Group Health Insurance
A Group Health insurance provides coverage to employees of a company or members of an organization. Although the health insurance law is undergoing more changes than ever before, this is one of the most critical benefits to your employees.
Group Health insurance provides several advantages such as shared risk & cost, easy enrollment, and tax advantages. Employees usually receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders. The premium cost is usually split between the employer and employee, and there is a minimum percentage rate the employer must contribute to the premiums.
Based on coverage, health insurance policies are categorized as below:
- Health Insurance
- Dental Insurance
- Vision coverage
- Health Savings Account
Employers select from a number of plan options including Preferred Provider Organization (PPO), a Health Maintenance Organization (HMO), Exclusive Provider Organization (EPO), and Health Savings Account (HSA), to offer their employees and their dependents.
- PPO: Allows you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.
- HMO: Offers a wide range of healthcare services through a network of providers who agree to supply services to members. With an HMO you’ll likely have coverage for a broader range of preventive healthcare services than you would through any other type of plan.
- EPO: Allows you to visit the doctors and hospitals within the EPO network, but cannot go outside of the network for care. There are no out-of-network benefits.
- HAS: Allows a tax-advantaged medical savings account available to taxpayers who are enrolled in a High-Deductible Health Plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit.
Group health insurance includes both small and large groups, which have different regulations. In most states, small group refer to up to 50 employees, while a few states including California and New York define it as up to 100 employees. If an employer has more employees than the state’s definition of small group, the plan is considered a large group plan.
Premium for group health insurance is dependent on the type, size, and location of the business. Other factors that determine your premium are based on enrollees’ age and tobacco usage. You may also consider adopting workplace wellness programs to help save on group health insurance premium.