Dallas, Texas Small Business Owners with Subchapter S and LLC forms of business may choose whether or not to be included in their company's group health plan. This gives the small business owner a bit of extra flexibility in determining their own and their company's health plan. In some circumstances, this extra flexibility can lead to lower insurance premiums for the TX small business owner.
In Texas, small group coverage (under fifty employees) insurance carriers require that 75% of all full-time eligible employees must opt for coverage in the company's group health plan. Eligible employees who can substantiate that they waive coverage because they are covered under a spouse's group (not individual) health plan do not count towards the 75%, but eligible employees who decline coverage do count against 75% particpation.
But small business owners with Subchapter S or LLC forms of business do not have to pay themselves a wage through payroll, can instead receive a portion of the business' income on their own personal tax schedule, and can decide whether or not to be in their company's group health plan. If a small business owner with these forms of business chooses not to be covered by their Texas small business group health plan, they do not count as a "decline" in the 75% calculation.
Here are a few situations where a small business owner with Subchapter S or LLC would decide to decline coverage in the business' group health plan:
–If the business owner's own and dependent's health were fine, the business owner could select an individual health plan with different level of (higher or lower) benefits than the business' group health plan, and possibly at a lower monthly premium expense than the business' group health plan premium.
–If the business' owner's own or their dependent's health is impaired with serious pre-existing conditions and if the owner's spouse is eligible for a group health plan, then by obtaining coverage through the spouse's plan, the business owner can transfer the underwriting risk/expense from the owner's plan to the spouse's plan.
Since Texas small group health insurance carriers can charge up to two thirds higher than standard premiums based on the underwriting risk of the pre-existing conditions of the eligible employees and dependents, by transferring the risk out of the company's group health plan, the business owner could possibly receive a reduction in the company's group health plan premiums, or put the company in a better position to shop for lower cost coverage with a different carrier at renewal time.
For more smart tips on how Texas small businesses owners can control the cost of their employee benefits and group health insurance, contact Michael Chapman of TexasGroupBenefits.com at 214-764-6315 or (888) 398-6246.