Each year, Open Enrollment offers the opportunity to review your health insurance and make sure it still aligns with how you practice medicine. If you own a small practice or work independently, you may assume your choices are limited to individual coverage, often an HMO or a short-term medical plan.
However, for 2026, even if you don’t have employees, special group PPO options may allow you to qualify for group health insurance just for yourself and your family.
Below are a few essential tips to help make this year’s Open Enrollment more successful.
Tip #1: Start Early to Discover Your Options
Sorting through carriers and plan details takes time, but starting early lets you explore your options without deadline pressure. Having someone who understands the Texas marketplace on your side can make the process easier.
We’ve already done the research to identify special options that may allow you to access group PPO coverage:
- Practice owners seeking group coverage for their practice can turn to TMA Insurance Trust for assistance. The special options may help your practice manage costs, allowing you to offer your employees group health insurance, including a mix of group PPO and HMO plans.
- Practice owners with staff on their own health coverage (such as a spouse’s plan or another provider) may qualify for “group of one” PPO coverage, just for yourself and your family.
- 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).
- Physicians, 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.
- Physicians, if you are opening your own practice, TMA Insurance Trust can help you start your group plan. Open Enrollment is the best time to take advantage of special options.
- Establish a Health Savings Account (HSA): If you select an eligible high-deductible health plan to manage costs better, you can open an HSA. These accounts offer tax advantages, spending flexibility, and ongoing saving and investment opportunities.
You’ve built a practice that works for you. Before you renew, see if one of the special, lesser-known group PPO options available during 2026 Open Enrollment could do the same for your coverage.
Tip #2: Compare Plan Types Before You Renew
Understanding how different plan types work can help you make a more informed decision.
HMO plans often come with smaller networks and require referrals before you can see a specialist. Care outside the network may not be covered at all. Short-term medical plans, while sometimes less expensive, can exclude maternity care, mental health services, and pre-existing conditions. In some cases, applicants may even be denied coverage.
By comparison, group PPO plans generally offer broader network access and more flexibility, without the need for referrals. You’re not limited to a narrow network of providers, and with special options available this year, you may qualify, with or without employees.
Tip #3: Get Help from a Trusted Advisor
Health insurance shouldn’t feel like a second full-time job. Working with a licensed TMA Insurance Trust advisor can help ensure there are no coverage gaps and may uncover ways to improve your health insurance situation and better manage costs.
We will explain your eligibility, gather quotes, and compare plans on your behalf. This service is offered at no cost or obligation, with no sales pressure. It’s part of our ongoing commitment to support TMA members by making insurance decisions clearer and easier to navigate.
Tip #4: Enroll and Confirm Your 2026 Coverage
To have coverage in place by January 1, 2026, please complete all enrollment paperwork by Thursday, December 11, 2025.
A TMA Insurance Trust advisor is ready to help at 800-880-8181, Monday through Friday, 8:00 AM to 5:00 PM CST.
