A group health plan is an employee benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or otherwise.
Many of these plans have no annual deductibles, but require that each member has a primary care physician who directs their care and provides additional referrals if needed. Plans emphasize wellness among other features.
These plans are traditional health insurance plans typically comprised of an in-network and lower out-of-network level of benefits. You are free to choose any given network provider and do not require a referral in most cases. Many plans have office co-pays and prescription drug cards. Many PPO networks are national and therefore provide coverage in most areas of the country.
You must purchase a qualified high-deductible health plan in order to setup a tax-deductible health savings account (HSA). These plans are designed for someone who wants excellent major medical coverage but does not want or need some of the more expensive features of many health plans, such as office calls or a prescription drug card. It gives you the control over how you spend your health insurance dollars and enables you to be more involved. HSAs are a good fit for many companies and individuals.
Health reimbursement accounts allow an employer to take advantage of the savings from higher deductible plans by reimbursing a portion of the out-of-pocket cost for those employees that reach certain limits. This still allows an employer to provide an excellent plan, while also reducing their overall healthcare costs.
This is not a new option; in fact, it was used very heavily about 20 years ago for the same reason it has become more popular again today. By self-insuring (paying) for part of the deductible in your plan, you can reduce and control cost, yet not give up vital benefits. For example, you could increase your plan deductible to $1,000 or more while internally maintaining a $500 deductible at the employee level.
Options range from a variety of supplemental plans, such as cancer or accident policies, all of which are payroll-deducted through an employer and paid for 100% by the employee. This gives employees the ability to get benefits that fit for them, but costs an employer absolutely nothing to offer and may actually save them some money on payroll taxes.
Short term plans are very affordable and are a great option when you need coverage for 6 months or less. A job change, high COBRA premiums, or someone just getting out of college or no longer eligible as a dependent under their parents’ policy are some situations where the plans can fit best.