What things should we look for in group health plans? How do we know that we get the maximum benefits and coverage offered by the insurance company?
Some group health plans do not discriminate against employees or members of a business, association or even union when they offer coverage. Even if the insured has a pre-existing condition, they cannot be denied of coverage. The employees are responsible for the application process and payment of the first premium within 30 days of employment. Otherwise, they lose the right to automatic coverage. When approved, they will receive a certificate of insurance. The group health plan must include in the schedule of benefits the complete scope of coverage for the insured and their dependents. However, there are exclusions in this type of plan. If certain benefits are already enjoyed under Workers Compensations, these benefits will no longer be included in the group health plan. Group health plans also have clauses on Coordination of Benefits. If you are married and your spouse has a group health plan, check which one is the primary and secondary plan. When you have to make a claim if a dependent used any medical service, the primary plan pays first and the rest of the expenses will be covered by the second plan. Answer by general public - June 26, 2009 @ 3:36 pm No CommentsNo comments yet. Leave a comment |
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Group health plans guarantee medical or health coverage on members of a group, often employees of a company with no less than 20 workers. Some of the basic benefits are hospital services, doctors’ fees and other essential medical expenses.
