Finding Large Group Medical Insurance Plans In Southern California

By Jeannie Monette


Many companies offer Southern California large group medical insurance to their employees as an incentive to work for that company. A health coverage policy is purchased by the employer for eligible employees within the company, and sometimes their family members. Many companies do this because medical plans are an attractive part of the employee benefits package.

When medical emergencies happen, having insurance makes the cost of treatment more bearable. If someone purchases a policy alone, it is likely that they will pay more each month. A comprehensive group plan makes it possible for contributions to be spread, thus reducing costs for all the members. The normal payment plan is that both the worker and the employer pay the premium fifty-fifty.

When contracts are agreed upon, they cannot be enforced definitively. The insurer can deny coverage if the historical claims of a company have been shown to be unstable. Individual beneficiaries do not fall into this category, however, since they continue to receive coverage once they prove their eligibility.

Federal law mandates that these contracts be renewed every year, if the employer believes it is acceptable, except in the case of non-payment of a premium. When non-payment happens, the employer has committed fraud and misrepresented themselves. The contract can also be suspended if the employer does not comply with all the terms of the contract.

It is also required by law that a health coverage company must give a worker full credit for any preexisting condition that she or he may have. The coverage for each worker will be calculated by an underwriter at the time that it is purchased by the providing company. Rates can vary between groups, but they are generally based on worker participation and any outstanding claims that have not been settled.

The business owner who wants to offer the coverage to his employees must ensure that his employees provide accurate date for the insurance company. This is usually done by the participants completing a form or questionnaire at the time of enrollment. The questionnaire normally deals with general health issues, such as smoking and heart disease, so that the company assuming the risk can calculate how much coverage to provide. In most cases, the risk subsides when more people enroll.

The insurance company will generally base its annual premiums on the amount of claims filed by participants in past years. This is done so that the company can estimate how much coverage is likely to be required the next year. However, the increases for Southern California large group medical insurance may be due to other factors as well, such as hospital and doctors fees, which the company does not control.




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