How Can My Business Qualify?

Ready to enroll?

You can offer TexHealth coverage if you are a small employer located in Central Texas, employ between 2 to 50 employees, and have not offered group health benefits to your employees during the past 12 months. Employees are eligible if they work an annual average of 20 or more hours per week and are not receiving Medicare, Medicaid or benefits through another government program.

Employer/Employee Eligibility Requirements

Employer Requirements

1. Small employer group of 2 to 50 employees
2. Employer cannot have offered group health insurance in the last 12 months
3. Must be a licensed business entity in one or more of the counties in the TexHealth Central Texas service area
4. Must provide proof of employee grant eligibility through State Unemployment Tax Authority report, W-2, 1099 or other acceptable documentation
5. 60% of all eligible employees must enroll in the plan (if only 2 in group, both must join)

Employee Requirements

1. Employee (W-2 or 1099) of enrolled group
2. Must work, on average, a minimum of 20 hours per week
3. Must be a resident of Texas but may live outside the TexHealth Central Texas service area
4. May not be receiving government health coverage benefits (E.G. Medicaid, Medicare, SSI, Texas Risk Pool, County Indigent Care programs, etc)
5. Any pre-existing condition identified or treated within the 6 months prior to the effective date will not be covered by TexHealth Central Texas for 12 months, with some exceptions.