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Need more help deciding?Jeff Skeesick can answer questions you may have. 866.696.3154 orjskeesick@aiin.net

What is an eligible employee?

An eligible employee is any employee who meets the definition in the plan for participation. Definitions of eligible employees vary widely from employer to employer, policy to policy and by the type of insurance offered, though they may be influenced by legal considerations and company structure.

Can an insurance carrier deny certain employees coverage under a group insurance plan?

Because group insurance implies that all employees can be covered, generally, carriers will not deny coverage to any fulltime employee who is enrolled in the plan within the required time.

 

Are employers required by Federal law to purchase group insurance for their employees?

Federal law does not require employers to provide employee group insurance as of this writing, however, with the new HealthCare Reform Act, some form of national health insurance requirements will be legislated to be in place by 2014.

What types of services are generally covered by a group health insurance plan?

 

Obviously, plans can vary by insurer, but typically cover the same types of services, such as:

• Anesthetics

• Blood transfusions

• Casts, splints, trusses, braces, crutches

• Certain ambulance services

• Home healthcare

• Hospital charges for semiprivate room and board, necessary services and supplies

• Laboratory procedures

• Mechanical equipment rental

• Oxygen

• Physical therapy

• Physician services, often including osteopathy, naturopathy and other recognized medical practitioners

• Prescription Drugs and medicines

• Prosthetic appliances, except as replacement

• Services of registered nurses (RN) and/or licensed practical nurse (LPN)

• Surgical charges

• Wheelchair or hospital bed rental

• X-rays


What is meant by “individual” health insurance?

The term “individual” insurance refers to medical insurance that is obtained privately as opposed to insurance acquired either through a government program or through an employer. Individual health insurance plans are often a good choice for people in the following situations:

• Individuals who have exhausted COBRA coverage through a former employer or who can't afford COBRA premium costs.

• Self-employed individuals.

• Students, spouses or dependents rather than enrolling through a parent or spouse's group plan.

• Retirees who need coverage until they reach Medicare eligibility.

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Fx: 509.777.2675 | E: jskeesick@aiin.net

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