It is hard to believe that we are two-thirds done with 2025. Texas businesses have been navigating challenging waters this year, and we want to make sure they don't get more challenging as we approach some end of year deadlines.
Angela runs a small marketing firm in San Antonio with 12 employees and called us recently. She’s proud of the team she’s built and the results they deliver for clients. As the end of the year approaches, she wanted to make sure that she was doing everything she could secure the best health plan for them.
She has heard that health insurance premiums are going up for everyone. It seems like employees are asking more questions than ever about their benefits. And Angela feels stuck in the middle, wondering how to balance her budget with her team’s expectations. She knows that if she makes the wrong move, her business could start 2026 on the wrong foot.
She isn’t alone. Across Texas, small business owners are facing the same challenge. The last quarter of the year is when decisions about health insurance plans matter most, and there are three things every owner should know.
Three Things To Consider Right Now
If you're pressed for time, here are the three big ideas to take in.
- Open Enrollment Decisions Matter
- Exploring Affordable Plan Designs Can Save Your Budget
- Compliance and Competitive Edge Go Hand In Hand
If you want to dig further, there are FAQs at the bottom of the page. Now back to Angela's story.
Employer-Sponsored Open Enrollment Decisions Matter
Open enrollment is the time in your business calendar when employees choose, change, or renew their health coverage options. It’s also the time for employers to take a hard look at their current group health insurance plan. For Angela, this was her chance to step back and ask if their plan is still working for the team and bottom line?
Many small business owners roll their coverage over without much thought. But that’s often a mistake. Premiums shift. Benefits get used differently from year to year. And employees’ needs change. Reviewing plan design now can save you money and help employees feel supported.
Angela called us to review her level-funded health plan from the past year and see if their might be a better option available. She realized that the plan she had was heavier on features her employees didn’t use. By tweaking her plan, she could cut costs while still keeping what mattered most to her staff.
Open enrollment isn’t just paperwork. It’s a chance to reset and make sure your plan matches your people.
Exploring Affordable Plan Designs Can Save Your Budget
Like most small business owners, Angela was frustrated by rising healthcare costs. She wanted a plan her employees valued, but she couldn’t let it eat her budget alive. That’s when we introduced her to a new approach that many owners have been using for small business health insurance plans. It involves pairing a catastrophic health plan with a local direct primary care physician.
Here’s how it works. The catastrophic health plan covers major medical events like hospital stays, critical illnesses, injuries, or surgeries. A direct primary care physician, on the other hand, gives employees unlimited access to routine care and preventive visits for a flat monthly fee to the business. Together, they can create a low-cost alternative to traditional group health insurance plans.
Angela liked the idea. Her employees would still have protection for emergencies, but they’d also get easy access to everyday care that is incredibly personalized. And the kicker is the total cost is less than a standard group health insurance plan.
For Texas businesses trying to control expenses without cutting off care, this hybrid option is becoming more popular. Especially in urban centers like San Antonio and Ft Worth. Employees see real value in having a doctor they can visit without worrying about a copay, while employers know they have healthcare coverage if something big happens.
Compliance and Competitive Edge Go Hand in Hand
Angela employs only 12 people, which means she isn’t required by law to provide health insurance under the Affordable Care Act. But here’s the catch. If she pulled back on employee benefits altogether, her team would notice. And in today’s job market, competitors would happily lure them away with offers of better medical care for them and their family.
That’s the reality for many Texas small businesses. Offering health insurance, even when it isn’t required, can make the difference between keeping good people and losing them to someone else. For companies with 50 or more employees, compliance isn’t optional. Those businesses must meet affordability and minimum ACA-qualified health coverage standards to avoid penalties.
Angela realized her benefits package wasn’t just a line item on her budget. It was part of her competitive edge. Her employees valued having health insurance, and it made them more loyal to her business.
Whether you’re over the 50-employee mark or well below it, health insurance plays a bigger role in retention and hiring than ever before.
Finding the Right Plan Doesn’t Have to Be Overwhelming
Angela learned a lot during her review process. She discovered that open enrollment is an opportunity to make smart changes. She found that affordable plan designs exist if you’re willing to think outside of the traditional box. And she realized that health insurance isn’t just about compliance, it’s also about staying competitive in a tight Texas labor market.
But most importantly, she discovered that she didn’t have to figure this out on her own. By working with a Texas-based health insurance expert, she got guidance that made the options clear and manageable. Insurance For Texans helped her walk away confident that her health insurance choice was right for her business, her budget, and her employees.
If you’re a Texas small business owner staring at rising costs and confusing paperwork, you don’t have to go through this process alone. At Insurance For Texans, we specialize in helping small businesses like yours cut through the noise and find group health insurance that works.
Click the button below to connect with Insurance For Texans and explore the best health insurance options for your business.