7 Truths About Group Health Insurance Your Broker Doesn’t Want You to Know

Truths About Group Health Insurance

As a physician, you may run a private practice, which means that you will be regarded as a business owner.

Group health insurance is a common solution for employee benefits, often offering advantages such as shared costs and simplified administration.

Insurance brokers earn commissions from their plans, but reputable brokers provide valuable advice on selecting the most appropriate coverage.

However, small group plans come with some disadvantages and we are here to inform you about them.

1. It Will Take up Much of your Time

Conventional group health insurance is typically administered through the owner. This means that you are tasked with picking health insurance for your entire staff every year.

Now, this may sound easy, but between finding options within your budget, reviewing existing and new options, and trying to save against premium inflation, that could take weeks or even months.

Health insurance agents may assist small enterprises in choosing group health insurance plans.

Once they assess your business needs with you, they will then set up meetings with each of your employees.

The meetings are supposed to help the employees pick plans that suit their distinct needs while you sit back and watch or concentrate on other things that will grow your practice.

2. You will be the Decision Maker

As a business owner, the administration of group insurance for your employees will be your job. That means that most coverage options will be your call before your employees assess their options.

From the lowest paid to the highest, your choices will determine networks, out-of-pocket expenses, and premium costs for the employees.

Ask yourself if you can carry the weight of such responsibility. Business owners often decide to offer group health insurance options, but employees ultimately choose from the available selections based on their needs.

3. You will be included in the Coverage

Regarding group plans, the cost of coverage is usually split between the employer and employees. Often, your practice must contribute a minimum rate to your employees’ premiums.

Most business owners will tell you that this is not the ideal scenario.

4. There will be no Subsidies for you

Under the Affordable Care Act, which is designed for individuals buying insurance through the marketplace, group plans do not qualify for individual subsidies. On the other hand, individual health plans do as long as one qualifies.

Moreover, obtaining a subsidy under an individual health plan is not rare.

If your employees choose individual plans, they may be eligible to apply for subsidies independently.

Subsidies can reduce monthly premiums or out-of-pocket expenses for your employees quite significantly.

5. You will Pay Higher Premiums

Now that you know group plans do not offer subsidies, you better prepare yourself for the possibility that you and your employees may have to pay higher premiums to get coverage.

6. There is no Continuous Coverage

Group coverage can often be continued for a limited time under COBRA, where the individual may pay the entire premium.

The only difference is that the individual would be responsible for up to 102% of the plan’s cost.

This is because the employer ceases to cover their part, which increases the cost.  Individual plans go on with coverage regardless of employment status.

7. Choices are Limited

Group health insurance plans may offer a range of options chosen by the employer but are designed to meet the diverse needs of employees.

On the other hand, individual plans offer various choices based on where an individual resides.

Employees get to pick a plan that suits their needs and budget with the help of a qualified agent.

Final Thoughts on Group Health Insurance

Insurance brokers for group health plans will never tell you the truths above.

You have to do your due diligence before opting for the same and as you have seen, such plans are hardly in your favor.

You would be better off allowing your employees to pick their plans.

See Also

What is a Resident Doctor

Residency for Dermatology

Best Insurance for Dental Implants

Current Version
April 11, 2024
Updated By
Andrea Morales G.
October 28, 2021
Written By
Shubham Grover

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