By Cammie Scott, NOARK Legislative Chair
A group health insurance plan is an insurance plan provided by an employer. A group plan is different than an individual plan. A group plan must cover things that an individual plan does not cover such as pre-existing conditions provided you have had previous credible coverage. A group plan cannot “rate up” any individual in the group based on their health conditions.
When a company provides health insurance, they pay for part or all of the premiums for the employee. Because the company pays for a portion of the employee’s premium, it’s generally cheaper if a couple enrolls in individual employee only plans with their respective employers rather than an employee plus spouse plan.
Companies are not mandated to offer coverage. Beginning next year, large employers must offer coverage or pay a penalty. Companies with fewer than 50 full time equivalent employees will not have to offer coverage.
When an employee starts to work with a new employer, there is generally a “waiting period” of time an employee must wait before coverage goes into effect. When a person is considering changing jobs they need to learn what the waiting period is for the new company. They also need to consider when the coverage with the current company will end. In order to not have a gap in coverage, you may want to consider either COBRA coverage or a “short term” or “temporary” insurance policy.
COBRA allows employees and their families who have lost coverage, the option of continuing group health insurance that is provided by their previous employer. COBRA coverage is generally limited to 18 months however for certain circumstances; it may go up to 36 months. You are able to continue coverage after circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transitioning between jobs, death, divorce and other life events.
Short term policies cover you for a “short term” or period of time. These policies are lower in cost than COBRA; however they do not cover any pre-existing conditions. If you only need coverage for one or two months and you do not have any pre-existing conditions this is a great way to protect yourself.
Keep in mind some of the provisions in this article will be changing with the implementation of the new Health Care Law. This advice is good throughout the remainder of 2013.