In an atmosphere of ever-growing health care and health insurance costs, group health insurance coverage is becoming critical for many employees. In fact, surveys cbdrumourcom show that employees value health insurance benefits above all others.
Studies have shown that a solid majority (over 60%) of Americans receive health insurance benefits via group health insurance coverage through their employer (or their spouse’s employer). Of course, from the employee’s point of view, this is the least expensive option for securing health insurance. Nevertheless, whether you are a business owner or employee, what follows is a discussion of some interesting aspects of the group health insurance market.
There are two main reasons that employers offer group health insurance coverage. The first is to attract talented employees. The second reason is related to the first: To reduce employee turnover. It’s not uncommon for employees to become “dependent” on their health insurance. For example, an employee who may otherwise leave their job to become self-employed may not do so because of health reasons. That is, he or she may not be eligible under an individual policy due to a preexisting condition. Preexisting conditions are typically not covered under individual health insurance plans.
The primary difference between individual and group health insurance is that group plans are “guaranteed issue”, while individual plans are not. “Guaranteed issue” means that an insurance company cannot deny coverage due to any preexisting medical conditions.
Some individual health insurance plans are issued to individuals with preexisting conditions, but usually only with what is called an “exclusionary rider.” This “exclusionary rider” will exclude coverage for treatment related to the preexisting condition. It’s interesting to note that in California, insurance companies are not allowed to practice this policy. As you might expect, the result is a much higher rate of declined applications for individuals, since insurance companies choose simply not to issue coverage for individuals with preexisting medical conditions.
For group health insurance coverage, premium cost sharing between employer and employee has pretty much become a common feature in today’s labor market. In the vast majority of cases, insurance companies require employees to pay a minimum of 50% of the premiums, although many choose to pay a higher percentage. In general, the larger the company, the greater the percentage paid by the company. Not all insurance companies require coverage for dependents, although again many businesses elect to offer this coverage as well.