Group health insurance is when an employer is able to offer health insurance to eligible employees as a benefit for working with that company. Most employees in the US get their health insurance in this way.
The type of coverage your company receives as well as the premium rates will differ depending on what state you are in as well as the size of the company. Small employers and large employers have different policies with different regulations and rules.
Small employee group health insurance must provide health insurance to everyone even if they have a pre-existing condition. This type of insurance is also known as guaranteed insurance. Small employer insurance must be renewed each year. While the insurer must accept all employees they can review employee’s medical health and change the policy when it is renewed to not provide coverage for certain health issues.
The insurance companies tend to use medical underwriting to determine the insurance premium rates. Some insurance companies may also use community rating or modified community rating to determine the premium rates. Medical underwriting again uses your medial history to determine the coverage for each company’s insurance policy.
Large employers do not have a guaranteed issue requirement so an insurance company can reject a large company based on its past medical claims. However if you are an employee and eligible for benefits you cannot be excluded from the group insurance policy even if you have a pre-existing condition.
Large company group insurance policies will set rates and premiums based on the companies prior claims and which employees tend to participate in the health insurance program. Large companies do not require medical history or health questionnaire.
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