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TEXAS SMALL BUSINESS HEALTH
INSURANCE PLAN OPTIONS

Affordable Health Care Coverage For You And Your Team

Our employer-sponsored group health insurance plans allow you to cover all your employees and their family members.


Blue Cross and Blue Shield of Texas (BCBSTX) has the flexibility and choice that growing companies need. BCBSTX provides Texas small business employers with a variety of health care plan options that include access to a large network of providers and comprehensive benefits to fit your employees’ needs and your organization’s budget.

Small Business Health Insurance Group Plan Options

When it comes to health plans, “metal” tiers easily identify how costs are split between the insurance company and the insured.

Platinum
Plan Pays: 90%
 10%
You Pay:

Platinum plans are the most expensive plans from a premium perspective because they are also considered the richest. Insurance carriers typically cover approximately 90% of the cost of covered services.

Gold
Plan Pays: 80%
20%
You Pay:

In Gold plans, the insurance carrier typically covers about 80% of the cost of services, which results in higher premiums than the Bronze and Silver plans.

Silver
Plan Pays: 70%
30%
You Pay:

Silver plan monthly premiums are more than Bronze plans, but the out-of-pocket costs for services are lower with the insurance carrier covering around 70% of the cost of services.

Bronze
Plan Pays: 60%
40%
You Pay:

Bronze plans have the lowest monthly premiums, but highest out-of-pocket costs. Typically the insurance carrier will cover 60% of the cost of services.

Plan options within each metal tier include Participating Provider Option (PPO) and Health Maintenance Organization (HMO) choices. Learn more about the differences between these options:

PPO


PPO plans allow members more flexibility than an HMO to see specialists. Members can choose a primary care physician (PCP).

HMO


Members in HMO plans choose a primary care physician (PCP) who coordinates the patient's care. To see specialists, members need a referral from their PCP.

Network Offerings

Our plan offerings leverage different networks of providers in order to create plan options that fit any small business budget*.

Learn more about small business plans available in your area.

Blue Choice PPOSM

2-50 Employees

Blue Choice PPO gives you flexible benefit design options at a price you can afford while giving your employees a wide range of benefits and the freedom to visit any doctor they choose, with benefits paid at a higher level when the doctor is within the network.

Network

Broad

Coverage

Statewide/Nationwide

Medical Group
Selection Required

No

Referral Required

No

Out-of-Network
Coverage

Yes


BlueAdvantage HMOSM

2-50 Employees

This cost-effective health plan is designed to provide affordable quality health care services to the uninsured and underinsured whenever they access care through a participating Blue Advantage HMO network provider.

Network

Smart

Coverage

Statewide

Medical Group
Selection Required

Yes

Referral Required

Yes

Out-of-Network
Coverage

No, with the exception
of emergency or
accident

*Metallic-level availability varies by plan and network.

Essential Health Coverage For Your Employees

All of BCBSTX’s small business health plan options include comprehensive coverage under the Affordable Care Act (ACA), including:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Prescription drugs
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including dental and vision

More Access to Health Care

Blue Cross and Blue Shield of Texas plans give you and your employees more access to care with in-network Telehealth visits at the same cost as an in-office visit.

$0 Preventive Drugs on Health Savings Account (HSA) Plans

Select an HSA plan for you and your employees that features $0 copay for some preventive drugs. HSA plans help employees stick to their treatment regimen and better manage their health conditions.

Health Savings Account Copays

Specific HSA-compatible plans have copays after the deductible is met for office visits with a primary care physician and specialist. Plus, pharmacy benefit copays.


Dental Insurance Plans

Our small business dental plans include a wide network of providers to help you and your employees receive the right care.1

Contributory dental plans include minimum contribution requirements from employers.


Voluntary dental plans do not include minimum contribution requirements from employers.


Healthier Employees. Healthier Business.

Ready to see your options?

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Phone

Get in Touch by Phone
833-923-1785

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