Best Health Insurance for Small Business in Texas

Health Insurance Companies that Offer Small Businesses Insurance in Texas  

If you own, or work within a small business, you may be curious about your health insurance options. The first being, are there any? You will be relieved to know there are several options.

The Texas Department of Insurance defines a small business as an employer with between 2 and 50 employees. The number of hours an employee works is not factored into the equation. Here are a few additional factors small businesses must take into consideration:

  • If an employer offers insurance to an employee, they must offer coverage to all employees who work over 30 hours and their dependents.
  • Some employers require a 90-day wait period after employment to enroll in benefits. Otherwise, an employer has 31 days to enroll an employee in the health plan, or they must wait until the next Open Enrollment opportunity.
  • When purchasing health insurance, companies will require 75 percent participation to issue small business coverage. This does not include employees who have insurance from another source, such as a spouse.

Understanding Small Business Insurance

As we go through our review, here are a few definitions to know when shopping for your Small Business Health Insurance:

Indemnity Insurance – This is a form of insurance that does not have a network of doctors. You can go anywhere you choose. With that, the insured is the one who files the claim, not the doctor. The insurance company also has a schedule limit that it will pay for each type of procedure. When you submit your claim, if your claim is above this amount, you will be responsible for the overage.

Supplemental Insurance – A form of insurance that usually pays a lump sum amount to the insured when a covered incident or other event, such as a diagnosis, occurs. Examples of Supplemental coverage include Critical Illness, Accident Insurance, and Hospital Indemnity.

HSA Health Saving Account – These types of accounts are paired with High Deductible Health Plans (HDHP). An insured can contribute to the HSA through pre-tax payroll deductions and use the funds to pay for medical expenses such as copays, deductibles, and many other medical needs, such as OTC medications.

HMO, PPO, EPOHealth Maintenance Organizations, Preferred Provider Organization, and Exclusive Provider Organization – These are the primary three networks insurance companies use to coordinate medical benefits. EPOs are the strictest; you must remain within your network, or you will not receive coverage; HMOs, you can go out of network with their permission; PPOs allow you to see any doctor you wish without preauthorization, but you may receive reduced benefits if they are out of network.

HDHP High Deductible Health Plan – These types of health insurance medical plans are best suited for those who are healthy or are on a budget and are seeking a low upfront premium. Your health insurance plan is tied to an HSA that you contribute to. When you have a medical expense, you pay for it out of your account.

Finding small business health coverage in Texas does not have to be complicated. What you need to know is that each insurance provider defines small business differently. Especially with how many employees define each group. Pretty much the commonality is that a small business has between 2 and 50 employees. Some companies can include as high as 100 employees.

The second is that there are three different portions of health coverage: medical, dental, and vision, as well as supplemental coverage. Health insurance for a small business will often be either an HMO or a PPO. Some companies have additional options, such as EPO networks or indemnity plans, where as we learned from our definition, do not have networks.

Finally, each company’s offerings are a bit different. You can especially see this in supplemental offerings. This is what an employer would consider additional benefits. Availability would depend solely on the package the employer chooses to offer their employees.

Health Insurance Companies that Offer Small Businesses Insurance in Texas  

Below, we have selected four small business insurance companies and broken them down by what they offer employees in terms of health insurance, dental and vision insurance, and supplemental coverage.


Aetna assists small, mid-sized, and national companies in obtaining health coverage for their employees. Small business coverage with Aetna is from 2 to 100 employees. They offer Medical, Dental, Vision, and Ancillary plans such as Dental and Vision Insurance and Supplemental coverage. They also offer Indemnity plans.


Aetna small business insurance entails first medical insurance. The plans offered are based on networks. They provide the big three: HMO, EPO, and PPOs. The employer will select which plans they will offer the employee. They offer HDHPs, which gives employees the ability to contribute to HSAs.

Dental and Vision

Like medical insurance, Aetna Dental coverage has networks, DMO, PPO, and indemnity plans. Aetna’s basic plan has a children’s vision benefit built into it. Their small business group insurance would add adults to the plan.

Supplemental Insurance

Supplemental Insurance is, for the most part, indemnity insurance that pays specific dollar amounts for occurrences depending on the plan you have. Among the plans available are Accident, Critical Illness, and Hospital Indemnity. These can help you pay out-of-pocket expenses that your medical plan does not cover.

Blue Cross Blue Shield of Texas

Blue Cross Blue Shield of Texas divides their group health coverage a bit differently. Their small business health plans are designed for 2-50 employees, mid-market health plans for 51-150 employees, and their large business health plans are best fit for 151 plus.


BCBS of Texas offers small group health insurance plans on both an HMO and PPO network. Both networks are available statewide. Their PPO network is called Choice. Their HMO small group network is Blue Essentials. PPO plans with a high deductible may have the ability to include an HSA for employee and employer contributions. BCBS also uses a program called a Health Care Account (HCA.) This is a unique employer-funded program to be used for medical expenses.

Dental and Vision

Group Vision and Dental with BCBS of Texas are separate plans. Children’s Dental is included with the basic health insurance plan, this just includes check-ups and exams. BCBS Dental insurance would consist of periodontics, oral surgery, and orthodontics. Group Vision provides exams and vision devices and discounts on correction surgery.


Blue Cross Blue Shield of Texas extends a wide range of ancillary products for employers to include in their benefits package. Accident insurance, Critical Illness, and Hospital Indemnity can enhance an employee’s medical insurance. BCBS also offer short-term and long-term disability, accidental death and dismemberment (AD&D), and Life Insurance.


Cigna small business insurance divides its health coverage into four groups. Their small employees range from 2 to 99 employees, small to mid-size employees range from 100 to 499 employees, mid-size to large employees range from 500 to 2,999 employees, and large employees are 3000 employees plus. They have medical plans, dental and vision, and supplement insurance. They also allow HSAs to be part of an HDHP.


Cigna’s networks are a bit different. They offer an HMO and PPO, but they also offer a network called an OAP (Open Access Plus), which is similar to a PPO. Cigna has Medical Indemnity plans, which, remember, do not have a structured network but do have a savings program with physicians under it. Finally, Cigna has a customizable plan called SureFit, but it’s only available in certain areas.

Dental and Vision

Cigna has a host of dental options, from a low deductible, a high annual max, and a bundled option that includes vision and hearing benefits. Dental insurance includes services from cleanings to restoration services. As for Vision insurance, their benefits cover optometrists as well as ophthalmologists on a copay schedule and scheduled allowance depending on the service provided.


Cigna offers a few supplemental insurance benefits. Accidental Injury Insurance which covers a fixed benefit for injuries. Critical Illness Insurance pays a lump sum when a covered individual is diagnosed with a covered critical illness. If you have a hospital stay due to a covered illness or injury, Hospital Care, also called Indemnity insurance, pays the fixed benefit amount.


UnitedHealthcare divides its offerings into three categories. Small Group plans with up to 100 employees, Key Accounts that have between 101 and 5000 employees, and National Accounts are for businesses with more than 5000 employees. They also offer a minor group called Small Business Store that provides plans for employers with up to 50 employees. They offer medical, dental, and vision care and a wide variety of supplemental policies. Would you believe they even offer pet insurance?


UnitedHealthcare is an HMO, and its plans offer a structure called tiered benefits on some plans. This offers value when the plan is structured to the employees’ medical or financial needs. There are four: Premium, Hospital, Place of Service, and Preferred Lab. They also include Level Funded options that are based on actual medical claims.

Dental and Vision

Dental from UHC offers screenings, prenatal, and orthodontia. They even have a Teledentistry benefit. As for vision, they provide screenings and discounts on frames and lenses, including contacts. UnitedHealthcare also has hearing plans available.

Supplemental Insurance

Accident Protection, Critical Illness, and Hospital Indemnity plans are among the lump-sum benefits UHC offers. Other supplemental insurance plans include Short and Long-Term Disability and Life Insurance. As we mentioned earlier, Pet Insurance is a unique insurance UHC offers. It allows pet owners to take their fur buddies to any vet and a live chat 24/7.

Small Businesses in Texas Can Help with Health Insurance

A couple of additional best health insurance options small businesses have to assist employees with health coverage are:

Small Business Health Option Program (SHOP)

This option is for businesses with fifty or fewer employees. It is a form of health insurance cost-sharing. This benefit helps provide insurance through a tax credit program called SHOP (Small Business Health Options Program). It is basically small business health insurance through the Marketplace.

The qualifications for taking part in SHOP are:

  • Fewer than 25 FTE employees.
  • Average employee salary is 56K or less.
  • Employers pay 50 percent of employee’s premium costs.
  • Employer offers SHOP to all their full-time employees.

Individual Coverage Health Reimbursement Arrangement (ICHRA)

Individual Coverage Health Reimbursement Arrangements are plans that work outside of an employer’s benefit plan. It is a benefit program giving employees reimbursements through the company for obtaining health coverage on their own.

After the employee signs up for insurance, they are able to submit their premium payments as a claim to the employer. Once their claims are approved, employees are reimbursed for their expenses.

Then, employers are given three options to contribute to the employee’s account:

  • Option One: Pre-Imbursement Only: This will either give a predetermined amount of money or a percentage to the employee toward their premium.
  • Option Two: Premium Imbursement + Pre-tax: All the benefits of Option One plus the option to pre-tax excess premium not covered set amount.
  • Option Three: Premium Imbursement + Pre-tax + Medical Expenses: All of one and two plus a predetermined amount of pre-tax dollars for medical expenses

Our Choice for Small Business in Texas

Small businesses in Texas have many options for their employees’ health insurance benefits. Through our review we have found that Blue Cross Blue Shield of Texas has the best offerings with the most availability in the state. With both PPO and HMO networks, they give businesses options to offer employees multiple levels of coverage. They also provide a benefit called a Health Care Account that allows employers to invest in their employees by contributing to an account for their medical expenses.

Blue Cross Blue Shield of Texas offers plans with deductibles from $0 to $8550, with co-insurances generally around 80 percent, depending on your plan selection. With the widest nationwide network, you won’t have an issue finding a medical provider; this includes telemedicine and virtual visits when you cannot make it to the doctor’s office.

Employers will have access to Blue Access for Employers. This feature helps you keep track of your employees for eligibility, shows you how to enroll them, and teaches you how to modify their status, including adding dependents.

At CoverMile, we assist small businesses like yours to find the best health insurance for your employees and guide you through the enrollment process. Contact us today and begin the process of signing up your small business with an insurance plan like Blue Cross Blue Shield of Texas.