Though most people feel that group health insurance – such as the plans offered by many employers – are highly beneficial, it should be noted that they were not all created equal, and that there are many surprising things that consumers can learn about those policies that might change their opinions about their value.
Consider the following often unknown issues regarding group health insurance:
• Some group health plans don’t provide pregnancy coverage – as a result of the Pregnancy Discrimination Act of 1978, the majority of health insurance plans sponsored by employers do not provide coverage for pregnancy-related expenses. Companies with fewer than 15 employees are not required to cover pregnancy on their health insurance unless the state law mandates it. For larger companies, the pregnancy coverage depends on what payments are offered for other medical conditions.
• Some plans force workers with unhealthy habits to pay higher premiums – among group health plans sponsored by employers 20 percent penalize workers for unhealthy habits such as smoking. Another 10 percent of employers penalize their workers based on specific health issues such as cholesterol or weight. Twenty three percent of employers have stated that they intend to apply those techniques next year.
• Some employers can exclude employees from a group insurance plan – an employer is not required to offer health insurance coverage to all of its workers, and it can offer different levels of coverage to different groups of employees.
• An employee sponsored health plan doesn’t have to cover the worker’s family.
• Employers aren’t required to pay for the policy’s premium. Though most do, they are starting to require workers to pay an increasing portion of the premiums.