Duraclean Journal of Marketing, Management and Technical Topics

Group, Multiple, Individual and Family Health Insurance Plans




Group Health Insurance Plans

Group health insurance is an industry term. Group insurance generally has the following statistics and/or requirements:

• Group medical plans are employer sponsored plans on behalf of the employees. The employer is normally required to pay 50% of the employee premium.


• Group medical insurance must meet minimum participation requirements, which are normally 50% of all full time employees – 75% after valid waivers (employees with other valid coverage are
  counted towards total participation). Plan participants are “guaranteed issue” or guaranteed coverage as long as they had prior coverage with no lapse in coverage in the past 63 days. This can
  vary by state.


• Group medical insurance plans are underwritten based on state mandates. The insurance carrier files the base (best possible) rate with the State Department of Insurance. Once the employee
  applications are completed, there is a maximum rating the insurance company can apply to the base rate, regardless of employee medical conditions or their severity. This applies in most states.


• Group medical insurance may be more expensive than individual health insurance coverage, which is not guaranteed issue. Individual coverage is usually less expensive because the insurance company can decline coverage or exclude conditions. This means they take on less risk and, therefore, premiums can be lower.


• Group medical insurance does not necessarily mean you are getting a “bulk rate” especially when your “group” is under 5 covered lives. A company with 3 or less healthy employees can usually realize a substantial savings versus a group medical plan.

Multiple Plans

Multiple plan designs can be offered to employees. Generally, the employer decides which plans will be offered and the employee chooses the plan that best suits their needs.

Most companies choose from traditional plans, which have deductibles and co‐pays for doctor and prescription expenses. Many companies now choose alternative plans like HSA’s and HRA’s, which in many cases will lower total costs without lowering benefits.

Waiting periods for employee eligibility in the plan (30, 60, 90 days or longer) are determined by the employer. Companies with 20 or more employees are subject to COBRA, and must extend coverage to terminated employees. The employer is not required to pay any portion of the premium after the employee termination date.

To learn more on how you can save, get a group health insurance quote from our affinity partner, Mass Marketing Insurance Consultants, Inc.

To get a free, no‐obligation health quote, go the website – www.mmicinsurance.com/Duraclean or call toll‐free 1‐800‐349‐1039.

Individual & Family Health Insurance Plans

Individual medical policies cover one person or a family. Most people think that because an individual health insurance policy is not part of a “group plan” that you’ll have less coverage and pay a higher price. This couldn't’ be farther from the truth. The main reason people think this is because their employer had been paying half of the cost. Most employers will pay at least 50% of the employee premium each month. Some employees are required to pay the full premium for any dependents that are covered under their company group plan. Many savvy employees have saved thousands by obtaining an individual policy for their dependents, or in lieu of COBRA coverage.

Individual health insurance can provide the same coverage that a group plan offers. More importantly, individual coverage is usually far less expensive! Individual medical plans also provide greater flexibility by allowing you to purchase only the benefits you and your family need.
On a group plan, you share the cost for many benefits that you may not need, such as maternity coverage.

If you start a business, retire early, work for a company without health insurance or even lose a job that provided medical benefits, you’ll most likely be shopping for affordable individual health insurance. Health Insurance is a vital component to any sound financial plan and is needed by everyone. Without proper coverage, you leave yourself open to financial risk and possibly financial ruin. Unexpected medical expenses are the largest reason people file bankruptcy.

To learn more on how you can save, you can get an instant individual health insurance quote from Mass Marketing Insurance Consultants, Inc. by going to the insurance website: www.mmicinsurance.com/Duraclean or call 1‐800‐349‐1039.

Labels: Health Insurance, Insurance, Personnel