Getting Group Health Insurance Tips

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Look For Local Chronic Disease Support Groups

If you or a member of your family has a chronic disease, it can be is financially and emotionally straining. Look for a local or even national support group that may provide guidance on how to lower treatment costs, find an inexpensive health insurance plan, or even dealing with medical bills. These groups can be found through your local state department or you can search the Centers for Disease and Prevention at or call 1-800-311-3435 and press 0.


Join A Community Plan

If you do not have a job that provides benefits, look into forming a group or even joining a group that already has them like your local Chamber of Commerce, Alumni association, your local religious organization, or even an association. Just be sure you review the policy because the community plan may be one that is based in another state with different rules, so the benefits may as well as the rules that govern the policy from a different state. It important that you do your same due diligence on these plans as you would any other. Find out if there have been any complaints filed against the organization or the insurer and if the state protections apply.

What are HIPAA and COBRA?

The Health Insurance Portability and Accountability Act

HIPAA is a federal regulation designed to provide workers with health insurance security. HIPAA stands for Health Insurance Portability and Accountability Act. Among other things, this regulation guarantees that workers and their dependents are able to continue group health insurance coverage in the event the primary insured loses his or her job, becomes disabled, dies, or gets divorced and that if you transfer to a new health care plan you will not have to qualify again during waiting period restrictions for pre-existing conditions which was met under the old plan.

Provisions of HIPAA apply not only to traditional employees, but also to freelance contractors and others with self employed health insurance. For more information on HIPAA, please visit the United States Department of Labor's Employee Benefits Security Administration Web site.

What is group insurance?

Group Health Insurance

Group health insurance is health insurance provided to a large number of people under a single master policy. Group health insurance is most often obtained through an employer but is also available to small business owners and freelance contractors through professional associations and unions.

Since groups are able to negotiate better terms with insurers, the premiums are generally lower and the service coverage generally more comprehensive when getting group health insurance. The rates available were you to purchase an individual health insurance plan would likely be considerably higher. Individual health insurance plans are those plans that are privately purchased by consumers and include coverage for individuals, couples, and families.

What is open enrollment?

Open Enrollment For Group Health Insurance

Open enrollment is the window or period of time each year when you can make changes to your company health insurance elections. Generally speaking, except for when you are initially hired, unless you have had a qualifying event, you cannot change your health insurance coverage outside of open enrollment.

Open enrollment is usually sometime in October or November to give employees and employers a chance to make changes in time for the upcoming calendar year. Changes do not usually take effect until the first day of the New Year. If you have a family status change outside of open enrollment, you can change your insurance choices then as well. Family status changes include the adoption, birth, or death of a dependent child or spouse; marriage or divorce; and the loss of eligibility for health insurance benefits by your spouse. At these times, you can add or drop family members to your plan.

What is an SPD?

Summary Plan Descriptions (SPDs)

An SPD, or summary plan description, is your group health insurance plan administrator's description of your legal rights under the Employee Retirement Income Security Act (ERISA). ERISA is the federal law that protects your health benefits. Your company's SPD should include information about coverage for your dependents, co-pays, as well as when and under what circumstances your employer can cancel your health insurance.

You should receive a copy of your company's SPD each year in your benefits package as part of your group health insurance quote. Save it and any memos, letters, or e-mails (print these out) that relate to the SPD. If you cannot locate your SPD, ask your human resources department for a copy.

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