According to the Kaiser Family Foundation, 130 million Americans rely on group health insurance from their employers or member based organizations in order to meet their health care needs, totaling nearly 70% of all Americans who carry health care insurance in the U.S. With such a sizeable chunk of the 2.3 trillion dollar health care industry devoted to group health insurance, it's safe to say that individuals, employers, and group administrators alike have a lot to choose from in the group health medical plan department. The trick is understanding how medical group health insurance works, and how to make it work best for you.
Group Health Medical Costs
To start with, it's always helpful to get an idea of what group health care plans are going to cost both plan participants and the businesses and organizations that administer them. That said, keep in mind that the numbers below are industry averages, and that the size of the business or organization, the type of medical group health plan selected, and even the health histories and ages of individual participants can all influence group health care premiums.
- Individual Group Health Medical CostsAccording to the 2009 Employer Health Benefits Annual Survey by the Kaiser Family Foundation and the Health Research and Educational Trust, group health insurance cost single participants an average of $4,824 in 2009, while families paid average annual premiums of close to three times that amount, at $13,375.
- Employer Group Health Medical CostsAs expensive as medical group health costs were for participants, the statistics show that employers and member based organizations do, in fact, shoulder most of the burden where group health insurance costs are concerned. According to the same Employer Health Benefits Annual Survey cited above, employers pay an average of 73% of group health medical coverage for families, and an average of 83% of medical group health costs for individuals.
With those kinds of numbers being thrown around, it's no wonder that businesses and member organizations are on the hunt for group health medical plans and providers that offer quality health coverage and affordable rates.
Sorting Through Group Health Medical Plans
Whether you're a business looking to acquire medical group health coverage for your employees, or an individual trying to sort through your group health medical plan options, medical group health plans can be divided into two primary groups: traditional managed care plans and newer High Deductible Health Plans (HDHPs), usually paired with a Health Savings Account (HSA).
- Managed CareManaged care plans generally offer better overall health coverage, lower deductibles, and are more family friendly. They range from HMOs (Health Management Organizations) that strictly manage patient care and rarely cover out-of-network expenses, on up to more liberal PPOs (Preferred Provider Organizations) that provide greater freedom to patients both in terms of determining health care providers and in controlling their own health care choices. The catch: the more comprehensive a managed group health care plan gets, the higher the monthly premiums are going to be for both administrators and plan participants.
- Non-Managed CareThe most popular alternatives to managed care plans are High Deductible Health Plans (HDHPs) coupled with Health Savings Accounts (HSAs) or Health Reimbursement Plans (HRPs). These options can drastically reduce the cost of premiums for all parties, though those price reductions come at the cost of increased out-of-pocket expenses for plan participants. With their high deductibles and high rates of self-determination, HDHPs, HSAs, and HRPs are sometimes criticized as insurance for major injuries or serious illnesses only, though for those same reasons these plans can be an excellent option for a younger workforce with lower health care expenses and needs.
Moving Beyond the Tip of the Ice-Berg: Customizing Group Health Plans
Finally, it's important to realize that choosing a broader group health insurance plan is just the tip of the iceberg when it comes to procuring group health care for your business or organization. Setting deductibles and co-pay amounts, deciding whether to add additional benefits like dental or prescription drug packages, and determining employee contribution amounts are equally important when you're setting up a group medical health medical plan. That said, soliciting a number of insurance quotes through a service like NetQuote.com is always a smart plan of action, allowing you to compare providers, seek out expert advice, and contrast different plans, benefits, and rates on the way to finding the best medical group health insurance possible for all of your group health needs.