Texas General Lines — Life, Accident, Health and HMOTexas Statutes and Rules Specific to Accident, Health and HMOEasy
A small employer with 15 eligible employees in Texas is looking to purchase a group health benefit plan. How many of these employees must participate in the plan for the employer to be considered an 'eligible small employer' under Texas law, assuming there are no other existing health benefit plans?
- AAt least 1 employee.
- BAt least 5 employees.
- CAt least 7 employees.
- DAt least 10 employees.
Show answer & explanationAnswer & explanation
Correct answer: A. At least 1 employee.
Under Texas law, a small employer is generally eligible for a group health benefit plan if they employ at least one eligible employee, and the employer contributes to the cost of coverage. The 'at least 75%' participation rule applies to the number of eligible employees, but the minimum for eligibility as a small employer is one.
Why the other options are wrong
- B. This is a common misconception related to other states or older regulations, but not current Texas small employer law for initial eligibility.
- C. This percentage (7/15 ≈ 47%) is not a standard minimum for small employer group eligibility.
- D. This is often a requirement for larger groups or specific types of plans, but not the minimum for small employer eligibility in Texas.
Texas Small Employer Group Health Eligibility
In Texas, a small employer (1-50 employees) can be eligible for a group health benefit plan if they employ at least one eligible employee and contribute to the cost of coverage.
- Employer size: 1-50 employees.
- Minimum participation for eligibility: 1 eligible employee.
- Employer must contribute to the cost.
Memory trick: Small businesses in Texas only need 'one' person to start their 'health' journey.