General Guidelines for Group Insurance Plans

General Guidelines for Group Insurance Plans

Many employers offer group insurance programs today in order to provide financial security to their employees.

  • Coverage is available to full-time, permanent employees subject to working a minimum number of hours per week, usually between15 to 24.
  • New employees are normally required to complete a waiting period, such as three months.
  • Coverage is generally mandatory for all employees.
  • The employee's spouse and dependent children under age 21, or 25 if full-time students, are also eligible for coverage.
  • When the spouse also has health and dental group insurance the benefits will be coordinated so that both carriers share in the claim.
  • Most carriers require some form of medical underwriting for small groups of fewer than 5 lives. Groups greater than 5 lives will have a certain level of coverage available on a non-medical basis.
  • Employees must apply for coverage within 31 days of becoming eligible, otherwise, they will be subject to medical underwriting or the benefits may be restricted in the first year.
  • All carriers have their own underwriting guidelines with respect to the type of business and industry for which they will accept risk. Eligibility will vary from being acceptable for all lines of coverage; all coverage except disability; to no coverage at all.
  • The life insurance products are generally a mandatory part of the benefit package.

Insurance is done as an OBA.

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