Many independent physicians have questions about how group PPO health insurance may apply to their situation. Below, we’ve addressed some of the most common ones.
Do I need employees to qualify for group PPO coverage?
It’s a common assumption that group PPO plans are only available if you have employees. But TMA Insurance Trust has found special options that may provide access to group PPO coverage — even without employees.
Can a PPO plan work for my practice?
For small practice owners or physicians without employer benefits, group PPO coverage offers flexibility and access to a broader network of providers when compared to an HMO plan. You can see physicians and specialists directly without extra referral steps. TMA Insurance Trust can help you compare both group PPO and HMO options to find the coverage that best fits your needs and how you practice.
Who qualifies?
We’ve gathered the details, so you can quickly see how eligibility could work for you.
🔹 If you are a practice owner with group coverage for your practice: You may have opportunities to help manage the cost of coverage while offering your staff health insurance – with a mix of group PPO and HMO plans.
🔹 If you are a practice owner with staff on their own health coverage: (a spouse’s plan or that of another provider), you may be able to access group PPO coverage just for yourself and your family.
🔹 If you share a practice with a partner but have 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 a recent K-1 (Form 1065).
🔹 If you own a business with your spouse, or your spouse is a W-2 wage employee: You may qualify for group coverage even without partnership documentation.
🔹 If you’re starting your own practice: TMA Insurance Trust can help you create a customized group plan that aligns with your practice’s needs.
🔹 If you’d like to establish a Health Savings Account (HSA): Selecting an eligible high-deductible health plan allows you to open an HSA, offering tax advantages, spending flexibility, and long-term savings opportunities.
Our research reveals how group PPO coverage may be possible for independent physicians in different practice settings, and we can help you explore what may apply to your situation.
What makes TMA Insurance Trust different?
Since 1955, we’ve supported Texas physicians and their families. With no shareholders, any surplus funds are returned to you through programs and resources that strengthen the medical community both personally and professionally:
- Financial Savings: Members have access to free CME courses that can save you hundreds each year, plus an ongoing 25% savings credit on own-occupation disability insurance.
- Mental Health Resources: Unlimited, no-cost counseling through Anticipate Joy, provided with complete confidentiality.
- Community Support: Funding for county medical societies, member sections, and emergency relief.
Along with these benefits, our salaried advisors provide guidance without receiving sales-based commissions. Their recommendations reflect only what’s best for you, just as they do for more than 800 practices across Texas that trust TMA Insurance Trust as their Agent of Record.
What should I do next?
With Open Enrollment beginning in November, now is the time to review your options for group PPO coverage — whether or not you have employees.
Call 800-880-8181, Monday–Friday, 8:00 AM–5:00 PM CST, to learn more.
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