Answers
What is Group Insurance?
- When you are eligible for group insurance in Florida, insurance companies cannot deny health insurance due to health problems. There may be a waiting period for health coverage when you start your new job. For pre-existing conditions, the insurance company can only look back six months into your medical history. If you have a pre-existing condition, coverage can be excluded for no more than 12 months. If you have had prior group coverage continuously, with no breaks of more than 63 days, you can apply for continuous coverage credit. Top
What is Individual Insurance?
- In applications for individual health insurance, the companies can turn you down for medical problems. For pre-existing conditions, you can encounter an exclusion period of no more than two years; the insurance company may also write a special rider to exclude the condition altogether. There are no limitations in Florida on the price of an individual health policy. However, due to illness, your insurance cannot be cancelled. Top
How do I get in touch with the Florida Department of Insurance?
- 200 East Gaines Street, Suite 531
Tallahassee, FL 32399
(800) 342-2762/ (850) 413-3100 Top
Why should I offer Group Insurance to my employees?
- In order to stay competitive in today’s working environment employers need to offer a health package to their employees. Small employers who offer health benefits will achieve greater employee recruitment and retention. It is hard to compete with the big boys without a health benefit. So offering some type of coverage is necessary if you want to attract quality employees. Another major benefit is 100% of the health insurance premiums you pay to cover your employees are a business deduction. The deduction can be a significant advantage over individual or family coverage. Also, group coverage for Florida small employers is guaranteed issued coverage. So people who cannot get insured under a family plan may have no other choice but to enroll in a group plan. Therefore, it could be viable for an employer to offer group plans just to keep their good employees with them. Top
What are some of the rules in Florida for my company to be eligible for small group coverage?
- Most carriers require at least 70% of eligible employees to enroll. You can exclude part time employees, who work less than 25 hours, and newly hired employees. Employees that are on another group plan through a spouse are exempt and do not effect your requirement percentage. Employers must pay 50% of the employee’s premium. Carriers rate up or down 15% of the premium based on the health status of the group. Top
What is the HIPAA preexisting rule?
- If the employee does not have prior coverage with in 63 days from the start of the new group policy, there is a 12 month waiting period for preexisting conditions. A preexisting condition is defined as a medical complaint that you have been seen for with in the last 6 months. It is up to the insurance companies’ discretion to utilize their HIPAA right. However, it is normal practice for them to cover minor expenses and decline the major expenses. Maternity does not apply to this rule. Top
What is the difference between a HRA and a HSA?
- Health Reimbursement Arrangement (HRA)
is an instrument offered in conjunction with a high-deductible health plan, and is funded by the employer for each participating employee. It pays for eligible health care expenses typically covered under the medical plan. Unused funds can be carried over to the next year to cover future health care expenses, an incentive to employees to use their personal HRA wisely. If funds are exhausted, the employee is responsible for satisfying the remaining deductible before the plan begins to pay. If the employee changes jobs, the money stays with the employer. Top
- A Health Savings Account (HSA)
is also offered in conjunction with a high deductible health plan, however both employer and employee contribute to a portable savings account that can be used for clearly defined out of pocket expenses. HSAs are designed to help you manage medical expenses and reduce the continuing raising of health care expenses. Equally as important, the money you save remains part of your retirement account, even if you leave your present employer. In short, if you don’t use all the money in your HSA for medical expenses, it can accumulate as tax-free savings for your retirement. Top
