Chapter 16 - Group Life & Health (2)

Chapter 16 - Group Life & Health (2) - Employee...

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Employee Benefits: insurance RIL 211 Chapter 16
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Agenda Group Insurance Group Life Insurance Plans Group Medical Expense Insurance Traditional Indemnity Plans Managed Care Plans Consumer-driven Health Plans Group Medical Expense Contractual Provisions Group Dental Insurance Group Disability Income Insurance Cafeteria Plans
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Group Insurance Group insurance differs from individual  insurance in several ways: Many people are covered under  one contract Coverage costs less than comparable insurance  purchased individually Individual evidence of insurability is usually not  required Experience rating is used
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Group Insurance Group insurers observe certain underwriting  principles: The group should not be formed for the sole  purpose of obtaining insurance  There should be a flow of persons through the  group Benefits should be automatically determined by a  formula A minimum percentage of employees must  participate Individual members should not pay the entire cost The plan should be easy to administer
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Group Insurance Eligibility for group status depends on  company policy and state law Usually a minimum size is required Employees must meet certain participation  requirements:  Be a full time employee Satisfy a probationary period Apply for coverage during the eligibility period During the eligibility period , the employee can sign up  for coverage without furnishing evidence of insurability  Be actively at work when the coverage begins
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Group Life Insurance Plans The most important form of group  insurance is group term life insurance Provides low-cost protection to employees  Coverage is yearly renewable term Amount of coverage is typically 1-5 times the  employee’s annual salary Coverage usually ends when the employee  leaves the company Can convert to an individual cash value policy  
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Group Life Insurance Plans Many group life insurance plans also  provide group accidental death and  Pays additional benefits if the employee dies in  an accident or incurs certain types of bodily  injuries Some plans offer voluntary accidental death and  dismemberment insurance   Employees pay the full cost Some employers make available group  universal life insurance  for their employees
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Group Medical Expense  Insurance Group medical expense insurance  pays the cost  of hospital care, physicians’ and surgeons’ fees,  and related medical expenses Insurance is available through: Commercial insurers Blue Cross and Blue Shield Plans Managed Care organizations
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This note was uploaded on 03/27/2012 for the course ACC 101 taught by Professor Smith during the Spring '12 term at Missouri State University-Springfield.

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Chapter 16 - Group Life & Health (2) - Employee...

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