Large Group Versus Small Group Health Insurance in California
Large Group Versus Small Group Health Insurance in California
California Group health insurance denotes a policy that is bought by an employer and is offered to eligible employees of the company and in most cases, also to the employees' family members as staff welfare measure.
In California, majority of Americans have group health insurance coverage through their own employer or the employer of one of their family members.
There is a distinction between what is known as "Small Group" insurance and "Large Group" insurance and it may be worthwhile to know in greater detail what distinguishes one from the other.
In the State of California, Small Group Health Insurance is essentially an employer-sponsored health insurance and meant for small companies having up to 50 employees. Large Group Health Insurance is meant for companies that have more than 50 employees.
Millions of people who lose their group California health insurance coverage due to a change of employer, divorce, loss of job or other reason will still able to enjoy their group coverage, at least temporarily.
The laws that govern how insurance coverage for large groups is different from the laws for small groups, and the way that premium rates are determined are also different.
Interestingly, some insurance companies may allow employers that were originally designated as Small Group to continue on the Small Group insurance plans even if they outgrow the size and hire more then 50 employees.
In the state of California, the favorable aspect of small group insurance is the insurance company is mandated to offer coverage to an eligible company - regardless of the health condition of employees enrolling.
In other words, the federal law enjoins that whatever the pre-existing health conditions small employer group members may have, no small group insurance employer or employee can be refused cover by an insurance company. This requirement is known in the insurance circles as "guaranteed issue."
The basic requirements for small group insurance cover are the company should be 1) 2-50 employees/owners; 2) 75% of the eligible employees must agree to the plan; and 3) the employer must pay at least 50% of the employee's premium.
The law permits California small group health insurance companies to determine their initial premium rates for each company using a process known as medical underwriting. Each insurance company is however obliged to renew its small employer health insurance contracts every year except under extraordinary circumstances.
Large Group insurance usually refers to the coverage provided for large organizations with 51 or more employees who are eligible for employee benefits. The terms are different for large group plans and the insurer can decline coverage to groups based on claims experience and/or health history.
The large group insurance plan options are different from those offered to small group and are more versatile. Some insurance companies even offer a bundle of options where employers are allowed to pick specific benefits to offer and discard the others. When it comes to large group insurance, the company can charge different rates if they have employees with health concerns.
But, a health insurance company has the prerogative to reject an entire large employer group based on its claims history or for any other valid reason. But, no individual employee who is eligible for benefits can be excluded from large group coverage based on his/her medical history. If an insurance company issues a policy to a large employer, then all of its eligible employees must enjoy coverage benefit. Individual Health Insurance Your Own Insurance Affordable Kentucky Health Insurance to Meet Your Needs With a Skin Doctor Good doctors in Bangalore Natural Remedies for Menopause - Naturally Alleviate Your Worst Symptoms Asian Flush Treatment-Asian Flush Cure Get More From Your California Health Insurance Plan What Every Health Club Owner Should Know About Commercial Insurance What Tim Russert's Doctors May Have Missed Business health insurance- The Employee Benefits Need of an Organization Surgical Weight Loss Clinics in Tampa Help Alleviate Obesity Epidemic Health Insurance For Tennessee Expands Care To Walk-in Clinics Basics of a Health Insurance Exchange