Can You Get Non-Employer Sponsored Group Health Insurance?

Q: Is there a way that a group of people can enroll in an insurance plan, or is there such an insurance plan, where they are not related and do not work together…a co-op so to speak?

A: Some insurance companies (in certain states) will allow associations to join together to form a group that qualifies for enrollment under the same health plan. These associations must be small businesses within the same trade, such as franchise owners working as independent operators for the same corporation. Realtors are another common association that often ban together to form an association group health plan.

As for a group of individuals banning together to say “we are a group” for the purpose of getting a group health plan, we are not aware of such an occurrence. Insurance companies are permitted by most state and federal regulations to place restrictions on what types of organizations or “groups” qualify to purchase a group health plan. Such regulations are necessary because small group health insurance is “guaranteed issue” in most cases. This means that the insurance company must provide health insurance to any qualified group, regardless of their health history or current health status. If any group of people could ban together and qualify as a “group”, then this would occur quite frequently from groups of people that can’t get health insurance any other way, primarily because they have medical conditions that prevent them from being insurable.

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