Open Enrollment 2026 for Texas Small Groups: How to Prep Your Employees
Open enrollment for a Texas small group is the period when your eligible employees choose a plan for your plan year, and it follows your group's own start date. Texas small groups can start coverage on the 1st of any month, so you pick the date and work backward from it.
We are an independent employee benefits brokerage based in Corpus Christi and licensed across Texas. We quote the plan, build the employee packet, and run elections, and our broker cost to the employer is $0. 40 Google reviews.
How employee open enrollment works for a Texas small group
Open enrollment is when eligible employees pick a plan, add or drop dependents, or waive coverage for the plan year. Outside it, changes need a qualifying event under the federal special enrollment rules: a loss of other coverage, or a new dependent through marriage, birth, adoption, or placement for adoption.
Your start date sets the calendar. A group whose plan year begins January 1 runs employee open enrollment this fall. A group that starts on the 1st of another month runs it before that date. You are not waiting on a market-wide calendar, because a group that meets the carrier rules can start on the 1st of any month.
Open enrollment prep, from start date to first payroll
Work backward from the day coverage starts. The steps are the same for a small office and a larger group.
| Step | What happens | Timing |
|---|---|---|
| 1. Pick the start date | Choose the 1st of the month your plan year begins | Your call |
| 2. Send the census | Dates of birth, gender, and home ZIP, plus the renewal letter if you have one | Day one |
| 3. Compare quotes | Fully insured and level-funded options come back side by side | Usually about 48 hours |
| 4. Set contribution | Decide what the company pays before anything goes to employees | Before the packet |
| 5. Run employee open enrollment | Employees elect or sign a waiver | Before the start date |
| 6. Medical setup | The carrier builds the group | 3 to 4 weeks |
| 7. Coverage starts | Payroll deductions match the carrier bill | The 1st of the month you chose |
Start with the renewal, not the enrollment form
Enrollment is the last step, not the first. If you have a plan today, the carrier sends a renewal with next year's rates and sometimes a plan change. That letter is one carrier's number. Before anyone announces benefits to the team, we run the same census against the market so your people choose between real options.
If the renewal jumped, what a Texas group health renewal does walks through the moves we run. Shop first. Enroll second.
Set contribution and check 75% participation before you announce
Most Texas small-group carriers want about 75% participation after valid waivers and an employer contribution of at least 50% of the employee-only premium. Those are carrier rules, not Texas law. Set your contribution before the packet goes out. The Texas 75% participation rule explains how waivers count.
For planning, full single medical runs about $625 to $680 per employee per month in 2026. At a 50% employer contribution to employee-only, the employer share is about $313 to $340 per enrolled employee per month. Those are planning estimates from our published band. Your census, plan design, and funding type move the issued number.
A group that meets both rules can start on the 1st of any month. A group that cannot meet participation or contribution minimums is the one case with a calendar. Under 45 CFR 147.104, a carrier may restrict a group that cannot meet them to an annual enrollment period of November 15 through December 15. That period applies only to those groups.
Fully insured or level-funded: we quote both
Fully insured is a fixed monthly premium, and the carrier carries the claims risk. Level-funded looks like a premium on the invoice, but part of each payment funds your group's claims account, with stop-loss capping a bad year. It usually asks employees for a medical questionnaire, so the packet changes.
For groups that underwrite for it, level-funded often lands 15% to 30% under a comparable fully insured quote. That is an estimate, and the issued quotes decide it. On a level-funded quote we set our PEPM inside the monthly carrier payment, never as a separate bill, and PEPM vs commission explains how Texas brokers get paid. We quote all major carriers and several regional ones, fully insured and level-funded. Level-funded vs fully insured in Texas covers the tradeoffs.
Build the employee packet
Employees need three things: which plans are offered, what each costs per paycheck at each tier, and which doctors and hospitals are in network. Check the hospitals your people use on the exact plan, not the carrier name.
Federal rules also require the summary of benefits and coverage for each plan to go out with the enrollment materials, under 45 CFR 147.200. Include it in the packet. If you offer dental, vision, life, or voluntary products, run those elections in the same period and match the effective date to medical. Group dental and vision cost in Texas has the cost context.
Run elections and collect every waiver
Every eligible employee returns something: an election or a signed waiver. A valid waiver for other coverage, such as a spouse's plan or Medicare, comes out of the participation count. An employee who declines only because they do not want to pay their share counts against it.
Collect the waiver forms before the group goes to the carrier, with the reason on each one. A group can fail participation on paper while passing in reality, because the waivers were never documented.
After open enrollment: effective date, payroll, ID cards
Once elections are in, the carrier issues the group and sends ID cards. Confirm they are on the way before the effective date. Update payroll deductions to match each employee's tier before the first payroll of the plan year.
New hires enroll on the group's waiting period, which federal rules cap at 90 days under 45 CFR 147.116. After the effective date we handle adds, drops, qualifying events, billing questions, and claims escalations.
Frequently asked questions
When is open enrollment for a Texas small group?
It follows your group's start date. Texas small groups can start coverage on the 1st of any month, so your plan year and your employee open enrollment follow the date you pick. A January 1 start means a fall open enrollment.
Do we have to wait for open enrollment to start group coverage?
No. A group that meets the participation and contribution rules can start on the 1st of any month. The November 15 to December 15 annual period applies only to groups that cannot meet those minimums.
Can we change carriers for our next plan year?
Yes. Your plan year start is the natural point to move carriers or funding type, as long as the new plan is quoted and elections are in before the effective date.
Do employees who waive coverage hurt participation?
Only if they waive without other coverage. A waiver for a spouse's plan or Medicare comes out of the count with most carriers.
What does it cost to have a broker run open enrollment?
On the medical placement, $0 to the employer. Our broker cost to the employer is $0. Commission is built into the carrier rate.
The short answer
Employee open enrollment for a Texas small group follows your group's own start date, and coverage can start on the 1st of any month. Shop the renewal, set a contribution of at least 50% of employee-only, check 75% participation on real names, and collect every election and waiver before the start date. We quote all major carriers and several regional ones, fully insured and level-funded. Our broker cost to the employer is $0. Groups 2 to 250+. We do not cap. 40 Google reviews.
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Get your open enrollment dates and quotes lined up
Send a census and your renewal letter if you have one. We shop the market, help set contribution, build the employee packet, and collect elections before your start date. Corpus Christi base. Statewide license. Groups 2 to 250+. We do not cap. Clint Wallace, Lic 3200999 / NPN 21250478.
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