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Health Insurance for Groups
Health insurance coverage offered and financially supported by an employer as a benefit to the company’s employees is classified as group coverage. Group coverage provides an employer with the opportunity to provide an important benefit that employees value. Group coverage is available from multiple carriers, who offer a significant number of plan options, a variety of network choices and enrollment that is not limited by the Open Enrollment period.
Employers can design plans that meet a specific budget, plan design, or amount to be provided towards the plan premium. Group coverage can be an important benefit and can contribute to the well-being of a company’s workforce.
Which kind of health insurance should I get?
Health Maintenance Organization (HMO)
HMO Plans offer affordable, comprehensive health coverage with relatively low out-of-pocket costs, but most care must be done in-network to avoid additional costs.
- Each member selects an in-network Primary Care Physician (PCP)
- Referrals from your PCP are often required to see a specialist
- Out-of-pocket costs are predictable and often limited to low annual deductibles and copayments for doctor visits and other covered services
- The number of providers in the HMO network varies by location
Exclusive Provider Organization (EPO)
While premiums are often higher for a PPO than for an HMO plan, a PPOs typically offer larger networks and will give you more flexibility.
- Members don’t have to choose a PCP
- Members don’t need a referral to see a Specialist
- Members can choose any doctor or hospital regardless of whether the provider is in the plan’s network (costs may increase for out-of-network care)
- Out-of-pocket costs may include annual deductibles, copayments, and coinsurance for covered services
Need More Information on What Plan Works for You?
Small-group health insurance is an employer sponsored medical insurance geared toward businesses with 50 or fewer full-time equivalent employees. Small group health insurance plans are purchased by employers, and then offered to employees. Plans can only be purchased by groups or in some instances individuals who participate in a limited liability corporation (LLC).
Advantages of an employer group coverage:
- Premiums paid by the company are tax deductible as a qualified business expense.
- Your company often splits the cost of premiums with the employees.
- The employer does all the work choosing the plan options.
- Premium contributions by the company are not classified as compensation and thereby not subject to income tax for employees.