Get a Group Health Insurance Quote Now
East Coast Health Insurance offers group health insurance plans to business shopping for health insurance in nearly every US state. For an instant, group health insurance quote please submit your information by clicking on group medical insurance quote button.
Even better is that if you have a large company of over 100 employees you have bargaining power! East Coast Health Insurance can help you realize this power by getting you lower rates for your health insurance with your current carrier as well.
Has your broker not called you in awhile? East Coast Health Insurance will assign you a personal health insurance broker for you group and he or she will always be only a phone call away, so if you are unsatisfied with your current plan or your agent, give us a call now for an instant group health insurance quote.
Types of Group Health Insurance
Group health insurance in the United States is administered in much the same way as individual health insurance, which is of course the unique managed care health insurance plan. Under this managed care umbrella falls the subheading for HMO’s, PPO’s, EPO’s, and POS’s.
Also if you are a larger employer please see our page on self insurance for larger group health insurance plans.
The Economics of Group Health Coverage
Most Americans recieve their health insurance through their employers. In fact, the last estimates are that 162 million Americans have insurance through their employers.
The bad news? With premiums rising so quickly along with health care costs, not only are benefits being cut so is pay and raises in favor of these costly medical insurance policies.
Group health premiums rise 12% per year according to the Kaiser Family Foundation (a great HMO plan also), back in 2004 the average annual cost for individual health insurance in a group plan was $3,820 and family premiums being $9,602. Now the premiums are 40% higher!
With the economy tanking and the recession becoming a depression many employers are making full timers, part timers, which is putting a stronger push on the individual health insurance market.
Still, anytime your employer offers group health insurance you should take it because your employer is legally obligated to pay at least 50% of the employees premium by the insurance company not the states (except in the halls of Congress where it is 100%). Why do I point this out? Because people call us all the time asking us. Some Group health insurance companies make employers pay at least 75% of the premium to discourage adverse selection.
For example if you get a paycheck and see that your employer has deducted $250 for your monthly health premiums (assuming your an individual) that means your employer is paying a minimum of $250 as well. This makes the total premium that is being put towards your health insurance $500. So even if we can find an individual health insurance plan for less than $250 the plan will be deficient when compared to the $500 policy that you have through your employer.
But if your employer pays 0% for your family, they might be best served by shopping for an individual health insurance policy. Meaning you should stay on your group policy and compare health insurance plans for your family.
Group Health Insurance Requirements
All states require the insured in a group health insurance policy to be employed or at least an owner of the company. However each state has different eligibility requirements in order to qualify. Florida as an example requires all employees that work 25 hours a week to be considered an eligible employee.
The waiting period for eligibile employees also varies according to state but usually it is left up to the employee up till the state maximum waiting period usually 90 days. 90 days also happens to the most common waiting period or probation period to be met, once it is met the employee must elect or decline coverage.
HIPAA defines the time frame during a health insurance plan can exclude a condition for groups of more than two. However, HIPAA clearly states that if the individual prior “creditable coverage” (no discount plans) of 12 consecutive months without a gap of more than 63 days there can be no pre existing exclusions.
So what does Creditable Coverage refer to?
- Group Health Plans
- Any Legitimate Health Insurance plan including individual etc.
- Medicare
- Medicaid
- CHAMPUS
- Indian Health Service or Tribal Health Insurance
- State Risk Pools
- Federal Health Plans
- Public Health Plans (such as the local county health plan)
- Peace Corps Health Insurance Plans
Maternity and Group Health Insurance
HIPPA Laws eliminate pre-existing condition exclusions for pregnancy. Newborns and adopted children are also not subjected to pre-existing condition exclusions.
The Federal Maternity Act (prior to HIPAA) required employers to comply with Title VII of the Civil Rights Act. This act required employers with 15 or more employees to cover maternity as any other illness with regard to medical plans or disability plans. HIPPA mandated that if a woman became eligible for a group health plan and was pregnant, the birth would be covered by the group health plan regardless of previous creditable coverage.
