As an employer, offering group health insurance is one of the best ways to attract prospective employees and retain personnel. The pros of employer benefits include tax savings, lower rates, and simplifying the plan selection process.
Employers must first choose between many available group health policies from a particular health insurance company. To secure a policy, a business must be able to provide payroll documentation and proof of location and the business type.
For a plan to be valid, 70% of the employees must join the plan. There are also further mandates – a company has to offer this policy to all full-time employees or those working a minimum of 30 hours per week. Part-time employees are not entitled to this benefit.
Health insurance of any kind comes with the following:
Monthly payments for keeping the policy
Out-of-pocket costs individuals have to cover before insurance coverage kicks in
Fixed dollar amount an individual has to pay per visit
Percentage of overall costs the policyholder is responsible for
The costs for employer-sponsored health plans are much lower compared to individual health insurance plans. Two main factors behind its low costs are the risk being spread across multiple employees rather than one person and employer contributions to the plan premiums.
Many states require employers to cover at least 50% of the premium costs for each employee insured under the employer’s health plan. This also poses a major tax advantage because premiums can be paid with pre-tax dollars, which lowers the individual’s taxable income.
Group plans typically feature provider networks consisting of healthcare providers and facilities with a contract with the insurer. Plan policyholders have access to these providers for a highly discounted cost.
Policies allow for affordable inpatient and outpatient treatment and prescription drug coverage. Coverage varies, but common group plans include health maintenance organization (HMO), preferred provider organization (PPO), and point-of-service (POS) plans.
All plans feature a provider network, yet differ in whether they provide out-of-network coverage and whether the policyholder needs to select a primary care physician (PCP) from whom they will need referrals to see specialists. HMOs, for example, restrict coverage to the plan’s network, and they require selecting PCPs. PPOs don’t limit coverage to networks but provide better coverage to those who get in-network treatments, and policyholders don’t need to choose a PCP. POS plans allow out-of-network treatment but require choosing a PCP.
The Health Insurance Value is here to present you with health insurance that will benefit all parties involved. Whether you’re an employer or employee, we stand by you to help you get the best policy at the lowest price.
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