Well as of JANUARY 2017 THE STATE OF TEXAS HAS BROUGHT BACK HUSBAND AND WIFE TWO MAN GROUP’S. This means I now can again write husband and wife group health insurance if they have a business and are listed as owners on the LLC. If you are not getting a subsidy and paying full price for your Obamacare HMO plan you can now take back your Heath Insurance and not let the government pick your Doctor’s. Call today 512-963-5000 or email me at STIBROKER1@GMAIL.COM for your custom quotes emailed to you. I have been a Health Insurance Broker for 25 years and I leave no stone upturned we it comes to my clients health insurance needs, since people have different health needs, some of them want to be athletic while others only need supplements for stress as kratom capsules and others. That’s right Texas HAS made all the health insurance company’s that are pulling out of the ACA or as it has been called OBAMACARE to bring back Husband and Wife two man groups.Are you sick of not having a PPO to choose from? Well now Texas has reinstated the Husband and Wife two man groups. That’s right you can get the same Health Insurance plans that the big company’s offer. And to top it off the rates are the same as your crappy Obamacare Plan. Call today 512-963-5000 to get your custom quotes emailed to you and you can have a plan with all the doctors you want in your network.
Under Texas law, a small group carrier must issue coverage, consistent with TIC §1501.151, to a small employer with two or more employees, even if the employees are married to one another. A small group carrier may not non-renew coverage for an existing small group because the state and federal definitions of small group differ. In addition, TIC §1501.108 gives a covered employer the right to renew its group health coverage unless the employer fails to comply with the terms of the plan.
Federal law (42 US Code 300gg-91(e)(1)(B)) allows a state to elect to regulate coverage offered to very small groups as coverage in the small group market, and Texas considers a group of two eligible employees to be a small group, regardless of marital status. The Texas Insurance Code does not exclude spouses from the definition of “eligible employee” or exclude such employees in defining “small employer,” and consistent with this 28 TAC §26.7(d), prohibits a small group carrier from denying two individuals who are married the status of eligible employee solely on the basis that the two individuals are married. Commissioner’s Bulletin # B-0035-01 provides additional guidance regarding this requirement.
Federal law states that carriers must offer premiums on a per-member basis, but may also offer composite premiums as an option. Federal law also requires that the composite option be made uniformly, i.e. if a carrier offers composite premiums to one small employer in Texas, it must make that option available to all small employers in Texas. See p. 13750 of the HHS Final Rule.
Does this method apply to plans purchased on the SHOP exchange?
Based on information contained in the March 10, 2015, response from CMS, the SHOP exchange will not use composite premium methods for the 2015 plan year. The response also stated that the SHOP exchange will use the federal default composite premium method for the 2016 plan year.
How does the alternative 4-tier composite methodology differ from the default federal methodology?
The federal methodology consists of two tiers: one for adults age 21 and older, and another for children under the age of 21. The methodology approved by CMS for Texas consists of four tiers: employee, employee + spouse, employee + children, and employee + family, with tier factors of 1.0, 2.0, 2.0, and 3.0, respectively. In either methodology, federal law requires that the sum of the per-member premiums must equal the sum of the composite premiums for every small employer.
Yes. Texas law (TIC §1205.002) requires carriers to continue issuing certificates of creditable coverage, “as necessary.” However, given the reduced need for these certificates, TDI will consider carriers in compliance if they provide certificates of creditable coverage upon request, consistent with 28 TAC §21.1103(b).
If you are looking to START a group plan. BEFORE you decide on a voluntary or major insurance plan, use our Free program. Avoid paying or having your employees pay for certain benefits that you can get for FREE!
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