Employee Benefits
Major medical, dental, vision, voluntary, and group life and disability.
Employee Benefits · Statewide Texas · 5–500 Employees
Your renewal went up again. That was a choice — just not yours.
Most Texas employers with 5 to 500 employees are still on a fully-insured plan, taking whatever increase the carrier hands them each year. There are four other ways to fund a health plan. Nolasko Insurance Advisors shows you which one your group actually qualifies for — and what it would cost.
Download the free guide The Texas Employer's Guide to Group Benefits · PDF, 10 pages
Independent broker — not captive to one carrier
Texas-licensed since 2017 · groups statewide
You work with the principal, not a service pool
No cost · No obligation
Free Renewal Cost-Check
Send us your current renewal. We'll tell you — in writing, within three business days — whether it's competitive and what else your group qualifies for.
- Email your renewal letter, current plan summary, and a census (no names needed).
- We market it and model the alternative funding options your group is eligible for.
- You get a written side-by-side. If we can't beat it, we'll tell you that too.
No broker-of-record letter required to get the analysis.
Nothing changes with your current plan or agent.
6.5%Projected 2026 increase in employer health benefit cost per employee — the steepest since 2010
~9%What that increase would have been if employers made no plan changes at all
$26,993Average annual family premium for employer coverage in 2025
$2,631Average deductible at small firms — roughly 57% higher than at large firms
Sources: Mercer National Survey of Employer-Sponsored Health Plans, 2025 · KFF 2025 Employer Health Benefits Survey
The real problem
The increase isn't the problem. Having no alternative to it is.
Mercer's data makes the point cleanly: employers who changed something held 2026 cost growth to 6.5%. Employers who changed nothing were looking at nearly 9%. The gap between those two numbers is what a benefits strategy is actually worth — and it compounds every year you don't have one.
If this sounds like your renewal, you're not being advised — you're being quoted:
- Your broker shows up 45 days before renewal with one carrier's number and two "buy-down" options.
- Nobody has ever explained why you're fully insured instead of level-funded.
- You've never seen your own claims data — because on a fully-insured plan, you don't get it.
- Every year the fix is a higher deductible, and every year morale takes the hit.
- You've grown past 50 employees and nobody has walked you through the ACA implications.
- Your HR person spends open enrollment chasing paper because there's no enrollment system.
- You have no idea whether your Form 5500, SPD, or Section 125 plan document is current.
- Your best people are asking why the plan keeps getting worse while the premium climbs.
Where we're different
Five ways to fund a health plan. Most brokers sell you the first one.
Funding strategy — not plan shopping — is where the money is for a group of 5 to 500. A fully-insured plan hands 100% of your risk and 100% of your data to the carrier. Every step to the right of it gives some of both back. Here's the ladder, and roughly where each rung starts to make sense.
Rung 1
Fully Insured
Fixed monthly premium. The carrier keeps the risk, the reserves, and the claims data. Simple, predictable, and the most expensive way to be healthy.
Best fitGroups with high claims, no risk appetite, or fewer than 5 enrolling
Rung 2
Level-Funded
You pay a fixed monthly amount like a premium, but it funds a claims account with stop-loss protection built in. Good claims year? A surplus refund may come back to you. Bad year? Stop-loss caps the damage.
Best fitHealthy groups, roughly 5–150 employees
Rung 3
Self-Funded + Stop-Loss
You pay actual claims plus admin and stop-loss premium. Full claims transparency, no state premium tax on the self-funded portion, and plan design largely under your control.
Best fitRoughly 75–500 employees with cash-flow tolerance
Rung 4
Group Captive
You self-fund inside a pooled captive with other vetted employers, sharing a middle layer of risk. Underwriting credit for good experience, without carrying a catastrophic claim alone.
Best fitRoughly 100–500 employees, multi-year commitment
Rung 5
ICHRA
Instead of buying a group plan, you fund a defined-contribution allowance and employees buy individual coverage. Your cost becomes a budget line you set, not a renewal you receive.
Best fitDistributed workforces, variable-hour staff, hard-to-insure groups
Which rung fits depends on your census, claims experience, industry, cash-flow tolerance, and how much administrative work you want to own. There is no universally best answer — that's the whole point of modeling it. We show you the math on every option your group qualifies for, including the ones that pay us less.
By group size
What actually changes as you grow
A 12-life group and a 240-life group need almost nothing in common. Find your band.
Small Group5 – 24 employees
At this size you're rate-banded and community-rated on fully-insured plans — your own claims barely move the number. The leverage is in getting underwritten instead.
- Level-funded underwriting can price a healthy small group well below community rates
- Texas carriers generally require ~75% participation of eligible employees, excluding those with other coverage
- Section 125 makes employee contributions pre-tax — an immediate FICA saving for you
- Voluntary products add perceived value at near-zero employer cost
- No ACA employer mandate below 50 full-time equivalents
Mid Group25 – 99 employees
The band where the most money is left on the table. You're big enough to be underwritten favorably and usually still being sold like a 10-life group.
- Level-funded and early self-funded options become genuinely competitive
- Crossing 50 FTEs triggers ACA employer mandate and 1094/1095-C reporting
- Claims data starts arriving — and starts being actionable
- Multi-plan offerings (HDHP + HSA alongside a PPO) let employees self-select
- Dependent-tier and contribution strategy becomes a real cost lever
Large Group100 – 500 employees
Your plan is now a seven-figure line item. It should be managed with data, not renewed on faith.
- Self-funding, captives, and reference-based pricing all in play
- Stop-loss marketing becomes an annual discipline, not a formality
- High-cost claimant management and specialty drug carve-outs matter
- ERISA plan documents, SPDs, and Form 5500 filings are mandatory and audited
- Benefits administration and enrollment technology pay for themselves
What we place
The full benefits program — not just the medical plan
Medical is the biggest number. It's rarely the only thing your employees judge you on.
Major Medical / Group Health Insurance
The core of the program and the largest cost. What we work through with you:
- Funding strategy first — fully insured, level-funded, self-funded, captive, or ICHRA (see the ladder above)
- Network fit — whether your employees' existing physicians and hospital systems are actually in-network, whether they're in Houston, Dallas–Fort Worth, Austin, San Antonio, El Paso, the Rio Grande Valley, or a rural county where the network map matters far more than the premium
- Plan type — HMO, PPO, POS, EPO, and HDHP paired with an HSA
- Cost sharing — deductible, coinsurance, copay structure, out-of-pocket maximum
- Contribution strategy — employee vs. dependent tiers, and what that does to participation, affordability testing, and your total spend
- Pharmacy — formulary tiers, specialty drug exposure, and whether a carve-out is warranted
Dental & Vision
Low cost, high visibility. These are frequently the benefits employees use most and remember best.
- DHMO, DPPO, and indemnity/fee-for-service structures
- Preventive, basic, and major service cost-sharing tiers, plus annual maximums
- Orthodontia — adult, child, or excluded, and the lifetime maximum
- Vision exam, frame, lens, and contact allowances, plus network breadth
- Voluntary (100% employee-paid) versions when budget is tight — often still worth offering for the group rate alone
Group Life, Short-Term & Long-Term Disability
The benefits nobody thinks about until the day they matter more than everything else combined.
- Basic group life & AD&D — flat amount or salary multiple, with guaranteed issue up to a set limit
- Supplemental / voluntary life — employee-paid buy-up for the employee, spouse, and children
- Short-term disability — elimination period, benefit percentage, and duration; note Texas does not mandate a state STD program
- Long-term disability — own-occupation vs. any-occupation definitions, elimination period, and offsets
- Tax treatment — who pays the premium determines whether the benefit is taxable to the employee. Worth getting right before someone files a claim.
Voluntary & Supplemental Benefits
Employee-paid indemnity products that pay cash directly to the employee. They cost the employer essentially nothing and cushion the high-deductible plans that cost-containment usually requires.
- Accident, hospital indemnity, and critical illness — cash benefits paid regardless of other coverage
- Portable in most cases, meaning the employee keeps the policy if they leave
- Pairs deliberately with an HDHP: the indemnity payout helps absorb the deductible
- Optional additions — legal plans, identity theft protection, pet insurance, EAP
Section 125 Cafeteria Plan, HSA, FSA & HRA
The tax structure underneath everything else. A properly documented Section 125 plan lets employees pay their share of premiums pre-tax — which reduces their taxable income and your matching FICA liability. It is one of the few places in benefits where both sides win with no trade-off.
- Premium Only Plan (POP) — the baseline; required to run premiums pre-tax at all
- Health FSA — pre-tax dollars for out-of-pocket medical costs
- Dependent Care FSA — pre-tax childcare and eldercare
- HSA — paired with a qualified HDHP; triple tax advantage and the balance belongs to the employee
- HRA / ICHRA / QSEHRA — employer-funded reimbursement arrangements, including the defined-contribution ICHRA model
A cafeteria plan requires a written plan document to be valid. A surprising number of employers running pre-tax deductions don't have one.
Compliance, Administration & Enrollment
The unglamorous half of the job, and the half that generates penalties when it's skipped.
- ACA — applicable large employer determination, affordability safe harbors, and Forms 1094-C / 1095-C
- ERISA — plan documents, Summary Plan Descriptions, and wrap documents
- Form 5500 — filing obligations and the Summary Annual Report
- COBRA — election notices and administration for groups of 20+; Texas state continuation for smaller groups
- Notices — Summary of Benefits and Coverage, Medicare Part D creditable coverage, CHIP, and new-hire notices
- Enrollment technology — online enrollment and carrier EDI feeds so open enrollment stops living in a spreadsheet
Nolasko Insurance Advisors is an insurance brokerage. We are not a law firm or tax advisor, and nothing here is legal or tax advice — but we will tell you plainly when something needs to go in front of your ERISA counsel or CPA.
Texas rules that catch employers out
Four things Texas employers get wrong
Texas doesn't require you to offer health insurance — until it does
There is no Texas state mandate to offer group health coverage. But the federal ACA employer mandate applies at 50 full-time equivalent employees, and FTE math counts part-timers by hours worked. Plenty of employers cross that line without realizing it, then discover the reporting obligation and potential penalties a year later.
The 75% participation rule has more exceptions than employers think
Most Texas carriers require roughly 75% of eligible employees to enroll. What employers miss is that employees with other qualifying coverage — a spouse's plan, Medicare, Medicaid, TRICARE, VA — are generally excluded from the calculation. A group that looks ineligible on paper often qualifies once the census is counted correctly.
There's an annual window when participation stops mattering
If your group genuinely can't hit the participation threshold, carriers in Texas typically open a special small-group enrollment window each year, generally running November 1 through January 15, during which participation and contribution requirements may be relaxed. Miss it and you're waiting a year. We plan around this window on purpose.
Level-funded plans are regulated differently — and that matters
A level-funded plan is technically self-funded, which means it's governed by federal ERISA rather than Texas insurance law. That's largely an advantage: no state premium tax on the self-funded portion, more plan design freedom, and access to your claims data. It also means the state protections of a fully-insured plan don't apply. You should know that going in, and most employers on level-funded plans were never told.
Participation, contribution, and enrollment-window rules vary by carrier and change over time. Treat the above as orientation, not as a determination about your group — we'll confirm current requirements with the specific carriers we market you to.
How it works
From your renewal letter to a decision, in about three weeks
Start 90 to 120 days before your renewal date if you can. We can work faster when we have to.
1
Discovery
A 30-minute call. What you offer today, what it costs, what your people complain about, and what you're actually trying to accomplish — retention, cost control, or both.
2
Data & Underwriting
Census, current plan documents, renewal letter, and — where available — claims experience. We submit for underwriting across fully-insured and alternative-funded markets simultaneously.
3
Written Analysis
A side-by-side of every viable option: total employer cost, employee payroll impact, network disruption, and the risk you're taking on at each rung. Recommendations in plain English.
4
Implement & Service
Enrollment meetings, employee communications, carrier setup, compliance documents. Then we're the number your employees call when a claim gets denied — not your HR manager.
Why Nolasko
A small agency that treats a 30-life group like a real client
01
Independent, and it shows in the options
We're not captive to a single carrier and we have no quota to fill. We market your group across carriers and funding models — including the arrangements that pay a broker less than a fully-insured placement does.
02
You deal with the principal
At a national firm, a 40-life group gets an account coordinator and a phone tree. Here, the person who analyzed your plan is the person who answers when you call in March with a problem.
03
Commercial risk expertise behind the benefits
Nolasko is a full commercial brokerage and Lloyd's coverholder. If we also handle your property, liability, auto, or workers' compensation, your benefits program is being designed by someone who already understands how your business runs.
04
Written analysis, not a slide deck
You get numbers you can hand to your CFO: total cost of each option, payroll impact per employee, and the specific risk you're assuming. If the incumbent plan is the right answer, we'll say so in writing.
05
Compliance handled before it's a problem
ACA reporting, ERISA documents, 5500 filings, COBRA, Section 125 plan documents, required notices. Tracked on a calendar, not remembered in a panic.
06
Service your employees can reach
Claim denials, ID cards, prior authorizations, network questions. Your employees call us. Your HR person gets their week back.
Where we work
Every market in Texas — not just the one we're sitting in
Group benefits are quoted, underwritten, enrolled, and serviced remotely as standard practice. Your ZIP code determines your rating area and your provider network — it does not determine which broker you're allowed to use. We write groups from the Panhandle to the Valley.
HoustonDallasFort WorthAustinSan AntonioEl PasoCorpus ChristiLubbockAmarilloMidland–OdessaWacoBeaumont–Port ArthurMcAllen–EdinburgLaredoBrownsvilleKilleen–TempleCollege StationTyler–LongviewAbileneSan AngeloWichita FallsVictoriaTexarkanaSherman–Denison
Rating areas differ. A lot.
Texas is divided into multiple geographic rating areas, and the same plan design can price very differently in Midland than in McAllen. If your broker only works one metro, they only know one set of rates. We quote across all of them.
Multi-location groups are the norm here
Plenty of Texas employers run a yard in Odessa, an office in Houston, and crews moving between them. Network adequacy across those locations is a real design constraint, and it's one of the more common reasons a level-funded or ICHRA structure ends up being the right answer.
Texas-headquartered, multi-state
If your company is based in Texas with employees in other states, we handle the situs-state questions, out-of-area network options, and the multi-state compliance layer that comes with it.
Questions employers actually ask
Frequently asked questions
What is the minimum group size for employee benefits in Texas?
Texas small-employer group health coverage generally starts at two eligible employees, and most carriers will write a group of five or more without difficulty. Nolasko works with employers from 5 to 500 employees. Below five enrolling lives, options narrow considerably and an ICHRA or individual-market approach is often the better structure — we'll tell you if that's your situation rather than forcing a group plan.
How much does group health insurance cost for a small business in Texas?
Nationally, the average annual premium for employer-sponsored family coverage reached $26,993 in 2025, with the employer typically covering the majority. Your actual cost depends on employee ages, industry, plan design, contribution strategy, and funding model — which is why a real number requires a census, not a calculator. Geography matters too — rates vary meaningfully between the Houston, Dallas–Fort Worth, Austin, and San Antonio rating areas and again in rural counties. A healthy 25-life Texas group that moves from fully-insured to level-funded can see a materially different number than the renewal in front of them. The only way to know is to run it.
Is a level-funded plan actually safe for a small group?
The risk is capped by design. A level-funded arrangement bundles individual and aggregate stop-loss insurance, so your maximum annual exposure is known before the plan year starts — usually only modestly above what a comparable fully-insured premium would have been. The trade-off is real, though: if claims run high you may face a higher renewal the following year, and terminating a level-funded plan mid-stream has complications a fully-insured plan doesn't. We walk through the downside scenario, not just the surplus-refund scenario, before you sign anything.
Do I have to offer health insurance to my employees in Texas?
Texas has no state mandate requiring employers to offer group health coverage. The federal ACA employer mandate applies to applicable large employers — those with 50 or more full-time equivalent employees — who can face significant penalties for failing to offer affordable, minimum-value coverage. If you're near the 50-FTE line, the FTE calculation is worth doing carefully, because part-time hours count toward it.
What percentage of employees must enroll for us to qualify?
Most Texas carriers require roughly 75% of eligible employees to participate, but employees who have other qualifying coverage — through a spouse, Medicare, Medicaid, TRICARE, or the VA — are generally excluded from the count. Groups that assume they don't qualify frequently do once the census is counted properly. And if participation truly can't be met, carriers typically offer an annual small-group window (generally November 1 through January 15) when those requirements may be relaxed.
How much do employers have to contribute toward premiums?
Carrier requirements vary, but a common threshold is 50% of the employee-only premium. Contribution strategy is also a cost lever in its own right: what you contribute toward employee-only versus dependent tiers affects participation, ACA affordability testing, and your total spend — often more than the plan design itself does.
Can we change brokers without changing our health plan?
Yes. A Broker of Record letter reassigns servicing of your existing policies to a new broker without touching your plan, your carrier, your rates, or your employees' coverage. It typically takes effect within about ten days. You do not need to wait for renewal, and you do not need a BOR letter to get our renewal cost-check — that analysis is free and carries no obligation.
When should we start working on our renewal?
Ninety to 120 days before the renewal date is ideal. Alternative funding options — level-funded, self-funded, captive — require medical underwriting, and underwriters need time. Starting 30 days out effectively limits you to the fully-insured quotes your incumbent carrier already sent. We can still help at 30 days, but you'll have fewer doors open.
What does it cost to work with Nolasko?
Broker compensation on group benefits is typically paid by the carrier as a commission built into the rates you'd pay regardless of which broker you use — so in most cases there is no additional cost to you for having a better one. For larger or more complex accounts a flat fee arrangement is sometimes more appropriate and more transparent. Either way, we tell you exactly how we're paid before you engage us.
Which areas do you serve?
All of Texas. We're headquartered in the Houston area and work with employers statewide — Houston, Dallas, Fort Worth, Austin, San Antonio, El Paso, Corpus Christi, Lubbock, Amarillo, Midland–Odessa, Waco, Beaumont, McAllen, Laredo, and the smaller markets in between. Group benefits are placed and serviced remotely as a matter of course, so your location within Texas doesn't limit which carriers or funding structures we can bring you. We also handle multi-state groups headquartered in Texas with employees in other states.
Free renewal cost-check
Send us your renewal. We'll tell you the truth about it.
Three business days, written analysis, no obligation, and no Broker of Record letter required. If your current program is competitive, we'll tell you that and you'll have documentation for your file. If it isn't, you'll have options before your deadline.
- Your current renewal letter and plan summary
- A census — ages, ZIP codes, coverage tiers (no names required)
- Claims experience or loss runs, if you have access to them
Nolasko Insurance Advisors, PLLC
Phone(832) 592-1114
Email[email protected]
HoursMonday – Friday, 9:00 a.m. – 5:00 p.m. CT
ServingAll of Texas — Houston, DFW, Austin, San Antonio and statewide
Groups5 – 500 employees
Prefer to talk it through first? A 20-minute call costs you nothing and usually clarifies more than a quote does.
Objective advice, and professional service
We are a full-service independent insurance agency that specializes in insurance for businesses, small to large.
We offer assistance with plan design on qualified health plans (major medical), dental, vision, voluntary benefits, life and disability insurance.
Having solid employee benefits is a sound strategy to attract and retain quality employees. It also can impact the owners’ personal health and financial stability.
Speak To A Licensed Broker
Let Us Assist You
Major Medical Insurance
When selecting a plan to offer your eligible employees, there are multiple important factors that affect the premium and care received. These factors need be carefully considered, when designing your plan:
- Provider network
- Fully insured and self-funded plans
- Plan type, HMO, PPO, POS
- Co-payment plan vs. out-of-pocket for doctor visits
- Deductibles
- Co-insurance
- Medically underwritten or census based.
- Employer contribution towards employee, and family, if applicable.
Vision and Dental Plans
Similar to major medical insurance, there factors that will affect premium and coverage to eligible employees, including:
- Provider network
- Dental plan type, DHMO, DPPO, Fee-for-service or discount plans
- Orthodontia included, annual limit
- Routine care vs minor and major treatment cost share
- Lenses, frames and contacts allowance
- Employer contribution to monthly premiums
Group Life and Disability Insurance
Most people are uninsured or under-insured for life and disability insurance which replaces the employee’s income and protects the family in the event of an untimely death or disability due to illness or an accident. Things to consider when offering a plan:
- Elimination period for short-term disability
- Contribution to premium for short term and long term disability
- Employer-provided life insurance amount (multiple of salary)
- Employee paid supplemental life insurance option
Section 125 (Cafeteria) Plan
A section 125 plan, commonly known as a cafeteria plan, allows payment of benefits on a before-tax basis, bringing tax savings to both employees and the employer.
The design and implementation phase includes the installation of a cafeteria plan (section 125 of the IRS Code) at no cost to the employer.
Employer contributions to the cafeteria plan are usually made through a salary reduction agreement between the employer and the employee in which the employee agrees to contribute a portion of his or her salary on a pre-tax basis to pay for the qualified benefits.
A section 125 plan allows an employer to offer employees a choice between taxable and nontaxable benefits.
Voluntary Benefits
Voluntary benefits are employee-paid indemnity insurance policies that pay the employee an agreed-upon amount when certain events happen. Employees can only opt in through an employer-sponsored group
The most common coverage offered are:
- Accident
- Hospital indemnity
- Critical illness
These policies are designed to help with out-of-pocket expenses and are portable if the employee leave the company.
Other Considerations
Bilingual Enrollment Services:
Communication and education about your benefits is crucial and can affect participation. We offer enrollment services in Spanish.
Self-Funded vs. Fully Insured:
Employers with stable and predictable annual revenues may benefit from a self-funded benefits program that gives you more control on plan design and your cash. The business is protected by a stop-loss policy that covers services beyond what is forecast.
New Plans:
New small group plans may start at any point in time in the year.
Speak To A Licensed Broker
Let Us Assist You
We are here to assist you selecting, implementing, and servicing your benefits plan with the personal attention everyone in your business deserves.