Most people are generally covered under the group health plans provided by their own employer or by the spouse’s employer. Whichever way, coverage provided under the group insurance programs not only serves to control the medical expenses of employees, but also provides them with the security and peace of mind, which goes a long way in ensuring their loyalty towards the company.
Group plans can be broadly classified under small employer plans and large employer group plans. Texas government has made some provisions for the small employer group plans in that they do have to have to cover state mandated benefits that are to be covered by the large employer companies.
It is also important to point out that it is not mandatory for the employers to provide group health coverage. Also, the companies are not required to pay the premiums on behalf of their employees.
Small Employers Group Plans: To benefit from the small employers plans, the company should have between two to fifty employees. Another thing is that they should be full time employees putting in at least 30 hours of work every week. Part time or contractual employees are not eligible under this plan.
Large Employers Group Plans: To benefit from these plans, the company should have more than fifty employees. Also, another precondition is that the company should not be self funded or funded through organizations such as the churches, trade unions or any other professional organizations.
Being covered under the group plan makes sense because of the large number of employees involved. This is beneficial in the sense that the insurance company can give more coverage at reduced costs. Also, you can choose your priorities in your own group plan and another set of priorities in the plan of your spouse if he or she is also being covered through group plans that cover spouses also.