What are the Things You Should Know Before Getting Group Health Insurance?


The term insurance is nothing new to any entrepreneur in the modern world. Insurance companies have been there for some time now, helping businesses cater to underlying issues, such as employee’s health. Today, we have group health insurance, or what many people refer to as employer-sponsored health insurance. 

doctor holding red stethoscope



Without saying much, here are things you must know before getting started with group health insurance. 

How does it work?

Often, group health insurance is referred to as job-based insurance policies. As the name suggests, here it’s the employer who buys the policy or plans and then offers them to the members or employees. Therefore, once a new employee joins the group, he or she becomes insured automatically. Group health insurance policies can only be purchased by groups, which means that individuals can’t.  As such, it’s always important to check if it covers things like dental visits; for instance, if you book your appointment with the Dentist in North Eastham for a treatment.

What’s needed?

Now that you have an idea of what a group health insurance is, you must be asking yourself what’s needed for one to enroll. When it comes to signing up with an insurance company, professionals always insist on the use of a broker. One good thing about using a broker is that they help fasten the registration process. You can learn more here about the many other benefits that come with including a broker in the process. Apart from the registration, brokers can as well help with processing claims in case the registered risk occurs. 


Whenever you approach a broker looking to sign up, there are several documents that you will be required to provide. The fact that it’s a group health insurance means that you are needed to prove that you are a company with employees. Some of the documents used to prove that include;


  • Payroll records
  • Check paid from the company’s bank account with the company’s name
  • Partnership documents/ articles of organization/ partnership documents


Types of group health insurance policies

  1. Small employer group

The first and most common type of group health insurance policy is a small employer policy. As the name implies, this kind of insurance is for companies that have less than 50 employees. With this policy, employees can access services like primary healthcare, lab services, and physical examinations. 

  1. Fully insured employer group

In this policy, the employer is responsible for paying all or part of the insurance premiums. In contrast, the insurance provider pays for any costs related to the benefits stated in the insurance policy. The premium rates usually remain fixed. However, they may fluctuate depending on the number of participants enrolled in the plan. 

  1. Self-funded care

It’s one of the most commonly used plans among many companies. The plan offers a kind of arrangement where the employer will be the one to take care of all employee health care costs and other benefits. The employer is also responsible for costs related to the plan. 

  1. Health Maintenance Organization (HMO)

HMO is often referred by many as a prepaid health plan. This is because the policyholders are usually the ones paying for specific types of health services in advance through the monthly premiums. These policies are usually cheaper as compared to the others. The only shortcoming is that the services are limited. Policyholders can only get services from facilities and doctors included in the HMO list or policy guidelines. 

  1. Preferred Provider Organization (PPO)

PPO was born as a result of the limited services given under the health maintenance organization (HMO). In this policy, as a policyholder, you are flexible when it comes to choosing your doctor and health care facilities. Although there is a list of preferred health care providers, in this policy, you can choose to use different doctors or health facilities not on the list. 

What are the benefits of getting group health insurance? 

To the employer

  1. Motivates the employees – in the modern world where hospitalization costs have continued to increase, acquiring a group health insurance can act as the right motivation to your employees as they feel safe being part of your organization.
  2. Employee retention – almost every worker is looking forward to serving in a company where his or her health is considered. Therefore, getting a group health insurance means that your employees are likely to stick to your organization in the longest time possible. Besides, with an attractive health policy, you are likely to attract talented individuals from the outside. 
  3. Low cost – the buying of group health insurance policies comes at a low price as it’s like buying in bulk. There are discounts offered. 
  4. Flexible payment options – depending on your company’s policy, you can choose to pay the premiums either monthly or even yearly. 

To the employees

  1. No medical check-up needed – when it comes to registering for this kind of insurance policy, you don’t need to undergo any medical check-up or submit any medical reports to get enrolled in the plan.
  2. No waiting period – once an employee joins your company, he or she becomes part of the policy. Hence, there is no concept of the waiting period in group health covers. Therefore, even illnesses, such as heart issues, are covered from the very first day. 
  3. Institutional support during a claim – when making a claim, as an employee, you can get the help from your company when it comes to following up on those claims.

pink stethoscope


Group health insurance policies are essential when it comes to the running of any business. Explained in this article is everything that you ought to know concerning this kind of insurance. If you have read through the entire piece, then you now have an idea of everything you must know before getting started with the policies.