Large Group Health Insurance – Explained

Large Group
Health Insurance - Explained

What Is a Large Group Health Insurance Plan?

A large group health insurance plan is an insurance plan that covers a group of over 100 people for large businesses or small.

There is no legal maximum number of group members when it comes to large group health insurance plans. Whether you run a local business, or you run a Fortune 500 firm, you can find group insurance that will cover your employees.

Group health insurance plans are easy to work with and provide coverage for all recipients. Every person covered by the policy receives the same benefits, so individuals are processed quickly and efficiently.

You don’t have to worry about getting denied coverage because you have a specific condition.

Large Group health insurance is the best option if you are running a large business with at least 101 employees. A large plan is a good deal and keeps your insurance costs down by providing you with a bulk discount for your plan.

Another great feature for a large group health insurance plan is the ability to tailor the plan benefits and offer a composite rate. Unlike Small Group Health Insurance that requires you to select plans that have already been designed by the carrier and utilize Age banded rates, Large Group health insurance plans allow composite rating:

What Is the difference between a Composite Rate and a Age Banded Rate?

Composite rate indicates that all members of a certain group pay the same insurance premium. This is different from an Age Banded Rate, because rates will be different for every age 21 to 65. Spouses and children will have their own rates, and the total family rate includes the combined rates of individual, spouses, and children all together.

According to the California Department of Insurance and the Department of labor, millions of people in the state of California are without health insurance. The problem however, is many Californians do not qualify for the health care subsidy or Medi-Cal, and they do not have access to an affordable employer sponsored group health plan. Composite rating opportunities available through Large Group health plans can provide a solution by lowering the Employer & Employee costs.

What Types of Large Group Health Insurance Plans Exist?

There are several types of group health insurance plans that you can choose from. Each of them have unique pros and cons based on the coverage you require for you and your employees.

The Most Popular Plans:

Fully-Insured Plans. This is the traditional health insurance option that is risk-free for an employer. A fully-insured plan offers full coverage for an annual premium. Costs in this place are partially shared with your employees. Premiums are calculated by looking at the size of the group, average age, claim’s history, type of work, and what coverage and add-ons are needed.
Self-Funded Plans. Self-funded plans place the burden of risk on the employer. Employers charge premiums, pool the money, and use it to cover medical costs as they occur.
Level-Funded Plans. This plan includes paying set rates based on census data for your group. Payments are made monthly, and rates are adjusted at the end of the year based on group performance.
Health Maintenance Organization (HMO). An HMO requires members to pay monthly premiums for medical services. However, they will only have access to a specific network of healthcare providers and facilities. Receiving care out of network can result in significant extra costs for the individual.
Preferred Provider Organization (PPO). A PPO plan functions much like an HMO, but members are able to use healthcare services that our outside of their network. Out of network visits will require a higher co-pay.
High-Deductible Health Plan with a Savings Option (HDHD/SO). The HDHD/SO is a flexible and accessible insurance option that provides health insurance for a lower monthly cost. Employees will pay for medical expenses out of pocket and get a portion of them reimbursed by the company. Members can also pay into a savings account (tax free) and use this pool of money to pay for health costs.