Living internationally

Group Health Insurance

Have a company and need to provide them insurance? Group health insurance is employer-sponsored health coverage for business owners, employees and  their dependents. A majority of Americans have group health coverage through their own or a family member’s employer-sponsored group plan.

What is Group Health Insurance?

Group medical coverage refers to a single policy issued to a group, a business with employees, that covers all eligible employees and sometimes their dependents. Individual medical coverage, on the other hand, is a single policy issued to a single person or family.

The rules are quite different for group coverage versus individual coverage, in large part because the insurer’s risk is calculated differently. With individual coverage, the insurer has historically based its premium rates or denied coverage on the detailed medical history of the person or family. The Affordable Care Act brings important changes to the individual market, including eliminating the ability of insurers to deny coverage based on preexisting conditions.

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With groups such as small businesses, the insurer determines a premium price based on risk factors balanced over the entire group, using general information on members of the group, such as age. Insurers are required by law to offer coverage to small groups who meet minimum participation requirements.