The Pros and Cons of Group Health Insurance

 The health insurance marketplace is certainly challenging, but count the lucky stars that at least you have choices. To that end, this article is going to explore the pros and cons of group health insurance.

Group Health Insurance Pros

  • Group health premiums are subsidized by the employer. Generally, an employer must contribute at least 50% of the "employee only" premium. As such, if you are an employee, you can likely get a richer health plan for less premium than you would pay in the individual health marketplace. However, the cost of adding your dependents to the employer's plan may be cost-prohibitive. In this case, assuming that your dependents can qualify, then you may want to put them on an individual health plan.
  • Group health premiums for large families are the same as for small families; whereas, in the individual market, you pay a separate premium for every family member. So, if you have a large family, you may be able to get a better deal by adding them to your employer's plan. As with any insurance change though, don't make any changes without consulting with an experienced insurance advisor in your state.
  • Group health insurance in most states is a guaranteed issue - meaning that you can't be turned down because of pre-existing health conditions. This is a real blessing if you or a family member has a medical condition that prevents you from qualifying for an individual plan. But, this is a double-edged sword. While being guaranteed issue is a huge benefit for those with pre-existing medical conditions, it does come at a price. This one feature alone accounts for most of the disparity between group and individual insurance premiums. Yes, that is right - in most states, individual health premiums are almost always less expensive than group health premiums.
  • Most group plans cover maternity. So, if you are planning on having more children, you should definitely consider hopping on to a group plan. While you can add a "maternity rider" to individual plans, these riders tend to be expensive, restrictive, and otherwise provide less value than the coverage you can get in a group health plan. That being said, if you are considering having more children, we recommend that you contact a health insurance advisor in your state for advice about what is best for your family. The right answer is different for each unique family.

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