WHAT IS THE DIFFERENCE between individual & group?

Posted by: Patrick Reaume in Understanding group health insuranceIndividual medical insurance, Redlands health insurance brokerGuide to group health insuranceGroup health insurance, Redlands, caGroup health insurance solutionsGroup health insurance quotes CaliforniaGroup health insurance online quoteGroup health insurance caChoosing group health insuranceCalifornia small group health insuranceCalifornia group health insurance quotes on Print PDF

If you, the employer, are purchasing coverage for your employees, the law says it has to be group insurance.  This is primarily because of the guarantee issue law that group insurance offers.  Individual plans cover less (maternity has a separate deductible, for example) and are approved based on the applicant's good health.

 

California group health insurance is attractive because it offers guaranteed issue.  This means that the insurance company cannot turn you down solely based on your health status.  Individual health plans do have the right to turn you down because you are over weight, have high blood pressure or any number of things.  You might be perfect health but are taking an expensive maintenance prescription.  Still, you are declined coverage.

 

If you are in business for yourself, it may be possible to qualify for group coverage.  You would be interested in pursuing this if you are having a difficult time qualifying for an individual plan.

 

Group insurance coverage requirements:                        For 2 or more employees

            * Be in business for at least 50% of the previous quarter.

            * Have a DBA or fictitious business name statement.

            * Husband & wife businesses can apply as a 2-person business as long

              as both names appear on the fictitious business name statement.

            * Proof of income (Schedule C) is often required for owners.

            * Have a business checking account.

            * Bonified employee: Your employees must be on payroll.  You will need

              to provide a copy of your quarterly wage report.

            * Non-owners need to be covered by a workers compensation policy

 

Once you have all of these areas covered, we can then select a plan for your company.

I would be happy to review this information in person or over the phone.  Your best resource is a local health insurance broker.  We can help you with HMO and High Deductible PPO and HSA (health savings account) compatible health plans. Please call Reaume Insurance Solutions at 909-747-0280 anytime.  I look forward to assisting you with your insurance needs.

 

 

Sincerely,

 

 

Patrick D. Reaume, CFP, RHU

 Patrick Reaume, CFP, RHU is a California small group health insurance broker based in Redlands, California. He can be reached at 909-747-0280 or at www.reaumebenefits.com

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