You’re a mid-size company with rising health insurance costs…..now what?

Did you know that we spend more on Healthcare in the United States than any other sector in the economy? We spend more on Healthcare than Food and National Defense Combined.

Navali & Company Insurance Services (agency for Health Insurance Outlet) works with many companies in the middle market space. Companies between 51-299 employees have more complex cycles, verticals, and evolving business models that constantly need refreshing. We recognize this because we value those elements most important to your company: efficiency, risk, and time. We will work with your top management to make sure we properly evaluate your health insurance program and implement the right solutions to help manage risk moving forward.  To ensure you get the best coverage, we work with major carriers such as Aetna, Allstate, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Kaiser Permanente, Nationwide, PacifiCare and many more.

Similar to small group employers, risk management is still very critical to your company in the long run. We will help implement our Human Resource Interface with your current systems to make sure you have the tools to properly protect your company. Additionally, to help manage rising cost of health insurance premiums in the long run, companies in this space need to proactively promote healthy behaviors and also provide education to their employees. We will work with your management to implement a health promotion program that makes sense for your company.

Click here to learn more about our health promotion programs and how that can have a dramatic effect on your health insurance premiums. 

What are the coverage requirements for large group employers?

Large group health insurance contracts, unlike small group health insurance contracts, do not have to be offered on a guaranteed-issue basis. Meaning, health insurance companies can reject an entire large employer group based on its claims history. However, no individual employee who is eligible for benefits can be excluded from large group coverage based on medical history.

Federal law mandates all group insurance contracts, including large group contracts, be renewed every year at the employer's discretion, unless there is non-payment, fraud or intentional misrepresentation, etc. The law also requires health insurance companies to give employees credit against any exclusionary period for pre-existing conditions if they have had prior health insurance coverage within 63 days of obtaining the group coverage from the large employer.

How are premium rates determined for large group employers?

Large group health insurance is medically underwritten at the time of purchase, with rates based on employee participation and prior claims experience. In a large group employment situation, employees are not generally asked to fill out a medical questionnaire prior to obtaining coverage. The health insurance company bases annual premium changes for large employer groups primarily on the claims experience of the group in past years, as well as any overall increases in the cost of providing health insurance coverage.

To learn more about group health insurance options, and where your company fits, visit us here.

To get group health insurance quotes, submit your information here.