The Houston Business Journal reported last week that Texas now ranks in the bottom five states when it comes to employer-sponsored health insurance. Only 52 percent of Texas residents are currently covered by employer insurance policies, according to the report. The only states that have even fewer residents on employer plans are Louisiana and New Mexico.
In 1999, 62.3 percent of Texans were covered by employer insurance. The report attributes part of the reason for the recent decline to an increase in health insurance premiums. Since 1999, single coverage premiums grew by as much as 104.5 percent in Texas, with about 2.7 percent of this increase being shouldered by employees and the rest by employers.
Nationwide, it appears to be true that fewer employers are offering health plans than previously and when employers do offer plans fewer employees sign up.
One reason that fewer employees may be signing on for employer-sponsored insurance plans is the fact that medical claims are not always honored, so many people might think that there is no point in paying the premiums.
Employees should be aware that employer-provided benefits such as health or disability insurance are often governed by the Employee Retirement Security Act. This means that when a claim is denied, the employee might be able to dispute the denial and fight for benefits.
Workers often do not know whether a claim has been denied wrongfully, because the policy statements and summary plan description are so complicated. Those who have had a claim denied might wish to talk to an ERISA attorney about their case. In many cases, it is possible to obtain benefits by pursuing an appeal aggresively.
Source: Houston Business Journal, “Texas in bottom five for employer-sponsored insurance,” Byan Raji, April 11, 2013
- For more information about ERISA and disputing medical claim denials, please visit our Houston law firm’s Medical Benefits page.