Group Health Insurance

Introduction & Information

While businesses have long been familiar with the concept of group health insurance, insurance buyers in the individual health insurance market are now encountering the term that association health coverage has been extended to the self-employed, freelancers, and contractors. Put simply, group health insurance is a medical benefits plan that is offered (and restricted) to eligible people and dependents among business employees or organization members.

Group health insurance operates under different regulations and benefit requirements depending on whether it is a “small group” plan or a “large group” plan. Small group plans operate under the requirements of the Affordable Care Act, which include 10 categories of mandated benefits. Large group plans, in contrast, have more flexibility regarding what benefits they include within their plan, though there are some benefits that are mandated. For plans that are self-insured (otherwise known as self-funded), benefit requirements may differ further.