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How To Apply For Health Insurance For Your Business In Texas
By Pat
If you own a small business in Dallas, Houston or anywhere else in Texas and are looking for a provider for your employees, here's a standard list of business data you'll need to provide:
- Employer name. The legal name of your company.
- Address of your business. Insurers need the street address, not a P.O. Box, to determine your region or service area.
- A list of employees you plan to cover. Not all employees will be eligible.
- Tax identification or employer identification number. This is the EIN (sometimes called FEIN) you obtained from the IRS when you started your business.
- Business background. Depending on the size of your business, you may have to provide:
- Date your business started
- Payroll records
- Standard Industry Code (SIC or NAIC), informing the insurer what industry you're in.
- Quarterly salary and wages for the past two quarters.
- Employee census information. Insurers use this to estimate the health care costs your group is likely to incur. A census does not include health status, race, religion, sexual orientation (even if applying for domestic partner benefits), Social Security number, or U.S. citizenship/immigration status. In order to quote you a rate, insurers will ask you to complete a census form for each of your employees with this information:
- Name
- Age or date of birth
- Number of dependents
- Zip code.
Creating a Schedule
Next, you'll need to finalize these scheduling details early in the process of shopping for an insurance plan:
- Effective date of coverage. This should be at least six weeks ahead, so you'll have time to complete the administrative steps, but no more than three months ahead, so the quotes don't expire. Most employers choose the first of the month to begin coverage.
- Plan cycle. Many plans operate on a calendar-year basis (January - December). Some plans operate on a different 12-month cycle, or your company may have specific busy seasons when you don't want to deal with insurance issues.
Establishing a Budget
Once you finish creating a schedule, you'll need to determine how much money you can afford to spend for coverage, and then calculate the cost:
- By percentage of payroll. Calculate an amount as a percentage of your total monthly and annual payroll.
- Per employee per month. Calculate how much you could spend per employee per month. Determine a bottom-line maximum figure, without worrying about such variables as employee contributions or dependent coverage. Based on your budget, you can figure those variables later.
- Consider cash-flow issues.
- Monthly premium commitment. Most insurers require payment on the first day of the month covered. You would pay for April coverage on April 1, May coverage on May 1, and so on. If you're buying coverage for the first time or replacing existing coverage, the insurer will likely ask for a month's premium in advance.
- Grace period. Most insurers offer a 30-day grace period on paying premiums. If you're a few days late, your policy isn't likely to be cancelled. Ask about your insurer's grace period and notification policy regarding cancellation.
- Cancellation/reinstatement. If you're habitually late with payments, your insurer has the right to cancel
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your group insurance. Most insurers have their own procedures for reinstating canceled polices, so be sure to ask.
- Premium increases. Most premiums are renewed annually, which means the insurer can adjust the price once a year. Some plans allow insurers to increase premiums every six months. By law, you must be given at least 30 days' notice of a proposed increase.
How to Find Your Plan.
Now that you've gathered your information and put together your schedule and budget, it's time to start looking for a plan.
Brokers Versus Agents
These licensed professionals can help you find and choose the best plan for your business. They know:
- The best products available, and
- State and federal regulations to protect your business from liabilities.
- They've also satisfied licensing requirements that require them to keep up-to-date on Texas' insurance market.
A broker can direct you to products offered by a range of providers. An agent works with only one company and promotes that company's products. Both may be referred to as "agents" and are licensed professionals in the state of Texas.
The broker or agent will help you:
- Shop for the right plan for your company and provide one or more premium quotes
- Discuss alternatives to help you understand your plan options
- Implement the plan you select
- Service the account, including solving problems with billing, eligibility, and claims
- Do the legwork so you don't have to spend the time
- Get the most from the coverage you purchase
- Expedite the renewal process
Online Options
The online world is changing rapidly and the number of consumers and employers using the Internet to research or purchase is dramatically increasing. The Internet makes it easier to shop for health insurance, you can learn about your options from the comfort of your home or office and on your own schedules - without pressure to buy.
Implementing the Plan
Review the various plans you've chosen for your business:
- Weigh the benefits against the plan costs.
- Research the insurers for:
- Financial stability
- Ease of administration
- Overall quality of service
- Consider cost-saving strategies.
- Review at least two to three carriers and plan options.
Action Plan Checklist:
- Sign the contract before the quote expires, usually within 30 days.
- Communicate plan choices to employees.
- Distribute and collect enrollment materials for those people covered.
- Copy and return all original materials for enrollment before the requested date.
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