Group Health Insurance


What does Group Health Insurance mean?

Group health insurance is simply a type of health insurance that offers health care coverage to a specific group of employees of an organization or a group of people. This type of insurance is beneficial to both the employers and employees. All members of the group insured get the same benefits; it doesn’t exclude the employees’ relatives also.

There are so many group life insurance, but the one sponsored by employees seem to be very common. When employees are seeking or applying for jobs, they always consider this major benefit as one of the factors to be considered when applying for jobs.

What is Covered by Group Health Insurance?

Most companies or organizations provide their employees with benefits such as group health insurance; Group insurance is seen as a way of encouraging your employees. Immediately employees start working in a company, they get covered by group health insurance, and the amazing thing is that employees’ relatives are not left out. Medical underwritings are not required in order to implement this policy.

Group Health Insurance covers the following:

  • Maternity cover and pre-existing illness
  • Expenditures that are related to pre-existing illness
  • Features cashless hospitalization
  • Chronic illnesses
  • Pre & post hospitalization expenses
  • Day care procedures
  • Expenses incurred from using emergency ambulance

What is Not Covered by Group Health Insurance?

There are some exclusions in what group health insurance covers. There are various illnesses covered by Group Insurance, those that are not covered are defined by various plans. The exclusions include the following.

  • Injuries sustained as a result of war

Group disability insurance will not cover any illnesses, disabilities and injuries sustained during war. This also includes radiation injuries which may be sustained even when war does not exist.

  • External Durable Items

External durable items are things that are required for the patient’s use, this include hearing aids, spectacles, lenses, crutches, wheel chair etc., such items are not covered by health insurance as long as these items are not meant for treating a disease, they are rather required to help the patient carry out daily activities.

  • Pre-existing illnesses

Group health Insurance does not cover Pre-existing illnesses for a certain period of time. These illnesses might be covered if the policy continues for longer periods. The period goes between 12 to 48 months.

  • Pregnancy related and dental treatments

Pregnancy related treatments like IVF, GIFT or childbirth complications treatment will not be covered by group health insurance. Dental treatments that require corrective surgeries will also not be covered; the only exception is when dental treatment is required before an illness can be treated.   

  • Voluntary Medical Processes

Voluntary medical processes which involve circumcision, plastic surgery, experimental treatments, vaccinations, etc. will not be covered.  If these medical processes are carried out without a medical reason, health insurance will not cover them.

Also read about Surety Bond

Benefits of Group Health Insurance

There are so many benefits group health insurance has got; these benefits are enjoyed by both the employee and employers.

  • No waiting period

Getting the complete benefits of group medical insurance does not require going through a waiting period

  • No medical check-up

The insured does not need to conduct any medical check-up before he/she can be covered by group health insurance.

  • Maternity cover

Group health insurance provides individuals with maternity benefits. In some organizations, all maternity expenses are covered by group health insurance as soon as an individual gets employed in accompany or become a member of an association.

  • Lower cost

Group insurance requires a very low cost to be implemented.

  • Health security guaranteed

An employee is self assured of good health condition with Group life insurance.

When Should Businesses opt for Group health insurance?

According to the federal law, small employers can opt for group health insurance, regardless of the health condition of employees. A business having two to fifty full-time employees is regarded as a small employer.

Owners are also regarded as part of the employees; therefore sole proprietorship with just an employee is considered a small employer. Business owners can opt for group health insurance, if the coverage options are needed.

What are the Procedures Required for Applying for Group Health Insurance?

You might not necessarily make use of this policy immediately you opt for it, but it is advisable you opt for it in case something occurs. The necessary procedures are:

  • Buy a health plan
  • An individual who opts for this will be put in a statewide risk pool
  • You give and also receive from the pool

Other Coverage Options

Professional Liability Insurance

When business owners give advice to their clients and such clients accuse the business owner that such advice has a negative effect, professional liability insurance helps you recover from financial consequences that may arise.

Commercial General Liability Insurance

If the use of your product causes damages or injuries to a third party, commercial general liability insurance protects business owners from incurring loss if found legally responsible for such damages or injuries.

Commercial Auto Insurance

Commercial auto insurance helps to protect your commercial vehicle from any accident.


Group health insurance has lots of benefits for both employees and employers. It serves as a health guaranty for the insured. It provides benefits such as medical examinations, hospital stays, treatment etc.

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