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Group Health Insurance


With group health insurance, a single policy covers the medical expenses of many different people, instead of covering just one person. Unlike individual insurance, where each person's risk potential is evaluated to determine insurability, all eligible people can be covered by a group policy, regardless of age or physical condition. The premium for group insurance is calculated based on the characteristics of the group as a whole, such as average age and degree of occupational hazard.

How do you get group health insurance?

Find out whether you are eligible
Many employers offer group health insurance as part of their employee benefits package. Other groups that may offer insurance coverage include churches, clubs, trade associations, chambers of commerce, and special-interest groups.

Apply for coverage
Although your individual health is generally not evaluated when you apply for group health insurance, you must apply during the specified eligibility period. For employer-sponsored health insurance, this is often the first 30 days of your employment, or the first 30 days following your initial probationary period. For associational insurance, this may be the first 30 days of your membership in the group.

If you fail to enroll during this period, the insurance company has the right to treat you as though you were applying for individual insurance. This means you will probably have to answer extensive health questions, and go through a physical examination. The insurance company can then decide whether or not to insure you.

The purpose of the eligibility period is to reduce insurance costs by preventing people from waiting until after they discover a health problem to sign up for coverage. Both employers and associations may also have an open enrollment period each year, during which you may sign up for coverage, modify your existing coverage, or add dependents to your coverage.

What are the benefits of group coverage?
You don't need a physical exam
Under a group health insurance arrangement, the insurance company agrees to insure all members of the group, regardless of current physical condition or health history. The only condition is that the group members must apply for insurance within the specified eligibility period. Clearly, this is better for those with chronic health conditions, who might be unable to get individual insurance.

It's cheaper than individual insurance
Because only one policy is issued for the entire group, the initial cost of establishing group coverage is lower than the cost of issuing a separate policy to each person. Also, group insurance is somewhat less risky for insurers than individual insurance, since the risk is spread out among a larger number of people. Within a fairly large group, it is almost certain that the good insurance risks will equal or exceed the bad insurance risks. Since group insurance costs less for the insurance companies to establish and administer, it generally costs less to purchase.

You might get a break on premiums
In many cases, your employer or association will pick up some or all of the group insurance premium. This can make group insurance even more affordable.

What are the drawbacks to group coverage?
You can't customize your policy. In a group insurance situation, the provisions of the policy are negotiated between the insurer and master policyowner (usually an employer or association). You may not have the freedom to have provisions included or excluded, and your deductible amount and co-payment percentage are determined in advance. In some situations, however, you may be able to choose between two or more insurance plans.



Please Note: The information contained in this Web site is provided solely as a source of general information and resource. It is a not a statement of contract and coverage may not apply in all areas or circumstances. For a complete description of coverages, always read the insurance policy, including all endorsements Aetna HMO Plan 10-20
Aetna HMO Plan 10-30
Aetna HMO Plan 20-40
Aetna HMO Plan 30-40
Aetna EPO 90
Aetna EPO 80
Aetna Basic PPO
Aetna MC Zero 90/60 PPO
Aetna MC $250 90/70 PPO
Aetna MC $500 90/70 PPO
Aetna MC $250 80/60 PPO
Aetna MC $500 80/60 PPO
Aetna mc $500 80/50 PPO
Aetna MC $1000 80/50 PPO
Aetna MC $2000 80/50 PPO
Aetna HSA 2100
Aetna HSA 3000
Aetna Value HMO Value HMO 25-40
Aetna Value HMO Value HMO 15-30
Aetna Value HMO Value HMO 10-20
Blue Cross Saver HMO
Blue Cross Classic HMO
Blue Cross HMO 100
Blue Cross Basic PPO
Blue Cross Hospital BeneFits
Blue Cross Hospital BeneFits Plus
Blue Cross Hospital BeneFits Pref
Blue Cross High Deductible EPO
Blue Cross Saver PPO
Blue Cross PPO 40
Blue Cross PPO 30
Blue Cross PPO 35 GenRx
Blue Cross Power Fund 750
Blue Cross Power Fund 500
Blue Cross Advantage 25 PPO
Blue Cross Premier 20 PPO
Blue Cross Premier 10 PPO
Blue Cross PPO 2400
Blue Cross PPO 3500
Blue Cross PS HMO Power Select HMO Plan
Blue Shield Access+ HMO 5
Blue Shield Access+ HMO 10
Blue Shield Access+ HMO 15
Blue Shield Access+ HMO 20
Blue Shield Access+ H00025
Blue Shield Access+ HMO 40
Blue Shield Added Advantage POS 300
Blue Shield Pref Sav $1250 Ded
Blue Shield Pref Sav $2250 Ded
Blue Shield Pref Sav $2600 Ded
Blue Shield Spectrum PPO Zero Deductible
Blue Shield Spectrum PPO 250 Premier
Blue Shield Spectrum PPO 250 Standard
Blue Shield Spectrum PPO 500 Value
Blue Shield Spectrum PPO 500 Standard
Blue Shield Spectrum PPO 500 Premier
Blue Shield Spectrum PPO 1000
Blue Shield Spectrum PPO 3000
Blue Shield Active Choice 500
Blue Shield Active Choice 750
Health Net HMO 10
Health Net HMO 15
Health Net HMO 20
Health Net HMO 30
Health Net HMO 35
Health Net HMO 40
Health Net HMO Xtra Value 20
Health Net HMO Xtra Value 40
Health Net Variable Hosp Copay HMO 25
Health Net Variable Hosp Copay HMO 35
Health Net Elect Open Acces 30
Health Net Elect Open Access 25
Health Net Elect Open Access 20
Health Net Elect Open Access 10
Health Net Select 30 POS
Health Net Select 20 POS
Health Net Sel Prem 10 POS
Health Net Saver PPO
Health Net PPO 40
Health Net PPO 35
Health Net PPO 30
Health Net PPO 25
Health Net PPO 20
Health Net PPO 15
Health Net PPO 10
Health Net HSA 2000
Health Net HSA 3000
Health Net Silver HMO 20 Silver
Health Net Silver HMO 40 Silver
Health Net Silver HMO Xtra Value 20 Silver
Health Net Silver HMO Xtra Value 40 Silver
Health Net Salud Salud HMO
Health Net Salud Salud PPO
Kaiser HMO Ded 30/1000
Kaiser HMO Ded 30/1500
Kaiser HMO Plan 5
Kaiser HMO Plan 15
Kaiser HMO Plan 20
Kaiser HMO Plan 30
Kaiser HMO Plan 50
Kaiser Point of Service Plan
Nationwide Plan 1
Nationwide Plan 2
Nationwide Plan 3
Nationwide Plan 4
Nationwide Plan 5
Nationwide Plan 6
PacifiCare HMO 10
PacifiCare HMO 15
PacifiCare HMO 10/500d
PacifiCare HMO 20
PacifiCare HMO 35/600d
PacifiCare POS 15/80-60
PacifiCare PPO 80/60-250
PacifiCare PPO 70/50-250
PacifiCare PPO 80/60-500
PacifiCare PPO 70/50-1000
PacifiCare PPO 35-50/50-1000
PacifiCare PPO 70/50-2000
PacifiCare PPO 70/50-3500
PacifiCare PPO 80/50-2000/freedom
PacifiCare PPO 70/50-2000/freedom
PacifiCare PPO 50/50-3000/freedom
PacifiCare PPO HSA 2700
PacifiCare PPO HSA 3500
PacifiCare PPO HSA 5000
Pacificare Adv HMO HMO 10/500d
Pacificare Adv HMO HMO 35/600d
Sharp Health Plan HMO Plan A
Sharp Health Plan HMO Plan AB
Sharp Health Plan HMO Plan C
Sharp Health Plan HMO Plan AD

Sharp Health Plan HMO Plan AE
Western Health Adv HMO Premier 5
Western Health Adv HMO Premier 10
Western Health Adv HMO Premier 15
Western Health Adv HMO Premier 20
Western Health Adv HMO Advantage 15-30
Western Health Adv HMO Advantage 420
Western Health Adv HMO Advantage 70
Western Health Adv HMO Advantage 30-40
Western Health Adv HMO Advantage 40
Western Health Adv HMO Deductible 1000

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