Small Group Insurance Explained
Definition: 2-50 employees
Guarantee Issue Requirements
As per the federal Health Insurance Portability and Accountability Act of 1996, all health insurance contracts for employer-groups of 2-50 employees must be issued on a guarantee-issue basis. All group insurance contracts must also be guarantee-renewable, unless there is non-payment of premium, the employer has committed fraud or intentional misrepresentation or the employer has not complied with the terms of the health insurance contract.
Preexisting Condition Requirements
In California, all group health insurance carriers can impose a 6-month look-back/6-month exclusionary period for preexisting conditions on enrollees that do not have prior creditable coverage.
Underwriting Requirements
In the small group market in California, private health insurance carriers can medically underwrite rates. Rates may vary by plus or minus 10 percent of the indexed rate based no the health status of the group.
Creditable Coverage Requirements
As per the federal Health Insurance Portability and Accountability Act of 1996, credit for prior coverage is required as long as there is no more then a 63-day break in coverage.
Health
Health Savings Accounts
You can use this account to pay for your qualified health expenses, including expenses that the plan ordinarily doesn’t cover, such as eyeglasses and hearing aids.
Expenses paid out of the HSA that are eligible expenses under your high-deductible health plan will count toward the plan’s deductible.
