Texas Employer Health Insurance

Employers in Texas are able to save, find, compare, and enroll in group health insurance with Sanus Benefits. All throughout Texas the Sanus Benefits Portal gives you access to unique, affordable and comprehensive health insurance options. In fact we even have Unique Association Health Plans avaliable in Texas such as the Association of General Contractors Health Plan. We include all plan types in our quoting such as: Fully Insured Health Plans, Level Self Funded Plans, Self Funded Plans, Limited Benefit Plans, and Reference Based Pricing Options. Depending on your group, any one of these options could be a good choice for you and your employees. Your personal local Texas Group Health Insurance consultant will be able to guide your group through quoting and insure you receive quotes from plan options that would most benefit your populace.

The first step in saving on your group health insurance is to get a quote. The quoting process is simple and easy for most Texas Employers. You will need to provide your census information, and preferbally claims and renewal information as well. We streamlined this process for you via the Sanus Benefits Portal. It generally takes less than 5 minutes to quote all various carriers after census is uploaded.
As I mentioned earlier, we offer unique plan options to specific areas of Texas as well making the Sanus Benefits Portal the best option for Texas Employers. After you request a quote, you will be brought to our unique health insurance quote page that allows you to compare all carriers in Texas side by side. We are the only customer facing online quoting portal currently in the market and have perfected the entirety of the process from start to finish. Not only do you have the ability to review, analyze and price compare health insurance options but all other group benefits as well. After you select which plans to move forward with, the Sanus Benefits Portal creates a benefit packet on your behalf which you can pass out to start online enrollment immediately.

Texas Employee Benefits Quoting Considerations

Below are all of the various Considerations you need to take into account in additon to price when making a decision on Health Insurance for your Group in Texas.

Texas Employee Benefits Compliance

When offering group Health Insurance in Texas there are certain mandates you need to adhere to just as across the country. The most notable of these mandates is the ACA (Affordable Care Act). The ACA requires all employers with 50 or more full time equivelent employees to offer health insurance to their employees. Notice it does say equivelent, part timers are added together for the purpose of calculating whether or not your group is considered a 'Large Group'. The ACA also requires that all plans offered to employees are ACA compliant. This means that all plans offered to employees must cover the 10 essential health benefits. These benefits include: Ambulatory Patient Services, Emergency Services, Hospitalization, Maternity and Newborn Care, Mental Health and Substance Use Disorder Services, Prescription Drugs, Rehabilitative and Habilitative Services, Laboratory Services, Preventive and Wellness Services, and Pediatric Services. In addition to the ACA, there are other reporting and compliance requirements that need to be met. Such as 1094/1095 Reporting, HIPPA, Mandated Notices, and much more. Employers can rest easy with Sanus Benefits, we provide: Benefits Booklet w/ All Required Notices, Regular Compliance Updates, HIPPA certified Consultants Avaliable to Employer & Employees, Employee Coverage Tracking, and all other Compliance documents.

Network Of Texas Doctors And Plan Types

There are variety plan types and networks for employer health insurance in Texas. It is hard for employers to decipher their meaning and the best option for their group. There are PPO, HMO, and EPO plan types. PPO Health Plans are the least restrictive of these options. PPO plans generally have affordable copays, and a wide selection of providers/doctors. If your employees are adamant on using their doctor then I highly recommend a PPO option. Unlike the other options, PPO plan types even offer coverage for Out of Network Providers. EPO plans generally have the same network size as PPO plans (They use the same in-network doctors). However EPO Plans, do not offer out of network coverage. HMO plans are the most restrictive of the three plan options. HMO plans sometimes require employees to designate a primary care provider, and only go to specialist he/she recommends. However, not all HMO options have this restriction. Either way, HMO networks are the smallest in comparison with EPO and PPO plans. In addition to having the smallest network, HMO plans like EPO plans do not offer coverage to out of-network providers. This is just a quick synopsis of differences. To get exact details on your plan type I would recommend reviewing the SBC (Summary Of Benefits And Coverage). The SBC will show your coverage details, and plan type. The other aspect is the network of doctors/providers. Some carriers have a larger network than others and some have access to premimer providers in a certain area while others do not. The Sanus Benefits Quote Tool will allow you to quickly access each plans network for an indepth comparison. This will also insure you are checking the right network for each plan you are reviewing.

Texas Health Insurance Carriers Quoted

The Texas Health Insurance industry is very competitive and complex. The most affordable Health Plan in Austin, Texas can very well be the highest costing plan in Houston, Texas. Price is not the only difference, some carriers are not available statewide or use an alternative network when out of their coverage area. Like Memorial Hermann for example, they offer coverage to only Houston headquartered businesses. If employees are outside of Houston, they use the PHCS network. These are important aspects of the market that Groups in Texas should takes careful note of. Also, you should make careful note of how many carriers you receive quotes on and why. 10 years ago this was a non important factor, because there were only 4 carriers avaliable. Now there are over 10 Health Insurance Carriers avaliable with some areas having even more. They all use different underwriting methods and various plan options, unqiue cost saving features, different networks and other exclusive benefits to each. With the additional complexity being added each year, and the numerous opportunities to make a mistake it is apparent an online solution is needed to keep everything in line.

Our comprehensive Texas Employer Health Insurance Market Reivew via our group quoting portal will include these details and more to make sure you receive the best deal for your wallet as well as your health.

Health Insurance Funding Types Avaliable in Texas

Not only do employers need to be aware of the plan types (PPO, HMO, EPO) they also need to be cognizant of the funding type. This is a term you do not hear from most consultants but it is very important. In Texas, there are Fully Insured plans, Level Self Funded Plans, Self Funded Plans, and Reference Based Pricing plan options. All of them can meet the ACA coverage requirements some have more customization then others. What are the main differences with these funding options?

Fully Insured Plan Options

  -   these options comply with both state and federal mandated benefits. Meaning all plan options are required to offer all State and Federal coverage requirements. These plans are subject to community rating on groups under 50 employees. Community rating means that your group is strictly rated based off census information (Age/Gender/Residential Zip Code) that is it. Because of the limitations in information they can gather, the rates sky rocket. There is no way to differentiate a healthy group from a sick group using this option. This leads to extremely high premiums for very crappy plans.

Level Self Funded Plan Options

  -   involves the employer taking on more risk for claims than a fully insured plan. However, it provides more financial predictability and lesser risk than paying claims directly, like a typical self-funded plan. To quote this plan option, an actuarial firm reviews an employers prior claim experience, and generates a rate for the group based off claim estimations for the next year. This rate includes a claim fund, administrative expenses, and network costs. These plan options often offer a refund at the end of the year if your group has lower claims than anticipated. They are also generally more affordable than fully insured options for groups under 50 employees, or groups over 50 with limited participation.

Self Funded Plan Options

  -   these options are often best suited for employers with a substantial amount of savings set aside for claim payments. These plans offer the most flexibility with coverage types, and plan set up. As well as offer claim details that you are unable to pull from the carrier directly. However they do require more work to maintain. There are numerous cogs so to say in a self funded plan option. You will need to 'Rent a Network', find a reliable Claim Administrator, Quote various Stop Loss options (As well as understand what stop loss coverage is), assess the amount of risk your employer is willing to take on, and find a reliable broker that quotes these various options year to year to verify you are still receiving the best price (Sanus Benefits). We also offer a quarterly review to discuss prior claims and simple strategies self funded employers can take to lower future claim costs.

Reference Based Pricing Plan Options

  -   these are plans without a network. Instead of paying set network prices, they pay at a percentage of Medicaid. According to carriers that offer these options, 95% of providers take the payment without issue. In the case of a provider not accepting the slightly higher percentage of what medicaid pays, the carrier has a negotiation team that calls and works out the lowest price they are willing to accept. While this option offers the most saving potential, they are often too difficult to administer.

This is just a quick summary of each funding option. To review some of the larger carrier plan types avaliable review below. *Please note this is not all carriers avaliable in Texas. If you would like to see all Carriers create an account.

Texas Health Insurance Plan Types

Carrier	Available Statewide	Fully Insured Plans	Level Self Funded Plans	RBP* Plans
Blue Cross Blue Shield	Yes	Yes	Yes (Blue Balance)	No
United Healthcare	Yes	Yes	Yes (All Savers)	No
Humana	No	No	No	No
Aetna	Yes	Yes	Yes	No
Cigna	Yes	Yes	Yes	No
All State	Yes	Yes	Yes	Yes
Memorial Hermann	No *Houston	Yes	No	No
Association of General Contractors Health Plan	Yes	Yes	Yes	No

*RBP - Reference Based Pricing

Texas & US Employer Health Insurance Statistics

Below you will find a table demostrating the changes in Employer Health Insurance from 2009 to 2020. The data is based on the Kaiser Family Foundation Employer Health Benefits Survey. The data is broken down into Small Employers (1-199 Employees) and Large Employers (200+ Employees). In comparison at the bottom is the rate of change year to year for Sanus Benefits Portal Users. Giving a clear picture of how Sanus Benefits assists groups throughout Texas in saving on their Health Insurance.

*Based on Kaiser Family Foundation 2019 Employer Health Insurance Stats
**Based on Sanus Benefits Current Clients.

Employer Medical Premium Overview

So what inferences are we able to make from the above statistics? The obvious glaring issue/inference is the dramatic rise in premium with Health Insurance for all Employers. How is healthcare going to continue to be affordable for groups if the premium increase has been 50% in overall premium in the past 11 years? A sizable portion of the increase can be attributed to the Affordable Care Act (Enacted March 23 2010), which standardized Minimum Coverage Standards, and made sure groups with High Claimaints receive rates even given signficiant claim spend. However that is not the only cost driver by far. The 2019 Employer Health Benefits Survey by Kaiser Family Foundation, found that premiums are increasing by an average of 4-5% each year. Which is surpassing the rate of inflation ( 1.81% 2019) and wage growth (4% 2019). This is a conundrum which has no easy answer. Most groups just cut the benefits more and more each year which is why you see the increase in deductible, or they force the employee to pay more to participate. Keeping your group healthy year to year is a hard task for anyone. However, the Sanus Benefits Portal can immensenly help your group. We give employees access to their benefits year round and in depth information to make sure they utilize their plan to its full extent. Additionally, we provide live chat to your employees at anytime as well with a benefits consultant. Which is someone that is well versed in your coverages.

Finding Affordable Health Insurance in Texas

The fastest way Texas Groups can lower their health insurance is by using the Sanus Benefits Portal. Our quoting process takes an average of 0-7 business days. We then come out to discuss the market review options in detail or you can review online and hold a meeting via zoom to discuss options. Our Employee Benefits Quoting Portal has details and plan specs that are essential in making benefits decision as detailed in this article. As well as giving you direct comparisons to your current options for a quick and easy decision. This portal does not just save Texas Employers on Health Insurance but also Dental, Vision, Life, and Disability. To start the quoting process please click the quote request button below, and you can follow the easy steps in requesting a quote within 10 minutes from all avaliable carriers in your market.