Group Health Insurance
Group Health Insurance is insurance that a company buys for its employees or that a group of individuals who all belong to the same group, such as societies or professionals in the same group, purchase.
Group insurance coverage has two main advantages for members of the group, as opposed to people who buy individual health insurance coverage:
- Because employees of a company receive group coverage, which is most often negotiated between the employer and an insurance company, the employer usually pays half or sometimes more of the monthly premium. Since today's health care costs are so high and continue to rise, being covered by a group health insurance plan is one of the primary benefits workers receive from a company. Coverage usually costs less for a member of a group insurance plan contrasted to the purchaser of an individual plan.
- For group insurance coverage the cost of the premium is often the same or lower for all employees in the plan when compared to what buyers of individual coverage have to pay. This would reduce the cost of insurance for people who are older, are at greater risk, or have a pre-existing condition.
What Nevada Health Insurance Must Cover
In Nevada, the law requires all health insurance plans to pay for:
- Patient expenses for participating in clinical trials for cancer or for chronic fatigue syndrome
- Cancer screenings for the following cancers: breast, cervical, prostate and colorectal
- Care for a woman if she is pregnant
- Mental health disorders must be covered at the same level as physical health conditions are covered
Some federal health insurance laws protect Nevada residents. These are:
- HIPAA (Health Insurance Portability and Accountability Act of 1996). This federal law has a number of important provisions for Nevada residents. It limits the liability of a new employer plan to exclude coverage for preexisting conditions and forbids an insurer from discriminating against employees and their dependent family members based upon any health complications they might have, including preexisting conditions, previous claims experience, and genetic.
- COBRA (was created under the Consolidated Omnibus Reconciliation Act). This basically allows someone to retain, for a certain period of time, their health insurance coverage when they are between jobs.
Nevada's State Based Exchange Approved Jan. 3, 2013
A couple of weeks ago Nevada became the 17th state plus the District of Columbia to receive conditional federal approval to manage a State Based Exchange. Two states have received approval to run Partnership Exchanges. This will allow Nevada citizens to compare health care plans.
"Nevada's Exchange will provide residents of our state with a marketplace to shop for, compare and purchase Qualified Health Insurance Plans in accordance with the Affordable Care Act," said Governor Brian Sandoval as quoted in a press release from the Silver State Health Insurance Exchange.
The exchange should make it easier for residents of Nevada to decide which insurance plan is best for them.
What You Should Do if Your Claim is Denied
Mr. Sharp has years of experience helping people with group insurance claims. He represents individuals with problems, including valid claims denials, delays of payment and payouts that are less than what was outlined in the policy. If you have submitted a claim to your group insurance company to be paid for a condition, medical procedure, prescription, or any other type of medical issue that you believe your insurance company should be held responsible for and have not received a fair response, you should consult Reno insurance attorney Matthew L. Sharp.
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