07/02/2025 3:31 PM

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Group Insurance Benefits – Avoid the Traps, Get Expert Advice

Group Insurance Benefits

There are many things you can find and buy on the Internet instead of obtaining in person, but group insurance benefits are not one of them.

As a small business owner looking for the right coverage for you and your employees, you need to consult an insurance broker who specializes in group insurance. A thorough broker will interview you to find out exactly what your needs are and will design a plan that best fits those needs at the lowest possible cost.

Before you consult a broker, think about the types of coverage you want. It is a good idea to conduct an employee survey to find out what benefit plans and issues interest them the most.

For instance, ask them to rank the following benefits in order of importance.

·         Chiropractic Care

·         Dental Care

·         Long Term Disability Income Replacement

·         Medical Care – HMO

·         Medical Care – HSA

·         Medical Care – PPO

·         Retirement/401K

·         Section 125 Cafeteria Plan

·         Vision Care

Also, ask them how frequently they and/or their dependents would use each of these benefits.

Another question to ask is if you were to offer them voluntary/employee-paid benefits at low cost and group rates through payroll deduction, which of the following benefits would they be interested in?

·         Accident Coverage

·         Cancer Coverage

·         Critical Illness

·         Group Legal Plan

·         Hospital Income

·         Life Insurance

· Long-Term Care

· Long-Term Disability

After looking at the answers to these questions, you should have an idea of the types of benefits you want to offer. Now, it is time to consult an expert.

Facts about Group Health Insurance

In general, terms, signing up for a health insurance coverage plan through your company that covers all the employees as a group means that you receive the same benefits as everyone in that group. If your employer is especially generous, as is often the case, they may offer to cover your dependents on the plan as well. So basically, you would be receiving a health insurance plan that also covered your spouse and children, and anyone else considered a dependent of yours.

Your employer pays for this type of plan to be offered to their employees and depending on the type of plan they have chosen for their employees, you may be required to pay a small co-pay each time you visit the doctor’s office. However, the rest of the cost of the insurance is covered by the company, so you end up saving quite a bit of money.

Why would a company choose group health insurance for their employees over individual healthcare policies? When a company must purchase an individual healthcare plan for each employee, it ends up costing the company more money. By choosing a group health coverage plan, they can save money by not selling individual policies to each person, which means that group coverage would cost the company less money overall.

An even more worthwhile advantage for the employee is that there are coverage plans that are included in the group health insurance policy which may not otherwise be available or cost-effective for the company if they chose individual healthcare plans. Group health insurance is a great benefit to employees and employers alike.

You may have different options depending on the plan your company purchases. Under some types of plans, you have a Health Maintenance Organization, or HMO plan, which does require a co-pay when you go for a doctor’s visit. You will also be required to choose a primary care physician, or PCP. Any time that you need to see a specialist, you will need to get a referral from your PCP. Unless you constantly need to see specialists, an HMO plan may be all you need.

If your employer chooses a Preferred Provider Organization or PPO plan, you will have a network of doctors you can see, which does include specialists. However, if you decide you must see a doctor or specialist that is outside of the network, you will be responsible for paying the higher cost. It is best to stay in-network when it comes to PPO plans, but the good thing is that you have a wide range of doctors available to you in the network.

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