Group Health Insurance

Group Health Plans: Group health plans, also known as employer-sponsor health plans, are major medical plans designed to help businesses with one or more employees to pay for health care expenses. Like an individual medical plan, group health plans cover participant’s expenses associated with a serious illness or hospitalization subject to coinsurance once their deductible is met.

Group health plans are purchased by employers and offered to their eligible employees and their dependents. In general, group health plans receive their coverage at a reduced cost because the insurer’s risk is spread across a group of participants. They’re more affordable because the cost of the premium is split between the employer and employees. Their premium is less expensive because they’re paid pretax, which helps employees pay less in annual taxes.

Whether the group health insurance is through private carriers or the on-exchange marketplace, employers offer common types of coverages.

  • Health Maintenance Organization (HMO), which restricts care to doctors that work with the company.
  • Exclusive Provider Organization (EPO) limits care to doctors and hospitals within the EPO network. But on the good side, you don’t need a referral to see a specialist and its rates are much lower than HMO and PPO.
  • And Preferred Provider Organization (PPO) offers a larger network with more doctors and hospitals to choose from. It tends to be pricier because it allows more flexibility and freedom to receive care from any provider, in or out of network. You can see any doctor or specialist with no referrals or use any hospital.

We’ll be happy to work with your business and help you find the right coverage for your employees.

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