The Basics Of Group Health Insurance Indiana

Many states have strict regulations regarding individual and group health insurance coverage, and Indiana is no exception. According to the Indiana Department of Insurance, there are two different kinds of group health insurance Indiana plans -- fully insured and self-insured. Anyone who wants to learn more about group insurance in this state should know about these two categories. Fully insured health plans come in two different categories as well. There are plans for small employers with anywhere from 2 to 50 employees and plans for large employers with more than 50 employees.

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A fully insured plan means the employer has purchased coverage for the entire group from an insurance company, who then takes the risk to pay the claims from all employees. Often the bigger the plan the more substantial healthcare savings will be. The other type of plan is self-insured group. This means the employer is the one who bears the risk and is responsible to pay for all the claims. Self-insured and fully insured plans are often confused with one another because employers may hire a third party such as an administrator or insurance company when paying the claims. Your plan administrator can tell you which type of plan they use.

One issue that is regulated by Indiana is that of pre-existing health conditions. The issue of pre-existing health conditions can be a thorn in the side of many people with health insurance. According to the state, a fully insured plan for a small employer may exclude medical coverage for such conditions for a period of nine months. A fully insured large employer can exclude coverage for a period up to twelve months. Any self insured plan can exclude coverage also up to twelve months. Pregnancy is no longer considered a pre-existing condition according to the state of Indiana.

You may wonder what is covered under your group health insurance Indiana plan. This all depends upon the details of your individual plan. Most plans cover things like inpatient hospital stays, outpatient doctor visits, annual checkups, prescriptions and emergency room visits. Your plan may or may not cover vision and dental. You should check with your plan administrator or insurance company for all the details. In addition, you may also want to refer to the website of the Indiana Department of Insurance for more general information.

 


 

 

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