When Fifty Employees Enroll It Is Considered Large Group Health Insurance

By Jeannie Monette


An account of 51 employees or more is usually considered a large group health insurance policy. Some consider it a large size only when there are 51 who are eligible. If only a few are enrolling in the plan, some still consider it to be of the biggest size while others do not.

Since there are no legal requirements placed on the classifications, each insurer is free to set the number. On average, a large policy is usually considered to be over 50. However it can be higher or lower.

An insured company may start out as a small, or mid-size health care group. As the number of employees grows, that company can be moved to the next largest size group. Since a has flexibility in setting standards and percentages required to qualify for certain groups, the requirements will vary from insurer to insurer.

The larger the category, the more options can be offered in the way of benefits. This happens because the bigger group policy has the cost of benefits spread out among more enrollees and thus, the insurer collects more premiums. This provides the biggest group enrollees with the most options to choose from. When it comes to classification, there is no maximum number.

When a corporation applies for a policy to insure their employees, the insurer takes a number of factors into consideration. For instance, the risk assumed by the insurance company is higher when a low number of employees are paying premiums. Thus, a policy for the biggest category has less risk for the insurer because the cost is spread out among all those enrollees who pay premiums.

If a policy covered 50 people and three women were pregnant and eligible for coverage, that would be a strain on profits. But if 500 employees were paying for coverage, it would be a negligible expense if three of them became pregnant. As the number of enrollees goes up, the risk ratio goes down.

When a company applies to an insurer for coverage, they are able to negotiate the benefits that will be covered. This negotiation, of course, must stay within certain parameters. Some insurers find it cost effective to offer preventive benefits, such as exercise classes, free of charge. Sometimes the cost of the insurance goes up or down depending on how many members are smokers.

Some corporations simply dictate what the coverage will consist of and the employees can accept or decline to participate. Other companies will hold meetings to allow employees to state their preferences. As a result of those meetings, the coverage being negotiated can offer optional benefits the enrollees want. There is no need for a large group health insurance policy to cover any benefits that are not wanted.




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