Get in Touch by Phone
833-923-1785
Get in Touch by Phone
833-923-1785
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.
Explore the different metal tiers to find a health plan that fits your budget and the healthcare needs of your employees. Each tier offers a different level of coverage, making it easier to choose the right plan for your budget.
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.
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 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 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 plans allow members more flexibility than an HMO to see specialists. Members can choose a primary care physician (PCP).
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.
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
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.
All of BCBSTX’s small business health plan options include comprehensive coverage under the Affordable Care Act 
(ACA), including:
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.
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.
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.
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.
HMO (Health Maintenance Organization) plans typically require members to select a primary care physician (PCP) to coordinate care within the network. In order to see a specialist, members may need a referral from their PCP. Having care coordinated by a PCP may result in lower overall costs for the member. PPO (Participating Provider Option) plans do not require members to select a primary care physician, and in most cases, members can go to any provider within the network without a referral. This increase in flexibility may result in a higher overall cost for the member. Learn more about how insurance works.
The cost of health insurance for your small business will depend on the type of plan you choose as well as your contribution strategy. Most states require a minimum contribution for group coverage.
If you purchase group coverage between November 1 and December 15 for a January 1 or January 15 effective date, your contribution requirements are waived.
Get a better understanding of the different factors that can affect the cost of your small business health plan.
Generally, the higher a plan’s deductible, the lower its premium. Plans with higher deductibles have lower monthly costs but may make expenses less predictable if medical bills accumulate suddenly. If you choose a plan with a lower deductible, it will generally have a higher premium. Plans with lower deductibles allow employees to better control unpredictable costs when they need their insurance.
