Pennsylvania Group Health Insurance

Written by Norene Anderson
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Pennsylvania group health insurance is governed by the regulations of the state's department of insurance. All health insurance providers in the state must offer a policy to any small business. It must be a policy with the same benefits offered to any of the other small businesses in Pennsylvania. The definition of a small business is any business with at least two and no more than 50 employees.

Another requirement for Pennsylvania group health insurance is that the number of employees participating must meet the minimum level. Different insurance companies have a different percentage of employees required to purchase the policy in order for the business to qualify for coverage as a group. In some cases, the employer may be required to contribute a portion of the cost of the premium.

Pennsylvania Group Health Insurance Information

For companies with more than 50 employees, Pennsylvania group health insurance falls under different guidelines. For the smaller group, the premium is based on the health status of the insured and can be increased if someone on the plan incurs a large claim. For larger companies, there cannot be a differentiation of premium due to health conditions. The premiums can be raised only if everyone in the same class and with the same type of policy is included in the increase.

Group plans may have pre-existing exclusions for a limited amount of time. When changing from one group to another, it is possible to make the switch without incurring a pre-existing waiting period provided the service needed was a part of the original group policy. For example, if an individual has group coverage without prescription drug benefits and then transfers to a policy with the benefits, any medication taken previously for an ongoing condition is subject to an exclusionary period.


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