Group Health Insurance

Group health insurance is a health plan offered by an employer to a group of employees as part of their benefits package. The employer typically covers at least 50% of the premium, while employees contribute the balance.

Small Group

Designed for businesses with 1 to 50 employees (varies by state).
Plans must meet Affordable Care Act (ACA) requirements, including coverage for essential health benefits and no discrimination based on pre-existing conditions.
Premium rates are community-rated (not based on company claims).
Large Group

For employers with 51 or more full-time employees.
Offers more flexibility in plan design and pricing.
Not required to follow all ACA rules for small group plans but must meet certain federal standards.
Premiums may be based on the group’s health history and claims experience.
Level-Funded Group Insurance

A hybrid between fully insured and self-funded plans.
Employers pay a fixed monthly amount that covers claims, administrative costs, and stop-loss insurance.
If claims are lower than expected, the employer may receive a refund at year-end.
Offers cost savings and claims transparency with less risk than traditional self-funded plans.