross.

health insurance plans for small business in texas

We don’t do hidden fees. With Sana, your costs are transparent and predictable so you can budget with confidence.

health insurance plans for small business in texas

Forget out-of-network hassles and limitations. Our PPO Plus network is all-access, meaning you and your employees can choose any provider without out-of-network costs or referrals.

health insurance plans for small business in texas

Sana offers you access to high-quality providers and the ability to add dental and vision care to any plan. Video doctors’ appointments, mental wellness, physical wellness, maternity and pediatric care are all included.

health insurance plans for small business in texas

You own your plan, so you own your data. We give you access to modern tools that make understanding and administering your plan simple and transparent.

Texas does not require any company to offer health insurance benefits, although the Affordable Care Act (ACA) does. But not all companies are under the health care mandate. If your company has 1 to 50 full-time employees, you do not have to provide them with health insurance. However, offering coverage will make you a more attractive employer to employees evaluating their options.

Sana provides plans to businesses with five or more employees.

Establish your budget and objectives. You can streamline the process by working directly with Sana, so you don’t have to use brokers or third-party administrators. In addition to providing plan administration and claims adjudication, we’ve got a seasoned implementation team to help you onboard. Also, you are not required to wait until your current plan cycle ends. You’ll be able to transition mid-year with our team’s help.

Your costs will vary depending on the percentage of employee premiums you cover, the number of people you enroll, and whether you cover employees only or also their dependents. Your choice of plan also influences costs (and that of your employees).

Sana negotiates pricing with providers based on objective, industry-accepted metrics. Shrinking provider markups reduces the cost of care, making premiums more manageable. As a small business, you can deduct the cost of employee premiums from your federal taxes. You may also qualify for a tax credit.

Of course. The dashboard on our site allows employers and administrators to easily add new employees, update contact information, adjust benefits (such as when an employee has a Qualifying Life Event), or remove employees from the plan. Additionally, plan administrators can take advantage of Mineral (formerly ThinkHR) for free. Mineral provides plan administrators with a team of advisors for assistance with HR-related programs and tasks. They can get a compliant employee handbook with prewritten and automatic policy updates, and they can use an award-winning resource center.

See what our members say about Sana

“Thank you for everything that you’ve done for me! You made what could have been a difficult and stressful insurance process into one that is manageable. You took the time to explain everything to me and went out of your way to contact my providers. On top of that, you are one of the sweetest, kindest people I’ve had the pleasure to work with.” Kristi, Member
“We have been loving Sana, the customer service and coverage are both wonderful. You guys have been a breath of fresh air…health care carriers have always been a thorn to work with. So, working with y’all has been professional, efficient, and personable. Appreciate all you do!” Beth, Member
“We definitely reduced our cost in health insurance by about 40%. It was a big savings and a no-brainer.” Brian, Member

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Lowest monthly SHOP health insurance premiums in Texas

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Best Small Business Health Insurance in Texas

by Misty Berryman | Sep 17, 2022 | Group Insurance , Health Insurance , Small Business Insurance | 0 comments

Best Small Business Health Insurance Plans in Texas

Small Group Strategy #1: Do Nothing – Leave Your Employees to Fend for Themselves

If you have fewer than 50 employees, you’re not required by law to provide any coverage, so why should you bother?

Well, I just touched on one of the most important reasons. If you don’t do something, your current and potential employees may not hang around very long. They’ll find an employer who cares enough to offer at least something in the way of healthcare coverage.

Why does access to healthcare matter so much to employees and job hunters today? There are many reasons, but the most important include:

So, as you can see, doing nothing isn’t really an option. The good news is that even very small, cash-strapped companies can afford to offer something in the way of healthcare coverage. Your three real options are small group health insurance plans, small group health sharing plans, and health reimbursement arrangements, but they’re not the same. I’ll help you understand all three and what each offers your business (and your employees).

Small Group Strategy #2: Small Group Health Insurance Plans

So, now that we’ve done away with the myth that doing nothing is a viable option, let’s explore your first real choice – small group health insurance plans. What are they? How do they work? Why consider going this route?

Small group health insurance plans are available from quite a few carriers in Texas. They’re offered to groups of two to 100 employees, as well, so very small businesses can benefit, but companies with over 100 employees will have to consider something else.

Group health insurance remains the most popular way for small businesses to offer health benefits to their employees. And, if your business has fewer than 25 employees, you might be eligible for a small business tax credit, potentially saving you up to 50% of your total contributions here.

How do these plans work? First, you’ll need to compare your options and then choose a carrier. Once you have a carrier, you’ll need to pick a policy plan. Based on that plan, you’ll pay a fixed premium for every enrolled employee within the plan (your employees may elect not to join the plan, particularly those who are covered by a spouse’s plan with better coverage).

Each employee will pay their share of the premium from their paycheck. They will be covered by the plan as long as they are enrolled and employed. If they choose to leave the plan, they lose coverage. If they leave employment with your business, they also lose their coverage.

Small group health insurance plans work just like those purchased on the individual market. The benefit here is the ability to offer cost-effective coverage in most cases. You may also find that your small group plan is qualified for an HSA – health savings account – which can allow employees to use their healthcare plan as an additional savings vehicle, similar to a 401(k) or IRA.

Small Group Rules and Requirements

Most groups require participation of at least 70% of your workforce, during most of the year.

There is an open enrollment period that runs from 11/15 through 12/15 every year allows groups of any size to get the coverage they need, even if you don’t have the 70% participation rate required.

You are also able to set your waiting period before a new employee can enroll in the plan. Most employers choose to go with a 30-day period, but you can customize the duration to meet your specific needs.

Request a Group Quote for Your Small Business

The pros and cons of small group health insurance plans.

While there’s a lot to love about small group health insurance plans for Texas small businesses, there are a few drawbacks, too. Let’s check out the pros and cons.

So, there you have it. Small group health insurance plans are the most popular option for small businesses in Texas, and they can offer quite a few benefits. However, they’re not perfect and they’re not the right solution for all situations. Now let’s explore HRAs and what you need to know about them.

Small Group Strategy #3: Health Reimbursement Arrangement (HRA)

HRAs enable you to reimburse your employees for the cost of their individual health insurance, tax-free.

In this situation, you let your employees choose the plan that works best for them (an individual plan purchased on their own) and then you reimburse them for a portion of the costs of that plan. Most employers choose to use that reimbursement to cover their plan premiums, but there are other options, including using them for dental insurance, covering out-of-pocket costs, vision insurance, and more.

The primary benefit of an HRA is that it can be incredibly flexible. Whereas small group health insurance plans lock employees into a very rigid structure with little ability to customize their care, HRAs offer the opposite. Employees can choose a plan that offers precisely the coverage they want and need, and each employee can customize their health insurance.

That flexibility carries over to the employer, too. For instance, as a Texas small business owner, you get to decide how much to contribute each month and you don’t have to be concerned about unexpected cost fluctuations.

Both employers and employees appreciate HRAs for what they do best – allow individuals to customize their coverage while saving money and preventing them from being locked into a rigid plan that doesn’t meet their needs.

The Pros and Cons of Health Reimbursement Arrangements

As with small group health insurance plans, HRAs also have their pros and cons. Let’s look at how they stack up.

In the end, HRAs offer flexibility and individuality. They empower both employers and employees, too. However, they’re not necessarily the right solution for all small businesses in Texas. Now, let’s cover your final option – small group health sharing plans.

Small Group Strategy #4: Small Group Health Sharing Plan

Now it’s time to discuss what might be the most interesting of the three options for small businesses in Texas seeking ways to offer health insurance to their employees: small group health sharing plans.

Before we dive into the specifics of health sharing plans for small businesses, it might be helpful to explain the basics, since healthshares are available for consumers and businesses alike. So, what’s a health sharing plan?

It’s exactly what it sounds like – a group that comes together to share the costs of medical care for members. It’s a cost-sharing program, not health insurance. You can think of them like co-ops, and they’re increasingly popular with people across the US as healthcare costs continue to rise and the complexity involved with insurance increases.

You’ll also find that many of these plans are based around the idea of people of the same religious faith helping one another out. These so-called health care sharing ministries (HCSMs) usually reserve membership for those who share their specific faith and may not share the costs of procedures that don’t align with their faith or medical care for conditions sustained in activities not condoned by their faith.

With that being said, the healthshare model has become so popular that non-faith-based options are springing up. These provide the same cost-sharing benefits found with HCSMs, but they do not limit membership to a specific body of believers (or to any particular belief in the first place), nor do they place religious-based prohibitions on procedures or treatments.

How do health sharing plans work, though? In exchange for a monthly contribution, health share plan members can have their medical expenses shared across the group and paid for a fixed-price reimbursement model.

Is a health sharing plan the right choice for your business? If there are not a lot of serious pre-existing conditions (that could have waiting periods before sharing begins), it could be a very affordable way to provide excellent benefits to your employees.

The Pros and Cons of Health Sharing Plans for Employees

Like small group plans and HRAs, health sharing plans come with some pros and cons.

Compare Pricing on the Best Healthshare Plans Available

We help small businesses who don’t currently offer benefits find very affordable ways to do so. We also help businesses with high group health insurance premiums find ways to lower their costs while still keeping their employees happy.

Schedule a phone conversation with one of our Personal Benefits Managers to discuss your options as a small business owner. If you are considering an HSA or a healthshare plan, you can click here to get a quote on individual plans.

Here are some additional articles on small group health insurance programs: The Most Effective Healthcare Strategies for Small Businesses With Less Than 50 Employees | 6 Best Small Business Health Insurance or Healthshare Plans in Ohio

about-us-misty-300x300

Hi! I’m Misty Berryman, and I’m one of your Personal Benefits Managers. I like working with  HSA  for  America because we’re creating solutions to healthcare problems. Our focus on money-saving alternatives like HSA plans and health sharing programs, and the variety of health share programs we offer, are what set us apart. Read more about Misty on her Bio page .

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  1. Small employer health insurance guide - Texas Department of ...

    Note: Texas insurance law defines a small employer as a business with two to 50 employees, regardless of how many hours the employees work. If you provide health insurance, you must offer it to all your employees who work 30 hours or more each week. You must also offer coverage for their dependents.

  2. Texas Health Insurance | Texas.gov

    Health insurance is also called a health benefit plan. Health benefit plans cover preventative services like wellness visits, shots, and screening tests. These services help you stay healthy and avoid future health problems. Health insurance options You can get health insurance through: Your employer if they offer health insurance.

  3. Health Insurance For Texas Small Businesses Explained 2023

    Small business health insurance is group insurance designed to meet the needs of a smaller organization that may not have a full HR department to organize health benefits. In Texas, small businesses utilize the government’s Small Business Health Options Program (SHOP) and purchase insurance through the federal health insurance website.

  4. Texas Small Business Health Insurance Plans | Sana Benefits

    Sana offers Texas small business health plans that allow for predictability and control while cutting your costs – all without sacrificing quality care. Sana Primary care visits $25 Urgent care visits $25 Specialty care visits $50 Emergency room $200 No out-of-network fees 95% customer satisfaction Free virtual care visits on most plans

  5. Texas | HealthCare.gov

    Texas | HealthCare.gov Lowest monthly SHOP health insurance premiums in Texas Below is a snapshot of the lowest SHOP premiums available in Texas. Employers with between 1 and 50 full-time equivalent employees can offer insurance through SHOP. Premiums shown are total costs per employee per month.

  6. Best Small Business Health Insurance in Texas – HSA for America

    Small group health insurance plans are available from quite a few carriers in Texas. They’re offered to groups of two to 100 employees, as well, so very small businesses can benefit, but companies with over 100 employees will have to consider something else.