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Texas Groups
For eligibility for group insurance products in Texas, clients must be headquartered in Texas and have a majority of employees in Texas.
Contribution
Employers must be willing to contribute a minimum of 50% of the employee cost and have at least 75% participation of their eligible employees.
Eligibility
Eligible employee means an employee working at least 30 hours per week and has no other health coverage.
Quotes
Insurance quotes are based on the information you provide. To obtain the most accurate quote, an employee census needs to be provided. Due to HIPPA privacy rules, it is not always possible to know about the medical conditions of your employees and their dependents. Quotes will be based on insurance carriers' base rates. Employee applications will be reviewed, and the final rate will be determined by the insurance carrier.
On small group insurance plans (2-50 employees), no one can be ridered or excluded for coverage. However, the insurance company can rate up your group to a maximum of 67% of the base rate for existing health conditions.
Pre-Existing Conditions
Whenever you apply for new insurance coverage, you will be subject to a 12 month waiting period for pre-existing conditions. However, if you have a "Certificate of Creditable Coverage" from your prior insurance carrier that shows you had other coverage in the prior 12 months (with no more than a 63 day gap in coverage) you receive credit for the number of months you previously had coverage. All employees must have proof submitted, or they must meet the 12 months waiting period.
State Continuation
The state of Texas has "State Continuation" which provides for continuation of the group plan for up to six months after an employee has terminated. The employee must have been on the group plan a minimum of 3 months to be eligible for State Continuation.
COBRA
COBRA rights are available to employees who terminate from a group who had 20 or more employees 50% of the time the prior calendar year. COBRA benefits are available for up to 18 months.
Benefits Plus Services
972-315-7431
972-315-6199 (fax)
Click here to email!
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