Waivers and options available during Open Enrollment can make it a beneficial time for physicians to get the group PPO health insurance coverage they prefer more affordably. However, it’s not the only opportunity during the year to access better health insurance while controlling costs.

If you’re looking for health coverage, need to adjust your current plan, or have lost your group coverage during the year, you can benefit from special enrollment periods and options year-round.

Practice Owners and Independents

If you’re a practice owner or an independent physician, there are special options to take advantage of that may help you access group PPO health insurance, whether you have employees or not.

• For practice owners with group coverage for their practice, there are opportunities to help control the cost of your practice while offering your employees both PPO and HMO plans.
• For practice owners with staff on their own health coverage (a spouse’s plan or that of another provider), you may be able to get group PPO coverage just for yourself and your family.
• For partners with no W-2 employees, you may be eligible for group coverage only for yourself. You’ll need to provide partnership documentation and the company’s SS4 or recent K-1 (Form 1065).
• For physicians who own a business with their spouse, or their spouse is a W-2 wage employee, you may qualify for group coverage even without partnership documentation.

While these special options are available during Open Enrollment, few are aware they’re also accessible through TMA Insurance Trust throughout the year. If you need to renew your health coverage or are looking for a new plan, let us assist you with determining your eligibility before you secure coverage for another year.

Special Enrollment Periods and Specialized Support

Life-changing events that may happen during the year, such as getting married, having a child, adopting a child, becoming a foster parent, or becoming responsible for child support may mean you need to adjust your health coverage. If you need to add family members to your plan, you may qualify for a special ACA enrollment period.

If you lose your health insurance coverage during the year due to divorce, loss of dependent status, moving out-of-state or you lose coverage through your employer, there is a 60-day enrollment period you may benefit from.

TMA Insurance Trust’s experienced advisors can help you navigate through these insurance situations. They will work diligently to find ways to help you control costs by exploring the best ways to configure your benefits. They work for you, not a sales-based commission. Any suggested plans or guidance they present to you will be based solely on careful consideration of your unique insurance needs.

Your health insurance coverage is our priority all year long. Call us at 800-880-8181, Monday through Friday from 8:00 until 5:00, CST, and let us take care of you while you continue caring for others.

For over 65 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of the highest-rated plans in the industry.