Many employers supply health insurance for its employees under the group health plan. The employer is considered the policy holder and the employee is considered the certificate holder. Many times someone in the human resources department will work and negotiate with insurance providers and pick specific items to offer the employees.
With the group health plan employees can add riders, which are options such as vision and dental options that may not be covered otherwise. Open enrollment periods are usually offered once a year, during this time the employee can choose or change their coverage based on their families needs.
Some employers use self funded health plans, instead of purchasing insurance from another company. They do not pay premiums to an insurance carrier instead they “insure themselves” they take on the risk of paying direct for medical services. Companies that use self funded health plans often may set up a provider network, which offers a discount of fee for services provided. Often times the self funded health plan will also hire a third party administrator to handle the claims process and payments to providers.
There are a number of regulations that employers who are under a group health plan and also self insured employers have to follow. The Portability and credibility act insures that an employee that leaves employment can continue coverage under the cobra plan for approximately 6 months.
References
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