Large Group Health
Insurance - Florida
These are plans for companies with
51 or more employees. At this level all quotes are dependent
on prior claims history.
Large groups are companies having more than 51 or more
employees eligible for employee benefits. Eligibility is
defined as an employee working more 30 hours per week and
having passed the employee waiting period established by
the employer. Companies may exclude part-time, seasonal
and temporary employees.
Large group plans, unlike small group are not guaranteed
issue. As such, a group with a very poor claims history
might find themselves paying exorbitant rates. Or, a company
can be declined or rated based on the prior claims experience.
Large groups typically have employee rates that are composite
rated. The rates could be two, three or four tier. Two tier
is a rate for employees and a rate for families. Three tier
might also break out a rate with dependents. Four tier would
usually be an employee rate, employee and spouse rate, employee
and children rate and employee, spouse and children rate
(family). With a composite rate the insurance company or
HMO has calculated a rate that would apply to an employee
regardless of age, sex or location.
The final composite rate is usually determined by the actual
group of enrolled employees. This can make getting a precise
rate quote difficult if not impossible in some cases. A
business won't know exactly the census of enrolled employees
until they enroll. This is one of the reasons quotes have
a disclaimer stating that the actual final rate is determined
by enrollment. The larger the business looking for insurance
the less this matters. Therefore, very large companies can
receive accurate rate quotes in advance.
Past claims history plays an important role in determining
if an insurance company is willing to offer insurance and
at what rate. Underwriters will want to have as much information
as possible. Sometimes insurance companies will quote without
having this, but the danger is, the information would be
asked at enrollment. If there have been health problems,
the underwriter may decide to decline or rate up the company.
Benefit personnel could find themselves in a predicament
caused by agents anxious to get the company to commit, only
to have an underwriter decline or raise the rate. Plans
are usually scheduled to replace an existing health plan
at renewal, leaving the company little opportunity to look
elsewhere. It is wise to be sure the agent is provided good
information and be sure the agent also gives the information
to the insurance company.
Please call us at 800-986-4786 for
more information about Florida group health insurance plans.