Florida group health insurance provides medical coverage for individuals who are part of their employer’s insurance plan. These plans give you and your family the ability to receive treatments and preventative check-ups for typically at a lower cost than if you were covered under an individual health insurance plan or have no coverage whatsoever.

Small group health insurance in Florida is available to any company that employees between one and 50 employees on a full-time basis, and has made a profit in one of the last two years.

In order to qualify for a group health insurance plan in Florida, you may need to meet certain criteria as specified by your employer. For example, you may need to be a full-time employee working at least 25 hours per week. You may also need to have worked at your company for a certain amount of time, such as three months, before being eligible for benefits.

Group health insurance plans typically assess the risk of an entire group – everyone in your company – rather than that of an individual when determining insurability. This means that you are generally not required to take a physical examination or answer medical questions in order to qualify for coverage in a group plan.

Group health insurance in Florida is typically offered as managed care or indemnity plans, with managed care plans being the most commonly offered type of plan. Indemnity plans, also referred to as fee-for-service plans, specify a maximum amount of coverage for each type of service after you have paid your deductible and/or co-pay amount.

Managed care group health plans typically cost less than indemnity plans by offering affordable deductibles and/or co-pays without having to handle your own claims. These plans include:

– In this type of plan, the insurance company works with participating health care providers to render services at discounted rates. You are encouraged to use a physician within the network but have the freedom to choose an out-of-network provider for a higher deductible and/or co-pay. Additionally, most PPOs allow you to see specialists without having a referral from your primary physician.

– These plans provide coverage at a predetermined or fixed fee that often pays for services performed by participating health care providers for a small deductible or co-pay. In some instances, you may have no deductible or co-pay whatsoever. Also, some HMOs may allow you to choose your own physician but at a higher deductible and/or co-pay. Generally, your primary physician – also referred to as a gatekeeper physician – determines if you need to see a specialist.

– A POS plan is similar to an HMO; however, you have more freedom to choose a health care provider outside of a network and generally do not need a gatekeeper physician for a referral to see a specialist.

Each plan specifies which conditions and procedures are covered, along with the amount of any co-pays or deductibles. Florida group health insurance plans usually cover:

Routine check-ups and physicals
Broken bones
Diseases
Surgery

Under certain conditions, Florida group health insurance plans will cover pre-existing conditions that were previously treated if you were part of another group health insurance plan or if you have been covered by your current plan for a specified period of time. Additionally, group health insurance plans guarantee portability of coverage. This means that should you change employers and meet certain criteria, you can continue receiving full coverage even though you may have a pre-existing condition.

Florida group health insurance plans may or may not be paid entirely by your employer. In some cases, you may be responsible for paying a portion of a monthly premium; however, your payment is typically made with pre-tax money from your earnings. If you have dependents listed on your policy, your premiums generally will be more expensive than single coverage.

Having medical coverage is essential. As you choose a Florida group health insurance plan for yourself or for your employees, read the policies carefully and review everything from the premium costs to the list of available providers. Take into consideration co-pays and deductibles and how often you and your dependents may need to visit health care facilities.

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