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What Are The Features Of Group Health Insurance?

May 31, 2021, by New City Insurance

business partners discussing ideas about a Group Health InsuranceGroup health insurance refers to a single policy issued to a group rather than an individual. In a business setting, this generally includes eligible employees or members of the same operation or organization. Insuring members as a group saves both employers and employees money on premiums, deductibles and similar expenses. A group health insurance plan can also be an attractive addition to an employee benefits package.

How Group Health Insurance Works

Many businesses choose to purchase group health insurance to provide employees or members with essential medical coverage. Only groups can enroll in a group health insurance plan, and most require at least a 70 percent participation rate.

Employees have the choice of whether they want to enroll in the program or decline coverage. The cost of group health insurance is typically shared between the business and its employees. Many insurance plans allow family members and dependents to be added to the plan for an additional cost.

According to the Affordable Care Act (ACA), small businesses with fewer than 50 full-time or full-time equivalent employees are not legally required to provide workers with health insurance.

However, larger organizations with more than 50 full-time or full-time equivalent employees must offer insurance coverage to their staff. Money paid towards monthly premiums for employees is usually tax-deductible for employers.

Employees can also reduce their taxable income as premiums are typically paid with pre-tax dollars. Some small businesses may also be eligible for a small business tax credit.

Features Of Group Health Insurance

Choosing a policy can be tricky. It is important to carefully review the features of each plan to determine which best suits the business’s needs. Some of the most common features to look for include the following:

Cashless Hospitalization

Having access to cashless hospitalization prevents employees from dealing with meticulous paperwork after receiving certain healthcare services. If an insured member receives treatment at a hospital in the plan’s insurance network, the insurance allows for the cashless settlement of claims. This means that the insurer can pay the hospital directly for any expenses.

Coverage For Dependents

business people assembling jigsaw puzzle about Group Health Insurance

Before the introduction of the ACA, health plans could remove adult children from their parents’ coverage due to age, regardless if the adult child was a student or living at home.

Health plans are now required to extend dependent child coverage up to 26, whether or not the child is married. Group health insurance follows this rule by providing coverage for both members and their dependents, including spouses, children and even parents.

Pre-And Post-Hospitalization Charges

When the insured undergoes medical testing before hospitalization, it is referred to as pre-hospitalization charges. This may include tests like urine tests, blood tests or X-rays used for diagnosis purposes. Once the patient is discharged, further testing may be required to assess the patient’s ongoing health.

These post-hospitalization charges may include diagnostic charges, medication costs or consulting fees. Group health insurance generally covers both pre-and post-hospitalization charges.

No Exclusions Due To Preexisting Conditions

Under current federal law, companies cannot refuse coverage to an employee or charge a business more because an employee has a “preexisting condition,” meaning a health problem that existed before the new health coverage began.

Individual health insurance policies, on the other hand, can occasionally have these exclusions. The preexisting coverage rule does not apply to grandfathered individual health insurance plans where coverage started on or before March 23, 2010.

Better Benefits Compared To Individual Health Plans

In many cases, group health insurance offers more thorough and comprehensive coverage compared to individual health insurance plans. With group health insurance, the amount of risk to the insurance company is shared among a group of people rather than one individual or family.

This shared risk generally results in lower deductibles and more favorable copayment options. Employers also have the option to add vision and dental coverage if it is not included in the basic plan. Discounts may also be available for family members, helping to cut the costs of healthcare services.

Large Provider Network

Most plans require employees to see a provider that is in-network. A provider network is made up of a list of healthcare providers, facilities and pharmacies that have contracted with the insurance companies to offer services to members at an agreed-upon cost.

These policies generally have the largest available provider networks, allowing employees to choose from a greater range of health care professionals.

Work With New City For Group Health Insurance

group of business people in meeting with doctors about their Group Health Insurance

Group health insurance is often the most convenient and cost-effective option for businesses and their employees. Most policies are affordable for workers and their families, and employers can enjoy annual tax savings.

Offering a group health insurance plan is also an excellent way for businesses to attract quality talent and retain loyal employees.

To learn more about the features or to speak with an insurance professional about acquiring a healthcare policy, reach out to the insurance experts at New City Insurance.

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Filed Under: Group Health Insurance,  Insurance

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Google Rating
5.0
New City Insurance
New City Insurance
5.0
Carol Zhang
Carol Zhang
04:29 06 Mar 22
As a rapidly expanding national media organization, the employee benefits strategy and administration that New City has provided us during our growth has been invaluable. They have been proactive about informing us of the different benefit strategies available to us as we grow as well as managing the additional compliance laws and reporting requirements at each stage of our growth.
Claudia Villalobos
Claudia Villalobos
20:14 03 Mar 22
New City Insurance made navigating through all the health insurances super EASY. Their documents are highly informative, professional, and easy to work with. Thank you for making the process of choosing a health plan so simple. You guys are THE BEST!
Philippe Salas
Philippe Salas
17:02 22 Feb 22
I never expected to have a good time talking to an insurance salesman, but let me tell you Brendan was quite the treat. He was very helpful explaining the options and has a wonderful sense of humor. I hope to speak with him every time I call.
Jennifer Polito
Jennifer Polito
17:15 09 Feb 22
Super easy enrollment process. Fast and friendly customer service. If you are looking for an insurance company that is there for you every step of the way I highly recommend New City Insurance.
Rocky Salas
Rocky Salas
23:46 07 Jan 22
So friendly, I hope to speak to him again in all my future insurance needs.
Rocky Salas
Rocky Salas
23:38 07 Jan 22
So friendly and soft spoken. I hope to speak to him again in all my future insurance needs.
Jose Brena
Jose Brena
13:20 06 Jan 22
Eric Calciano has been extremely helpful in finding and selecting the right insurance coverage for our company. With many options out there Eric assisted us on getting a low cost provider saving more than 20% than from our competitors and providing excellent coverage for our employees.
Anastasia Beaverhousen
Anastasia Beaverhousen
17:05 28 Dec 21
Signing up for insurance was quick and easy. Felicity Sundsboe
SFCC
SFCC
22:08 29 Nov 21
Jeff Stoltey and his team provide excellent customer service. Jeff has always provided my company SFCC with straightforward options. I went to a larger insurance company only to RUN BACK to Jeff at New City Insurance. I recommend them to anyone needing insurance without hesitation.
Kevin Luby
Kevin Luby
19:13 22 Oct 21
Quick, easy & informative. We were able to secure quality insurance for our small business on a tight deadline. Thanks for the help New City.
Theresa Ruybol
Theresa Ruybol
19:30 01 Jul 21
Eric was so great with us. He was very patient and kind as we are a newer smaller organization who is growing rapidly. With that said, we had made our inquiry, he had great rapid response and mostly had to wait on me. Any request that we made and/or questions we had, he was great answering and helping us understand. Then when we were ready for all documents and to move forward, Brendan helped with getting that together and the two of them worked their magic on New City's end to notify me of what was needed, assist me in that process and confirming that all was complete and approved for the coverage. I just want to say thank you all again so much, as insurance has always been confusing to me, and you all made that process go a lot smoother.Thank you
Andrea Ordendorff
Andrea Ordendorff
21:06 07 May 21
I've been working with both Clayton and Brendan for well over a year. As the purchase of our dental practice was delayed well over 14 months they both patiently supported me and continued to make themselves available. When we were officially ready to sign up they made the whole process seamless and super easy. This team is highly knowledgeable, professional, supportive, and efficient! I can't thank them enough for everything they've done.
T W
T W
22:32 30 Aug 20
I love New City Insurance. I never had a good experience dealing with insurance brokers until I started working with Brendan. He’s awesome! He is patient with me and takes the time to answer all my questions. I’m very grateful for all his help and hard work!
Mary Jane Deyette
Mary Jane Deyette
00:57 11 May 20
Jeff Stoltey is so awesome...even thru my company had only two employees, he took the time each year to research and find the best plan for us. The only reason I am leaving New City Insurance is because we no longer have any employees. Thank you Jeff
Alma Ortiz
Alma Ortiz
22:25 23 Feb 20
Brendan was awesome! I couldn't figure out how to pick my plan and he returned my call on a weekend to help me. Outstansing service!
jessica kavanagh
jessica kavanagh
19:53 13 Feb 20
Brendan was so helpful I definitely recommend him if you’re in need of good help and getting it done promptly. Thankyou so much again.
Tricia DeYoung
Tricia DeYoung
19:49 13 Feb 20
I was very thankful I inquired about this info. with Brendan. He was very helpful so I understand the benefits available much better now. Thank you Brendan.
B Bayer
B Bayer
17:43 24 Sep 19
NCI handled almost everything from start to finish. Clayton and Brendan made the plans easy to understand and walked me through the application process. They got me my ID numbers before my cards arrived so that I could keep an appointment I had already scheduled. My last broker wouldn't have done that. 5 stars!
Jessica Lehr
Jessica Lehr
03:36 07 Jun 19
Our staff was interested in a health plan, but we didn't know how beneficial a solid employee benefits package would be for our business to expand. We'd lose prospective employees because they had more options for their medical insurance which was sometimes more valuable than more pay. The New City team was amazing and gave us as many affordable options as possible so that everyone had their needs met.
Mike McClay
Mike McClay
19:36 03 May 19
My employer uses New City as their insurance broker, and I'm always amazed when I call in for assistance by how knowledgeable and attentive their staff is with my requests. Their online benefits platform makes selecting insurance plans pretty darn easy. I would highly recommend their services.
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