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Protecting What Matters Most


Small Practice Owners: Take a Helping Hand During Open Enrollment

As a small practice owner, you are very busy playing all the roles that you are required to fill. You must care for your family’s needs, but also your patients’ - while not forgetting the needs of your practice staff. There is much on your plate - and that’s why we at TMA Insurance Trust feel that you deserve special consideration and support, and are looking out for your welfare during the Health Insurance Open Enrollment time period.

Unfortunately, many small practice owners had the misconception that they did not qualify for and/or could not afford group PPO health insurance coverage. Because of this, they have been getting by with health insurance benefits they may not be satisfied with. Over the past several years, we have made it a priority to inform small practice owners during Health Insurance Open Enrollment that they may have other options.

Health Insurance Options for Small Practices

Last year, we were pleased to assist practice owners in finding the right health insurance options for their needs during Open Enrollment. Here are some examples:

  • Some practices were finally able to offer their employees group PPO insurance,
  • Certain practice owners were able to get group PPO insurance for themselves
  • Some practices were able to offer their employees group HMO insurance and realize cost savings over their existing coverage.

Below, you’ll learn specific details about how we accomplished this.

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PPO Insurance and Potential Savings for Small Practices

Small practice owners may have a way to help manage certain aspects of their health insurance costs, even opening up a way for solo practice owners to get a preferred type of health insurance they did not think was an option - group PPO coverage for themselves. How?

In order to be eligible to offer a group policy, typically certain criteria need to be met:

  • A practice must have 75% of employees participate in the plan, and
  • You as an employer would have to pay 50% of your employees’ premiums.

This can be an insurmountable financial hurdle for some small practices.

However, during Health Insurance Open Enrollment, TMA Insurance Trust can assist you with special waivers that remove this criteria for a limited time. Therefore,

  • Your practice would not be required to pay 50% of employees’ premiums as most carriers now require. With this waiver, your practice can contribute as much - or as little - as you choose.
  • You would not need 75% of your employees to participate in the group plan. In fact, the waiver does away with minimum participation completely.

What could this mean for you? A solo or small practice owner could effectively create a “group of one” and just enroll themselves and their family in a group PPO plan. You could also offer this insurance to your staff, but the practice will not be required to pay for their coverage. Even if none of the employees take the coverage, the practice owner can still enroll in the group PPO plan as a "group of one".

How to Take Advantage of this Opportunity

To be eligible for these special ACA waivers, your practice must have a tax I.D. number and one full-time employee in addition to yourself. We are ready to assist you if you want to take advantage of this special opportunity. A TMA Insurance Trust advisor will be happy to give you more details and fully explain the waivers.

Get Continued Support Throughout the Year

Handling the administration of an employee health insurance plan can be a burden on small practice staff.  This is where we can support you. We make it our business to take on as much of the administrative burden as possible. This includes enrolling your staff and dependents, cancelling employees if they leave your office, distributing temporary ID cards and policy information, assisting with billing, as well as advocating for you throughout the year if claims or customer service issues arise. All these added services are provided at no extra cost to you or your practice. We can help, so you can spend more time caring for patients and running your business.

We’re Your Partner in Success

We understand that you want the best health insurance coverage possible at a cost that’s manageable. At TMA Insurance Trust, we are absolutely committed to providing the highest levels of service to Texas physicians. Let us give you specialized service so that you can focus on what you specialize in – providing the best medical care to your valued patients. Contact us today.

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For over 60 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.

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