ACA plans through HealthCare.gov, employer group coverage from level-funded to ICHRA, and Texas Medicaid context — all under one TDI-licensed platform with broker support from the Metroplex to Houston to Austin.
Benefitra is the parent platform for benefits brokerage, HR SaaS, marketing, and decision-support tools. Texas employers can adopt one pillar or stack them.
Seven funding paths: fully-insured, level-funded, self-funded, ICHRA, PEO-integrated, captive, Taft-Hartley.
Compare paths →Lead-engine and rankings for growing employers. Page-2-to-page-1 in months.
See trajectories →Texas health plans give consumers and employers more options for dependable health insurance coverage. These options match different budgets and needs.
Individual and family plans. Texas uses the federally facilitated marketplace at HealthCare.gov — Texas does not operate its own state-based exchange. Plans are ACA-compliant qualified health plans regulated by the Texas Department of Insurance (TDI). Coverage varies by household income, county of residence, and plan year. Texas has the highest uninsured rate in the nation at 16.4% (2023 ACS), partly because Texas has not expanded Medicaid.
Qualified health plans and subsidies. Marketplace plans cover the federal essential health benefits. Most Texas enrollees qualify for premium tax credits based on household income, and many also qualify for cost-sharing reductions on silver plans. Open enrollment runs annually (Nov 1 – Jan 15 historically), with special enrollment periods for qualifying life events. The American Rescue Plan and Inflation Reduction Act enhanced subsidies above 400% FPL through plan year 2025.
Texas Medicaid context. Texas Medicaid is administered by the Texas Health and Human Services Commission (HHSC). Texas has not expanded Medicaid under the ACA, which leaves a coverage gap for non-disabled adults: parents qualify only up to roughly 15% FPL, and childless non-disabled adults do not qualify regardless of income. Pregnant women qualify up to 198% FPL and children up to 201% FPL through CHIP. Texas continues to rank in the top three for uninsured rate among working-age adults.
Employer group plans in Texas. Texas employers with 2 or more employees can offer group health insurance year-round. Mid-market employers across the Dallas-Fort Worth, Houston, and Austin metros increasingly use level-funded, self-funded, or ICHRA designs to control renewals — especially relevant in Texas where the Medicaid gap means more workers depend on employer-sponsored coverage. Benefitra's Funding-Fit Discovery models the math across all seven arrangements.
Sam helped us bring Texas group renewals under control without cutting benefits. The strategy work made a measurable difference at renewal.
Switching to a level-funded design cut our health spend meaningfully and gave us monthly visibility we never had on fully-insured.
As a Texas family of four on the marketplace, our subsidies and plan choice improved year over year. The Benefitra team walked us through it.
Marketplace, Medicaid, group plans, and ICHRA. Common Texas-specific questions for families and employers.
Answer twelve short questions. We grade your fit across the seven funding arrangements — fully-insured, level-funded, self-funded, captive, ICHRA, PEO-integrated, and Taft-Hartley.
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