Group Health Insurance

What is Group Health Insurance?

It is health insurance that is available to a larger group of people, normally employees of a company or members of an association.

The group health plan is purchased by the company and then made available to employees. These types of plans are not available to individuals and require that 70% of employees are members participate.

When a company decides on a particular plan, employees can decide whether or not to participate. Some policies will have a tiered structure so the employees can decide on the level of coverage they want.

Employees and the company share the cost of the premiums.

Some plans also provide coverage for family members and dependents. This of course comes with an additional cost.

What Can it Cover?

There are many ways to structure a group health insurance policy and the coverage it provides.

If you choose a policy that offers tiers, it will be up to the employee to decide what level of coverage they would like.

Also, because of the diversity of policies available, each one will provide different levels of benefits.

Here are the main types:

• Catastrophe
• FSA
• HMO
• HSA
• PPO

The biggest benefit is that the employee’s premiums will be much lower than an individual health plan because there are more participants in the program.

One of the most popular group health insurance policies is the health maintenance organizations (HMOs). This allows them to better control costs in the provider’s contract. However, employees will have less flexibility over care options.

Another option employers have is Preferred provider organizations (PPOs). These give employees more options when choosing a physician or specialist. However, it will also have higher premiums than an HMO.

What Does It Not Cover?

This will depend on the type of plan chosen. As all policies are different, the options and limits can vary widely. Some plans allow for additional add-on coverage for specific medical coverage.

Are There Policy Limits?

All insurance policies have limits, so it will depend on the type of plan that you offer. It will also depend on the amount of coverage selected.

Group health insurance policies offer the best coverage with the lowest premiums because the risk level is spread across a larger number of people.

Because the group policy will be customized to you as a business, we cannot be sure of the limits and costs until we sit down with you to construct the policy.