Small-Business Health Insurance Requirements in Katy, Texas

Texas employee counts: small employer versus eligible employee

The Texas Department of Insurance describes a small employer as a business with 2–50 employees, regardless of hours worked. It says a small-employer plan must be offered to employees working 30 or more hours per week and their dependents. Counting a business's employees and identifying who is eligible for coverage are different steps.

At least one employee must enroll for an owner to enroll under TDI's guidance. Ownership, payroll records, employment relationships and the carrier's documentation requirements matter. Do not treat two owners, a married couple or independent contractors as automatically satisfying group eligibility.

• Confirm the legal business and employee relationships
• Identify eligible employees and dependents under the plan
• Ask how owners, spouses, part-time staff and remote workers are treated

Can a business with two employees get group health insurance?

Possibly, if it meets the applicable small-employer and carrier requirements. Two genuine employees can be a starting point, but a headcount alone does not establish eligibility. Ask for a written eligibility review before making an offer to employees.

SHOP uses a different framework: generally 1–50 full-time-equivalent employees and at least one eligible employee other than owners, their spouses, certain family members or partners. Do not confuse this with the Texas 2–50 employee definition. An owner-only business may need to consider individual coverage; an ICHRA also requires review of employee and owner eligibility.

Employer contributions and employee participation

TDI states that Texas law does not require an employer to pay premiums, but an insurer may impose a contribution requirement. Its guidance notes that an insurer may require at least 50% of the employee premium. This is not a universal promise or a fixed rule for every offering.

TDI's employer overview says most insurers require 75% of full-time employees to participate, excluding employees with other coverage. SHOP describes a general 70% rule with exceptions. Ask the proposed carrier which requirement applies, how waivers are counted and whether an enrollment exception is available. Never apply one program's percentage to all plans.

• Request written employee-only and dependent contribution requirements
• Check valid waivers and the participation calculation
• Confirm any exception period and effective-date deadline directly

Enrollment timing and practical setup

TDI says new employees must receive at least 31 days to enroll and a waiting period may be no longer than 90 days. Confirm the actual eligibility date, waiting-period wording and enrollment deadline in the employer's plan documents.

For an initial call, prepare the business location, approximate employee count, desired start date and contribution budget. Do not submit employee names, medical records, claims histories or dates of birth through this website. Required employee information should be handled through an appropriate secure carrier or administrator process.