Health insurance providers must work using a process known as guaranteed. In essence, this means that no employee, or your spouse or dependents, may be rejected for health insurance based on any pre-existing conditions. Health insurance from your employer must comply with this standard as a basis in federal law and may face substantial fines or other forms of punishment if it is determined to act against the law. Any employee who applies for health coverage through their employer can not be rejected for any reason.
This is in direct opposition with how private insurance companies usually work. Private insurance companies can decline an applicant on the basis of any pre-existing medical condition diagnosed in the last year. This can include serious diseases like cancer and diabetes, or minor problems such as headaches and stomach virus. Some states also allow group health insurance providers to implement a waiting period before covering any pre-existing medical condition.
This varies by state, but is usually between six months and one year. An employee with diabetes may have to wait six months or year-round, before your insurance covers all costs associated with the disease. This only happens in a small percentage of cases, usually when an employee has not had health insurance coverage existing within the last 63 days. If the employee has had medical coverage in the last 63 days, and his condition was covered, then they are not normally subject to a waiting period. This will vary from vendor to vendor.
Group health insurance policies
The types of insurance policies, health groups are usually divided into two categories, depending on the number of employees working for a company or business. Those with fewer than fifty employees fall into one category, while those with more than fifty employees fall into a different category. The reason for this is because the policies allowed under law are determined by the size of the company. In general, large companies with more employees have more options than smaller firms. Larger companies typically receive a discount on health insurance, based on the number of policies they use in a calendar year.
In some situations, employees of large companies can pay less for their premiums, simply because their employer can afford to help pay. With smaller companies, each employee may be responsible for the entire cost of your insurance premium. Some people may also benefit from group health insurance through the Federal Employees Health Benefits Plan. This plan only applies to current and former federal government employees, including retired military personnel.