The Basic Logistics of Group Health Plans

The Basic Logistics of Group Health Plans

Health and Fitness December 24, 2015

Human resource benefits administration

With such dramatic changes being made in the healthcare industry in recent years, staying up to speed with health insurances policies and mandates can be tricky. Changes made under Obamacare are aiming to revamp the way the healthcare system operates. With such changes kicking in constantly, it’s important to stay up-to-date with the fundamentals of health insurance.

Individual Health Plans:
If you are self-employed or work for a business that doesn’t provide health insurance, having an individual health plan is necessary. It is generally more expensive than a group plan because employers pay most of the premiums. However, the holder has the freedom to choose their policy. Individual plans are also known as ‘single-pay plans.’

After you’ve done your research on different plans within your budget, you can then branch out to more complicated dealings. As part of a single-payer plan, insurers may offer what’s called ‘riders.’ These are amendments that can be made to your policy and are often used to cover specific medical conditions, such as pregnancy and labor. It usually comes with a fee due to the added risk for the insurer.

Group Health Insurance Plans:
A recent study showed that employee benefits and group health plans were considered an extremely important reason to remain with their current employer by 50% of the employees surveyed. When it comes to group health plans, the logistics can be overwhelming. However, there are key aspects to know:

  1. The Affordable Care Act has mandated organizations to offer health benefits to all employees, as long as their staff consists of at least 50 full-time employees. This means there has to be employee benefits for small businesses, as long as they have at least 50 full-time employees.
  2. Due to the Family Medical Leave Act, employees are entitled to 12 weeks of leave during any 12-month period. This leave can be used for the birth of a child, care of an immediate family member, or self-care for a medical condition.

Aside from that, your employer should be well-versed in the health insurance coverage they offer and will be able to answer questions you may have. If they can’t, they can point you in the direction of someone who can.

Health insurance can be a complicated and messy matter but being covered is vital. The fact of the matter is that risking going bankrupt when you suddenly become ill isn’t worth it. If you have questions about group health plans, individual coverage or how to move forward, reach out to one of the many resources available: health insurance companies, employers, friends, family, etc. Read more here.