What is group insurance vs. individual insurance? This question is the most commonly asked by people researching their health insurance options. A simple way to explain this is that group insurance is a policy purchased by an employer, and an individual person or family buys individual insurance. Each option has very clear differences; some of these include cost, levels of coverage, and enrollment restrictions.
Cost and Premiums
Group health insurance plans usually offer more affordable coverage for individuals and families. Employers can cover or pay a portion of the total monthly premium and have the employees pay the outstanding amount, usually as a deduction from the employee’s paycheck. Some employers do not offer health insurance coverage, while others provide access to health insurance but do not contribute towards the premiums. Employers have the flexibility to decide when they set up group health insurance coverage for their employees.
Individual insurance is purchased by an individual who is responsible for paying the monthly premium. An insurance agent or broker will help guide and review multiple health plan options to ensure they pick the most affordable option with the best coverage.
Coverage Options
Group health insurance is limited to policies chosen by the employer, which results in fewer coverage options and less flexibility for employees, but with lower monthly premiums.
Since individual insurance is for a single person or family, it allows you access to many options with various premium costs and coverage levels. This will enable families and individuals the flexibility to choose customized health insurance coverage.
Enrollment Process
Group insurance plans have a set annual enrollment period and often have restrictions or waiting periods for new employees. These restrictions may create challenges for those needing insurance coverage for immediate or existing medical needs. However, it is essential to note that insurance companies are not permitted to deny coverage or charge more based on existing medical conditions.
Individual insurance also requires enrollment during a yearly period, known as the Open Enrollment Period. In some exceptional cases involving life events, such as losing previous health coverage, a person may qualify for a Special Enrollment Period.
For more information or guidance on selecting health coverage for groups, individuals or families, contact a licensed broker at Cosmo Insurance Agency. Our team of experts can guide you through researching and selecting health insurance coverage that meets your specific needs.
Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.
