Small Group Medical

Texas defines a small group as an employer who employed up to 50 Average Total Number of Employees (ATNE) in the calendar year prior to the effective date of the policy. Carriers may count all employees of groups related by common ownership, control, or affiliation together to determine the appropriate market segment for a given group. Each carrier uses a different methodology for computing the total. All traditional fully insured small group medical plans written starting in 2014 are subject to adjusted community rating and other requirements of the Affordable Care Act. Self-funded plans are able to avoid some of the restrictions placed on the plan designs and rating methodologies of fully insured policies.

Our Services

We specialize in group benefits for small group employers and maintain a broad portfolio of small business solutions for your clients including fully insured and self-funded programs. Our dedicated small group service teams coordinate with you to collect all necessary information you need to assist your client.

Our service teams leverage a proprietary quoting platform to automate the quoting process for each carrier. The Back Quoting system generates each official quote and packages the results in a dynamic Excel illustration package that summarizes all plans and facilitates plan comparisons. The client-ready package highlights each carrier so your client can make an informed decision based on benefits, network, and pricing. The service teams manage the underwriting and installation processes on your behalf.

Our service teams support the entire life cycle of the case—quoting, underwriting, installation processing, ongoing escalated service, and renewal management. Quote request forms are available on our Quote Requests page.

Our Markets

The table below provides an overview of the carrier portfolios for small group employers. We maintain formal general agent agreements with the major carriers who are committed to the broker & GA distribution channels and who offer traditional fully insured and self-funded / alternative funding products.

Carrier Fully Insured Self-Funded Comments Directory
BlueCross BlueShield Balance Funded requires 10+ enrolled. HMO and PPO plans. All Plans
Cigna ASO and Level Funding programs. EPO and PPO networks. Requires 25+ enrolled. All Plans
Humana Four network options available. Level Funded program requires 5+ enrolled. All Plans
Memorial Hermann PPO and HMO plans using the Memorial Hermann network providers. All Plans
National General Formerly Assurant. Requires 5+ enrolled. Aetna
Scott & White POS network plans. North and Central TX All Plans
UnitedHealthcare PPO, EPO and HMO plans available. UHC's self-funded plans available through All Savers to employers with 5+ enrolled. UHC ACA
All Savers