Group Health Insurance
There are many different options in group health insurance plans. Depending on the size of the company and the goals and objectives of the owners/shareholders there are different routes to pursue. Some companies will also take advantage of the flexibility that comes with implementing a cafeteria plan and Flexible Spending Account (FSA), a Health Savings Account (HSA), a medical reimbursement plan (sometimes called an Health Reimbursement Account or HRA), or any combination of the above.
Generally speaking, the fundamental difference between group health insurance and individual health insurance is that with most group plans there is a guaranteed approval while on the individual health insurance side an application can be declined in some cases because of the health status of the applicant. This is why group health insurance rates are approximately twice as much as the rates of a comparable individual health insurance plan.
As an employee, should you choose your employer’s group plan or an individual plan? If your employer will pay the entire cost of your group health plan premiums then choose the group health plan (if the employer does not offer to pay the portion of the premium for your spouse of children then you may want to consider individual health for them). If you have to pay all or most of your group plan premium and you are somewhat healthy then you will probably want to go the individual health route. Take a few moments and compare group and individual health insurance options now!
Group health insurance is usually the most affordable way to get health coverage for you and your family IF you or your spouse’s employer will foot the bill. Whenever it is an option, it should be seriously considered and investigated before being turned down. In a country where health coverage is a must, group health insurance is a gem. It is a great way to get good coverage at a reasonable price. Group health insurance is the way to go for anyone who is eligible. If you are not eligible for group health insurance then investigate further into individual health insurance as individual health insurance is much more affordable than group health insurance.
Advantages Of Group Health Insurance
There are many advantages to offering group health insurance at your business or other group.
Everyone is accepted onto the group health insurance plan regardless of health history (although typically there are pre existing condition exclusions if the applicant has not maintained continuous coverage).
There are usually no health screenings required for coverage (individual health insurance typically does not require health screening or physicals either).
Good benefits, especially health benefits, help to recruit and keep employees.
Disadvantages Of Group Health Insurance
For the individual, there may be some disadvantages to group health insurance, especially because they are often chosen on the basis of what the majority or management wants. That leaves some people dissatisfied with the plan. Some of these disadvantages may be:
The policies are not always tailor-made to your needs.
Deductibles and out-of-pocket minimums may be higher than you would like.
It may be a policy with strict choices of which doctors and/or hospitals to use and they may not be the ones you necessarily want.
5 Types Of Group Health Insurance
When making a decision of which type of health plan to offer your group, it is important to investigate all the possibilities. There are 5 different types of group health insurance available on the marketplace.
Traditional – The traditional type of group health insurance, also known as indemnity coverage, gives the members the most flexibility possible. There are no limitations as to what hospitals they can use, which doctors they can see and they do not need referrals to see a specialist. Because of this freedom, these policies are the most expensive and tend to have high out-of-pocket expenses and co-insurance charges. Fewer companies now offer this type of insurance because of the high cost to employees and employers.
HMO – Health Maintenance Organizations: These types of plans are the strictest and sometimes the least expensive. Members must choose a primary care physician and have him provide referrals to specialists, if necessary. If a member wants to visit a doctor, who is not in the HMO network, he or she must pay for it themselves. The limitations and guidelines of this type of insurance are difficult for many people to accept, making it a less popular type of plan.
PPO – Preferred Provider Organizations: This plan gives a good mixture of traditional and HMO type coverage. It is basically an agreement with doctors and hospitals to give a reduced rate on care for members. Policyholders can choose between using those health care options in the preferred list of providers or those out-of-network and pay higher rates, but still have coverage and choice. It is the most popular type of group health insurance right now.
POS – Point of Service: POS plans or open-ended HMOs are a combination of PPO and HMO. Members must have a primary care physician and get referrals for specialists. However, they can also use out-of-network providers like in PPOs and get the costs covered to some degree, however not as much as with the chosen providers.
CDHC – Consumer Driven Health Care: This is a type of coverage that is much more hands on for the employee and is relatively new to the marketplace. It uses high deductibles and health savings accounts (HSA). The HSA is meant to pay for costs of preventative and regular healthcare. The insurance part of the program is to cover members in case of serious illness or costly medical procedures.
Group Health Insurance: Alternative Groups
There is more than one way to obtain group health insurance. A group that is comprised of people who are associated in some way or another and seeking group coverage can get plans for their members. The group need not be an employer-based group. If groups you belong to do not offer health insurance, you may be the one to introduce it to them. They may be from:
Church / Synagogue / Religious Groups
Business Associations (Chamber of Commerce, Association of Realtors, Association of Mortgage Brokers, Bar Associations, AICPA, etc.)
Compare Individual And Group Health Insurance Quotes Now!
To get a quote on group health insurance or individual health insurance, use our tool at the top of this page to get in contact with a group health insurance agent or broker.
Comparison shop rates from multiple insurers offering both individual and group coverage.
Get started finding a top health insurance plan now!