Texas has 254 counties and 27 different geograhic rating areas. In Texas, like most states, the only factors used to determine the rates for fully-insured small groups is the ages of the covered employees and dependents and the location of the company. A small group health carrier must charge the…
Rating Areas
Under the ACA, all small group carriers in a state must use the same geographic rating areas when determining the rates of their health plans. Similarly-situated groups (those with the same census) would have the same rates for the same plan in any county in the rating area. The rating areas for each state are deceloped by CMS.