What Do Group Health Insurance Plans Cover?

When the employer's benefits meet the employee's needs, employees are more likely to work for the company for longer. In order for employees to maintain this loyalty, they need more than just a paycheck. A group health insurance plan is one of your business's most important benefits to encourage employee loyalty. It provides you with a way to better meet the needs, demonstrating your goal of supporting them.download our free commercial insurance handbook

What Is Group Health Insurance?

Group health insurance provides health insurance coverage for a specific group of people, often employees of a company, but it could also include people who belong to the same group or organization. Some group health insurance for small businesses covers all employees within the company, while others cover just certain qualified individuals.

This type of health insurance policy is very versatile. It can be customized to meet the unique needs of the entire group of covered individuals. Some policies are comprehensive and provide a significant level of coverage to the covered individuals. However, employers may also purchase and provide access to policies that are very basic and low-cost. Employers may wish to consider several options to determine which is best suited for the company’s needs.

What Does Group Health Insurance Include?

Group health insurance benefits range. Policies differ between insurers, and, in many cases, most insurance companies offer numerous types of plans as well. Often, the investor can choose the features most important to them at the coverage level that makes the most sense for their specific needs. Some of the benefits that may be a part of the policy include:

Hospitalization coverage: This type of coverage typically provides financial support for in-patient needs, such as when you need to have a procedure in a hospital setting or treatment for an illness. Different levels of coverage exist, with some providing more extensive coverage for procedures, locations, and treatments available in the hospital.

Preventative care services: Going to the doctor for wellness visits along with routine checkups, lab work, and screenings are often a core component of most preventative care services. Going in to see your doctor is typically included in most policies.

Emergency medical care: Many policies carry emergency medical care insurance. This allows you to receive coverage for ER trips for valid reasons and may include many of the tests, specialist care, and medications used in that ER setting.

Dental and health insurance: Some policies include dental and health insurance coverage to meet both preventative as well as illness or injury treatment. Policies with dental and health insurance typically have their own deductibles, limitations, and coverage allowances.

Pharmacy coverage: For those who need medications for their ongoing care of a chronic condition, as preventative care, or as a treatment for an illness or disease benefit from pharmacy coverage. Restrictions are sometimes in place on what will be covered and for how much.Blue-bann er-with-digital-image-for-downloading-Arnold-Insurance-cyberinsurance-ebook

Within each of these areas, insurance coverage ranges based on the amount of coverage purchased through the group health insurance plan. Often, employers or employees can elect more or less coverage based on what they believe their needs are. This can impact the cost of the policy.

Additionally, all services may have some restrictions on where a person can obtain care, such as if they are restricted to very specific hospitals or medical centers or not. In some situations, there are fewer restrictions on where a person can access care. Typically, in a life and death situation, treatment at any ER may be covered under the policy.

Many policies also have co-payments or deductibles that must be met. A co-payment is a required payment made at the time of the service. Often, policies set a specific dollar amount for these costs. A deductible is a common feature of these policies. This is the amount of money that a covered person must pay first before the insurance policy kicks in to cover the rest of the costs. Compare these carefully.

What Are the Benefits of Group Health Insurance?

Group health insurance for small businesses offers a number of benefits to employers and employees.

It saves the employee money

Small business health insurance can save money. The purchase of these policies, together with a large number of people, typically helps to lower the amount of risk present to the insurance carrier. As a result, they are likely to offer a lower cost because there is a larger risk pool.

This saves money for the consumer who is looking for affordable health coverage. The cost of purchasing a health insurance policy alone, without a group plan like this, is typically much more expensive, especially for employees who have preexisting conditions.

It could reduce tax obligations for the employer

In addition to this, employers who provide access to qualified group health insurance plans typically qualify for tax incentives for doing so. Speak to your tax advisor about the specific qualifications within your business. The Small Business Health Care Tax Credit could be worth as much as 50 percent of the costs an employer pays towards the coverage for employee health insurance.

A positive place to work

Employees typically need this type of health insurance access. As a result, they appreciate the company that is giving it to them. More so, this helps employers show that they are dedicated to their employees and providing them the benefits they need. That creates a positive work environment and happy employees. This may even lead to a reduced level of turnover and better employee satisfaction.

Getting Group Health Insurance in Place


Businesses should consider the advantages of group health insurance when deciding if they should offer it. By providing benefits and perks to employees, employers strengthen their relationship with them, ensuring a more productive and pleasant work environment. Group health insurance could play a significant role in that process.


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