By Guest Author
A group health insurance plan covers a specified group of people. Group health plans are often offered as employee benefits by employers who might choose to pay a portion (or all, or none) of the premium. Group health insurance is a great benefit for people with preexisting conditions or health issues, who might not otherwise be able to afford or obtain private health insurance. If you are shopping around for a group health insurance provider, then there are some things you need to consider. Here is what to look for when choosing a group health insurance provider:
Reimbursement plans versus managed care. Managed care plans, like HMO, PPO, and POS, are the most common type of group health coverage. These health plans offer varying degrees of restriction, but are less expensive than managed care plans, which offer policy holders the most flexibility and broadest coverage.
Primary healthcare benefits. There are certain circumstances that should absolutely be covered by a group health insurance plan. These are called primary healthcare benefits, and they include doctor’s costs, medical costs (visits, prescriptions, supplies, etc.), hospital stays, and surgeries.
Additional coverage. Depending on what you feel your group members will be willing and able to invest in, you may want to consider coverage outside of the primary healthcare benefits previously mentioned. Things like dental care, vision care, maternity coverage, and prescription costs can also be included in a group health insurance plan, but at an added cost to the premium.
Premium cost options. You will have to decide how you want to split the cost of the health plan coverage with the members of the group. A group health insurance provider will offer options for you to pay all or part of group members’ premiums, for group members to make a co-payment when they receive services, to raise or lower group member deductibles, to require a coinsurance payment, or to customize group member payment obligations using two or more of those payment plans.
Research, research, research. Once you know what you are looking for in your group health insurance coverage and provider, it’s time to do some research. Visit the website of the National Insurance Association Commissioner (naic.org) to find your state’s insurance site, and then use the site’s tools to identify and weigh out your provider options.
Choosing a group health insurance provider does not have to be intimidating if you approach the task with these tips in mind. Remember that your provider of choice should offer you and your group members everything you feel is important, and at a premium rate that everyone in the group can manage, and you will do just fine.
About the Author: Meaghan Gavenda spent 10 years working in insurance before entering the educational system. She now helps high school seniors find grants for college and plan their career paths.