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Group Medical Insurance Plans versus Individual Plans

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 Group Medical Insurance Plans versus Individual Plans
Group Medical Insurance Plans versus Individual Plans

Group Medical Insurance Plans versus Individual Plans

It has been a universal norm that employers offer medical insurance benefits to the employees. This insurance is offered at group rates which are supposed to be lower than individual policy rates. However studies have brought to the notice that actually this may not be true anymore. In many cases individual plan premiums may be cheaper than group plan premiums up to as much as 50%.

The plausible reason for this could be the states allowing insurance companies to screen their clients and offer different rates according to the individual cases. In this way a relatively healthy young person would have to pay less than what he would have paid through a group plan. Insurance companies can charge premiums based on the specific individual criteria. The group rates are more of an average which takes into consideration the conditions of all the individuals in the group. Also if the insurance companies are forced to accept all applications, they would have to charge higher premiums in order to cover their risks. This happens in the ‘guarantee issue states’ where insurance companies have to provide insurance to every applicant. Hence customers have to pay higher rates.

The medical insurance reforms which are in the planning pipeline will make individual plans even less expensive. The following features of the reforms will help to achieve this situation.

  • Under the Health Reimbursement Arrangements employees will be reimbursed for their individual medical insurance costs by their employers.
  • With the creation of state risk pools, employees will be sure of getting insurance under HIPAA rules.
  • There will be no denial of renewing existing individual plans based on history of previous claims. Individual plans will have to renewed. Premiums most likely will increase.
  • The Federal Health Care reform will ensure that all existing uninsured people can get individual medical insurance. A national risk pool will be used to cover all such people.

Over time the lifestyles and requirements of people keep changing. In order to keep up with the changes, it is important to revise and reform the medical insurance regulations. Through the government’s initiative and intervention people can hope to get better coverage and benefits from the insurance companies through individual plans.

Group Medical Insurance Plans versus Individual Plans


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