In Texas, group health insurers cannot refuse insurance to qualified persons because of a health problem, nor can they be charged more than others in their group. If you join a new company, your new employer can seek a waiting period to offer group coverage. In case you have group insurance through your small business employer, he/she must also include your spouse and dependents in the coverage. Newborn, adopted, grand, and disabled children are given special considerations in the state. Except for HMOs, group insurers are entitled to review your health records for the six months before new coverage. They can seek an exclusion period of not more than 12 months. If you have had continuous coverage of your pre-existing condition, with no break of more than 63 days, you get creditable coverage.

Small businesses with two to 50 employees cannot be refused small group health insurance and cannot be cancelled either due to sickness within the insured group. Texas also imposes limits on the cost of the premiums for businesses with less than 50 employees. A small business with two to 50 employees can join a statewide and approved purchasing alliance for group health insurance coverage.