What's the Difference Between Individual, Family, Group and
Health Insurance?
In general, group health insurance plans offer many advantages
over individual health insurance. These include smaller
premiums, better tax concessions, and extended coverage.
Virtually all business owners can qualify for group health
insurance.
Furthermore, because you represent a bigger chunk of business to
the insurance carrier, you can usually negotiate terms and
conditions quite a bit as a business owner. Hence it's advisable
to do your homework before you start negotiations. Some of the
online insurance websites are quite good; they provide plenty of
information for free. There are also a variety of free online
calculators you can use that let you play around with various
scenarios and see how it impacts your bottom line. You can also
request free insurance quotes by filling out a simple form on a
number of websites.
Insurance providers calculate group health insurance premiums
based on many factors. Some important considerations are: *
Average age of employees * Nature of work and occupational
hazards * History of illness amongst employees * Coverage amount
Group health insurance plans cover normal as well as emergency
medical treatment. The insuring company pays medical expenses,
in part or in full. The actual amount paid to a healthcare
provider depends on the type of policy you buy, but in general,
more coverage will be more expensive.
Employees can often opt for additional coverage in an
employer-provided group health insurance plan. Typically if an
employee wants to extend the coverage to spouse, he can do so by
agreeing to pay the additional payment.
In today's group health insurance plans, the employer usually
pays from 25% to 50% of the premium and the employee pays the
rest, but there are some companies that pay 100% of the premium.
Plans like fee for service, HMO, PPO, POS are all available to
groups, though each employer will most likely pick a subset of
these to offer to their employees.
AFFORDABLE HEALTH INSURANCE: INDIVIDUAL AND FAMILY
The popular adage - 'Health is wealth' is proving to be
increasingly true as medical and hospitalization costs continue
their seemingly relentless rise. If you can manage to stay
healthy, you can save tens of thousands of dollars in lower
insurance premiums and medical cost-avoidance. But that's not
always under our control. Thus, making the health insurance
purchase decision is a critical one. With so many options, and
so many stakeholders involved, choosing the right health
insurance can be an extremely frustrating task.
While the fee-for-service type of managed care plan has been
around for a while now, managed care plans are also very
popular. Fee-for-service insurance requires you to pay a certain
part of your medical expenses in advance and then submit the
remainder of your medical bill to the insurer for reimbursement.
While fee-for-service insurance gives you the freedom to visit
health service provider or hospitals of your choice, the
downside is that you may have to file claims, track payments and
end up paying higher out-of-pocket costs.
Managed care plans necessitate an agreement between the insurer
and a network of selected healthcare providers who must meet
certain quality standards. Managed care plan policyholders are
offered financial incentives to use the services of (only) the
healthcare providers in the network. Health Maintenance
Organizations (HMO) and Preferred Provider Organizations (PPO)
are the two types of managed care plans. A HMO is a prepaid
health plan wherein you pay a monthly premium. While costs may
be low, the HMO decides which healthcare provider you're allowed
to visit at each stage in your treatment. By contrast, a PPO
allows you to choose your healthcare provider... but if you
choose one outside of the PPO network, your out-of-pocket costs
will be higher.
It's important to remember that you always have full control of
the insurance policy you buy. While it's difficult to negotiate
(as an individual) on specific plan points with carriers, there
are an incredible diversity of plans available out there, and
you should never be afraid to "vote with your feet" if you find
a better deal.
SMALL GROUP HEALTH INSURANCE
Employers attract employees by offering them attractive
incentives and benefits, and one of the most valued benefits is
a comprehensive health insurance plan that fulfils most medical
expenses of the employee (and his or her immediate family) at a
low cost.
Most plans stipulate that any employer with between 2 and 50
employees is eligible for Small Group Health Insurance. When you
contact a broker or insurance provider, you'll be asked to
provide birth, age, and medical details of each employee,
including any pre-existing medical conditions amongst them.
While it's illegal in most states for insurers to deny to insure
groups because of pre-existing conditions, such medical problems
might make your rate-quote higher than it otherwise would be.
Depending on the size of your company and your financial
constraints, you might choose to pay between 75 to 80 % (also
called co-payment) of the premium... or the entire amount. It's
really up to you, as an employer, to decide what's fair for your
existing staff and attractive to prospective employees. If the
employee chooses to include a dependent under the group coverage
it is not compulsory for you to pay premium for the dependant.
When you avail yourself of a Small Group Health Insurance, you
are automatically entitled for yearly renewals. Employees pay a
standard deductible before receiving insurance benefits paid by
the employer. The deductibles usually range between $200 and
$2,000. As a rule, the higher the deductible, the lower the
monthly premium.