While group PPO coverage is available to all practice owners, its high cost can put this coveted, more inclusive coverage outside the realm of possibility for smaller practices. Requirements for eligibility also mean that most solo practitioners are only able to access individual or group HMO plans.

Though your practice may be small, to us you’re big. Since its existence, TMA Insurance Trust has committed to working tirelessly for small practices that feel limited in their insurance choices. Our recent efforts have uncovered two special insurance options that could transform coverage for many solo and small, independent practice owners.

“Small” Practice Doesn’t Mean “Limited”

Two little known health insurance waivers available during Open Enrollment give solo and small practice owners the potential to access group PPO health insurance for just themselves or themselves and their employees--for a cost comparable to that of an individual HMO plan.

Here’s the breakdown:

• The Participation Waiver: You no longer have to cover at least 75% of your staff in order to enroll for coverage as a group. Solo physicians and small practice owners can qualify as a “group of one”. You’ll need a tax ID number and at least one full-time employee besides yourself paid under that number. Partnerships and LLCs filing as a partnership with no employees may be eligible too. You’ll need to provide partnership documentation and the company’s Schedule K-1 (Form 1065) when enrolling.
• The Contribution Waiver: Practice owners do not need to pay a mandatory 50% of premiums in order to qualify for group coverage. With this waiver, owners now can opt to pay a percentage they can better afford, or, nothing at all.
• LIMITED TIME AVAILABILITY: In order to benefit from these special health insurance waivers, you must have your Open Enrollment paperwork completed and submitted by December 15, 2021.

Advocates for Independent Practices

TMA Insurance Trust has a history of advocacy and caring. While so much of the medical landscape has changed over this last year, our focus has not. We remain committed to helping practitioners--with any size practice--secure the best possible health coverage within their budget. As Open Enrollment is set to begin, we feel compelled to make every effort to inform solo and small practice owners about these special waivers. We know they have the potential to help smaller practices access the kind of health insurance that typically only larger practices can afford.

Our team is ready to help yours. Have your practice manager call us at 1-800-880-8181 to discuss these options and get you and your practice set for Open Enrollment. We’re here to help Monday through Friday, 7:30 to 5:30 CST.

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.