Saturday, November 30, 2013

Policy Covering Fifty Considered Large Group Health Insurance

By Jeannie Monette


An account of 51 employees or more is usually considered a large group health insurance policy. Some consider it a large size only when there are 51 who are eligible. If only a few are enrolling in the plan, some still consider it to be of the biggest size while others do not.

Since there are no legal requirements placed on the classifications, each insurer is free to set the number. On average, a large policy is usually considered to be over 50. However it can be higher or lower.

An insured company may start out as a small, or mid-size health care group. As the number of employees grows, that company can be moved to the next largest size group. Since a has flexibility in setting standards and percentages required to qualify for certain groups, the requirements will vary from insurer to insurer.

There are advantages for the insured who is an enrolled member of the coverage for the largest. This is because the most benefits can be offered. It gives the most options when it comes to choosing the exact benefits each enrollee would like to have. There is a minimum number of members required to classify as the biggest size. In most cases there is no maximum.

There are many factors that an insurance company takes into consideration when an applicant is being considered. The number of pregnancies is one such factor. Insurance coverage for sizable businesses can afford certain risks because a low percentage of members will suffer a specific illness and a low percentage will have an accident.

If a policy covered 50 people and three women were pregnant and eligible for coverage, that would be a strain on profits. But if 500 employees were paying for coverage, it would be a negligible expense if three of them became pregnant. As the number of enrollees goes up, the risk ratio goes down.

When a company applies to an insurer for coverage, they are able to negotiate the benefits that will be covered. This negotiation, of course, must stay within certain parameters. Some insurers find it cost effective to offer preventive benefits, such as exercise classes, free of charge. Sometimes the cost of the insurance goes up or down depending on how many members are smokers.

Some corporations simply dictate what the coverage will consist of and the employees can accept or decline to participate. Other companies will hold meetings to allow employees to state their preferences. As a result of those meetings, the coverage being negotiated can offer optional benefits the enrollees want. There is no need for a large group health insurance policy to cover any benefits that are not wanted.




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