Texas Group Health Insurance Plans

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Texas group health insurance plans are provided by employers for all eligible employees. There are no limits for pre-existing medical problems. This type of policy is generally more expensive than an individual policy where restrictions can apply.

Texas group health insurance plans are written on a large group of people under one general policy. There are several ways to obtain group health coverage. Some employees offer group health through an HMO (health maintenance organization). Another provision is through the services of an insurance company. Each one is a fully insured health plan.

Many Texas Group Health Insurance Plans

There is also a self-funded plan maintained by some employee groups. This works by the employee group setting aside premiums every month to pay claims submitted to the plan. This plan is made in connection with an HMO or third-party administrator. The risk, however, is assumed by the employer (plan). This plan is exempt from state regulations.

Texas group health insurance plans basically encompass two types of plans-- traditional and managed care. The traditional plans or fee-for-service plans require you to pay for the services and file your own claim for reimbursement. There are no restrictions on the choice of physicians. The managed care plans restrict the area of coverage and require the use of physicians and facilities contracted with them for services. There is usually a small co-pay required at the time of service. Some plans require a referral from a primary care physician before seeing a specialist.

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