Check With Your Own Insurance Company For More Information

Category: Finance, Insurance.

As with many other things, when it comes to buying group health insurance, there is strength in numbers. Currently, a large number of individuals in Dallas, Houston and throughout Texas obtain coverage through their employers.

And big numbers have traditionally gotten the best deals. Many of those employers are large companies with strong- arm power at the insurance bargaining table. The Small- Group Market. If you' re a small- business owner, there is no, however reason to feel left out. Small- group refers to the number of employees in a given company. Projected costs can vary dramatically from area to area based on local medical practices, and whatever price, local prices discounts the insurance company has been able to negotiate with local providers.

It can be as many as 100, but is most often two to 5In this market, health insurance prices have traditionally been based on two factors: - Projected costs of medical services in a given geographic area. - Projected utilization of services. After calculating projected costs, the insurance company adjusts the costs for the expected utilization level of your particular group. These details affect plan premiums for you and your employees. Insurance companies estimate utilization of services based on factors ranging from the medical history of your employees and their dependents to age and gender. If a member of your staff is considered a greater risk, the group will usually pay a higher premium for insurance coverage. The majority of small- group health insurance companies use a process called underwriting.

Why underwriting is important. An underwriter analyzes risk factors( including the medical history of each individual) to estimate potential claims and determine a group's premium rate. To offer coverage at a fair price and to ensure adequate income to pay for future claims and expenses. The insurer's goal? Small business coverage options. It's important to weigh the pros and cons of each choice when selecting a plan. Whether you are a small company or a Fortune 500 giant, you want to make sure you are getting your money's worth from a health plan.

While premiums vary among different carriers, recognize that there can be substantial differences in the benefits provided and in the amount your employees must pay out- of- pocket for services. When you start searching for a health care provider for your company, these are things you should consider: What information do I need to collect to get a quote? Things to Think about Regarding Small Business Coverage. All insurance companies will need a census of your employees that includes the number of employees, their age and gender, and the age and gender of all dependents to be covered. They will also need your company's inception date and the effective date of coverage. In addition, based on your number of employees and the practices of the insurance company, some insurance companies will ask each of your employees to fill out a medical questionnaire. Half of my employees are insured elsewhere.

This is a challenge for small business owners. What should I do? If one of your employees has a spouse who has family coverage where he or she works, your employee may be covered on that policy, and not interested in the health insurance plan you offer. An alternative solution may be found in the individual health insurance market. If you want to offer a group plan, be aware that your insurer may require you to cover all or most all of your employees. Can I purchase and offer individual plans to my employees? An employee who needs the coverage may not be eligible.

Yes, with individual plans, but generally, your employees would be subject to individual underwriting. Do I need both group health insurance and workers' compensation insurance? Workers' compensation is usually required. Group Health is optional. In Texas, employers are required to provide workers' compensation insurance, which generally pays for medical expenses and loss of income for employee injuries that are work- related. If you' re a sole proprietor, or officer of, partner a small corporation, you may not be covered automatically by your workers' compensation policy.

Most health insurance plans specifically exclude work- related injuries. If this is the case, you must determine whether your own health insurance has an exclusion for work- related injuries. Generally, most business owners should consider electing to cover themselves under workers' compensation if that option is available in their state. You could have a gap in your own coverage. Check with your own insurance company for more information.