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Critical Facts About Offering Employee Coverage in 2024


Health insurance has become a highly valued benefit, and many employees look for it when evaluating potential employers. For Texas-based small businesses, the question of whether offering health insurance is a requirement, and what benefits it can bring, is essential to consider. This article clarifies whether small business health insurance Texas laws require small businesses to provide health coverage, explores the benefits of offering it, and shares tips for navigating the available options.

Are Texas Small Businesses Required to Offer Health Insurance?

In Texas, as in most other states, small businesses with fewer than 50 full-time equivalent (FTE) employees are not legally required to offer health insurance. The Affordable Care Act (ACA) mandates that only businesses with 50 or more FTEs must provide affordable health insurance to at least 95% of their full-time employees or face potential penalties. However, even though there’s no federal or state mandate for small businesses with fewer than 50 employees, offering health insurance can still provide significant advantages.

Why Many Texas Small Businesses Choose to Offer Health Insurance

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Though not legally required, many small business owners in Texas choose to offer health insurance for several reasons. These include competitive advantage, employee retention, tax benefits, and overall employee well-being. Let’s explore these in more detail:

  1. Attracting and Retaining Talent: In a competitive job market, offering health insurance helps small businesses attract skilled employees. Health benefits are often a top priority for job seekers, and having a good benefits package can make your business stand out.
  2. Tax Benefits and Credits: Small businesses in Texas may qualify for the Small Business Health Care Tax Credit if they meet specific criteria. This credit can cover up to 50% of the cost of premiums, making it more affordable to provide coverage. To qualify, businesses must have fewer than 25 FTE employees, pay average wages of less than $56,000 (as of 2024), and contribute at least 50% of employee premium costs.
  3. Employee Satisfaction and Productivity: When employees have access to health insurance, they’re more likely to prioritize preventive care and address medical concerns promptly, leading to fewer absences and improved productivity. Offering health insurance can also boost morale and create a positive work environment.
  4. Reduced Turnover: Employees are more likely to stay with an employer that offers health benefits. High turnover can be costly and time-consuming for small businesses, making health insurance an investment in long-term employee stability.

Health Insurance Options for Small Businesses in Texas

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Texas small businesses can choose from several types of health insurance plans tailored to different budgets and needs. Here are some of the most common options:

1. Traditional Group Health Insurance

This type of plan, usually provided through a group health insurance provider, offers comprehensive coverage to employees. Premium costs are often shared between the employer and the employees, with employers generally covering at least 50% of premiums. This option is popular among small businesses due to its simplicity and broad coverage options.

2. Health Reimbursement Arrangements (HRAs)

HRAs allow employers to reimburse employees tax-free for qualifying medical expenses and health insurance premiums. Small businesses that don’t want the full responsibility of managing a traditional health insurance plan can use HRAs to offer flexible support to employees who purchase their own health coverage.

3. Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

A QSEHRA is a type of HRA specifically for small businesses with fewer than 50 employees. This arrangement allows businesses to reimburse employees for individual health insurance premiums and certain medical expenses up to a specified annual limit. QSEHRAs are a great option for Texas small businesses that want to offer health benefits without committing to a traditional group plan.

4. Small Business Health Options Program (SHOP)

The SHOP marketplace, part of the ACA, allows small businesses to offer health insurance to their employees while potentially qualifying for the Small Business Health Care Tax Credit. In Texas, employers with fewer than 50 full-time employees can use SHOP to compare and select plans, making it easier to manage employee coverage.

5. Association Health Plans (AHPs)

Some Texas small businesses may be eligible to join Association Health Plans, which allow small businesses within certain industries or professions to band together and obtain health coverage as a group. This can lead to cost savings by providing the small business with the buying power of a larger group.

Factors to Consider When Choosing Small Business Health Insurance Texas

If your small business decides to offer health insurance, here are some important factors to consider:

  • Cost and Budget: Understand the premiums, deductibles, and out-of-pocket costs for each type of plan to choose one that fits your budget.
  • Employee Needs: Survey employees to learn about their healthcare preferences and whether they prefer comprehensive coverage, lower premiums, or access to specific providers.
  • Tax Incentives: Explore potential tax credits and deductions to see how they can make offering health insurance more affordable.
  • Provider Network: Make sure the plan’s network includes accessible and quality healthcare providers to meet your employees’ needs.

Benefits of Consulting a Health Insurance Specialist

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Choosing the right health insurance plan can be overwhelming. Working with a specialist in Texas can help simplify the process. Health insurance brokers can provide insight into different plan types, assist in navigating tax benefits, and help you find cost-effective coverage tailored to your business needs. Partnering with an expert can also save time and help ensure your business is fully informed about the latest options and regulations.

Final Thoughts

While Texas small businesses with fewer than 50 employees are not required to offer health insurance, doing so can bring significant benefits. Health insurance enhances your competitive edge in the job market, supports employee health and productivity, and potentially reduces turnover—all contributing to the overall success of your business. With various flexible options, from traditional group plans to HRAs and SHOP, Texas small businesses have more options than ever to offer quality healthcare to their teams.

If you’re ready to explore small business health insurance Texas options, contact Custom Health Plans today. Our professionals will guide you through the process, helping you find the best solution to keep your business and employees thriving.

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