Health insurance may be obtained through two basic plan types: group and individual. The difference between the two types has little to do with coverage. In fact, a group plan and an individual plan may provide identical coverage. The difference is the way you access the two types. You may obtain a group plan through an employer or association. An individual plan is offered by an insurance company independent of any affiliation.
Group plans cover several people or groups under one policy.You will receive a certificate that acts as your policy when you obtain insurance through a group plan.
Most group policies suit the average person
and may include provisions to cover family members. Employers of one to 50
employees may offer “guaranteed-issue” group plans known as Small
Group Health Access Coverage.This coverage makes health insurance plans
available to small business employers regardless of the health claims experience
of an employee group or health status of an employee. In many situations
where a medical condition is a factor, this may be one of the only ways for
an individual to qualify for health insurance.
A well-designed universal life plan can do the following:
In Florida, group insurance is available to three different size groups:
Group insurance policies are issued on what is
called a "guaranteed
issue" basis, which means
that the carrier must accept the policy holder
for
coverage. However, depending on the size of the
group involved,
group policies are either subject to
medical underwriting or the group is
evaluated for
the group's claims experience, and premiums may
be adjusted
to reflect the experience of the group.
Group insurance is generally more expensive than
individual insurance, but
individuals who might have
been excluded from individual health insurance
coverage can not be excluded from group health
insurance coverage.
Florida offers an "open enrollment" period for
single
employee groups during the month of August, and
coverage is available
effective October 1. Carriers
do not generally announce policy offerings
until the
August open enrollment period.
Small group policies are offered to employers of between 2 and 50 employees. Carriers normally require employers to pay a portion of the premium, and requirements differ by carrier and size of the group.
"Non-discrimination" rules apply to all size employee groups. This means that all similarly situated employees must be offered the opportunity to participate in the plan. For example, if coverage is offered to full-time employees, it must be offered to all full-time employees and not just certain employees.
Groups of 10 or more employees are eligible for "composite rating," which means that the premium costs are determined based on average ages of the participating population. Composite rating is not available to groups of under 10 employees.
All Your Needs Insurance will listen to your concerns, assess
your needs, explain options, and help you get the right coverage for your
financial insurance needs. Keep in mind that the insurance marketplace is
dynamic. Because circumstances, coverage's available, and regulations change
from time to time, we suggest that you ask our All Your Needs Insurance financial
insurance staff to evaluate your coverage periodically — a service
that demonstrates our commitment to provide valuable insurance guidance.
Follow each link for more information and to submit a quote request.
