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Group health insurance in Georgia starts with a legitimate business structure and at least two full time employees on the payroll. The employer is required to contribute at least 50% of the cost of employee health insurance premiums and all group health insurance companies will require minimum participation standards.
In most cases, at least 75% of eligible employees must enroll in the plan but in very small groups the health insurance company may require 100% to enroll. If employee participation does not meet the minimum requirements the policy will not be issued, or if issued, can be cancelled subject to advance notification.
Most group health insurance companies require at least 6 months of payroll records before they will accept an application.
Is Group Health Insurance More Affordable Than Individual Major Medical?
This is a common misconception. Many times a group health insurance plan SEEMS more affordable because of employer contributions toward the premium. If the employer is paying half or more of the premium, then the employee believes the amount deducted from their paycheck is the true cost of health insurance. They get a rude awakening when they leave the employer and get their first COBRA bill.
Are Pre-existing Medical Conditions Covered by Group Health Insurance?
Federal and state laws require group health insurance plans to cover anyone without regard to prior medical history. If the employee or dependent applying for group health insurance does not have prior creditable coverage, or has incurred a break in coverage longer than 63 days, that individual may be required to have a waiting period before those conditions will be covered under the health insurance plan.
One exception to the rule is maternity. Federal laws require group health insurance plans to cover expenses related to pregnancy without regard to prior coverage and may not impose a waiting period.
Can I Cover Myself and my Family and not my Employees?
Probably not. This is especially so due to new Obamacare rules which make "carve out" health insurance plans a thing of the past.
Also, Obamacare mandates essentially make limited benefit plans illegal as well.
Setting up a properly designed group health insurance plan can take several weeks, even for a small employer and the cost may be prohibitive even with tax breaks. There are alternatives to group health plans that may be more flexible and affordable.
If you have questions about group health insurance plans, give us a call.