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. |