How does Group Health Insurance Coverage Work?

Group health insurance coverage works to extend health insurance protection to employees.  An employer-sponsored group health insurance plan is the largest provider of health care in the United States. The plan works by providing an opportunity for all employees of a business to apply, based on their eligibility to participate in the plan. Eligibility rules vary from state to state, since health insurance is subject to the laws of the state. Generally, an eligible employee is considered one who works a minimum of 40 hours or more a week and is over the age of 18.

Group Health Insurance Plan Enrollment

The employer enrolls employees as participants into the plan of their choice during the annual open enrollment period. New employees may also enroll into the plan after a pre-determined waiting period has been met. The reason for waiting periods and annual open enrollment periods is to reduce the risk of people only enrolling for health insurance benefits when they are sick or need them.  The waiting period tends to be 60 to 90 days.

Once enrolled, employees are able to use their group health insurance coverage in order to make appointments, see a doctor or receive medical services for themselves or a covered family member.

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