Group Health Insurance
How group coverage works
The employer or association holds the master policy; participants receive certificates. The group is underwritten as a whole (no individual evidence if actively at work), which is the core advantage of group insurance. Eligibility rules include a probationary period before coverage begins, an enrollment period (late entrants may need evidence or wait), and actively-at-work requirements. Contributory plans (employees share cost) require a minimum participation percentage; noncontributory plans enroll everyone.
Group life features
Typically** annually renewable term** with a schedule of benefits (flat amount or multiple of salary). Conversion allows a departing employee to buy an individual policy without evidence, usually within 31 days; portability keeps the group contract at the employee's expense. Creditor group life and franchise (individual policies sold to a group) are distinct products.
Continuation and portability law
COBRA: employers with 20+ employees must offer continuation after qualifying events; 18 months is standard, longer for disability or a second event. HIPAA guarantees special enrollment on marriage, birth, or loss of other coverage and restricts preexisting-condition use. ERISA preempts state law for self-funded plans; ASO arrangements and TPAs are common.
Trap
Group life conversion requires action within a short window and is priced at the individual's attained age. Do not confuse conversion (individual policy) with portability (continued group coverage).