Group Medical Health Insurance

Group Medical benefits are probably one of the most important services that employers and unions provide to their employees. The government at the Federal, State and local level regulate group medical health insurance through the following: Child Care Assistance; Compliance Assistance; Consumer Information on Health Plans; Continuation of Health Coverage (COBRA); Employee Retirement Income Security Act; Fiduciary Responsibilities; Health coverage Education; Mental Health Benefits; Newborn & Mothers Protection; Participants Rights; Plan Information; Portability of Health Coverage (HIPAA) and Women’s Health & Cancer Rights Protection.

States don't require employers to provide child care or adoption assistance except for the Family and Medical Leave Act. Must be in compliance with the Employment Retirement Income Security Act. Provide information about their right under federal health benefits law with respect to their job related plans. Give workers and their families the right to continue their plans upon leaving employment. Require plans to have grievance processes. Protect plan assets. Develop new educational tools and strategies. May not impose dollar limits on mental health coverages. New Born Act require that group health plans offer maternity coverage for at least 48 hour hospital stay. Elect to temporarily continue group health coverage after losing coverage. HIPAA include protection for coverage that limit exclusions for preexisting conditions. The Womens' Health and Cancer Rights Act provide protection regarding breast reconstruction in relationship with a mastectomy.

Group Medical normally include all full time employees that are eligible to enroll for medical such as the following one (1) full calendar month of employment. In the event of any conflict between this or any other policy statement regarding insurance and the coverages, the insurance contract shall prevail. Some of the following benefits and co-payments are depicted below:

Medical Emergency Visit-$_____co-payment

Inpatient Hospitalization-$_____co-payment

Outpatient Surgery-$_____co-payment

Diagnostic Lab Test and X-rays-$_____co-payment

Physical Therapy Visit-$_____co-payment

Maternity Care-$_____co-payment

Initial Allergy Consultation-$_____co-payment

Eye Refraction-$_____co-payment

Well Child Care-$_____co-payment

Routine Physical Exam-$_____co-payment

Home Health Care-$_____co-payment

Skilled Nursing Facility-$_____co-payment

Mental Health Care-$_____co-payment

Substance Abuse & Rehabilitation-$_____co-payment

Private Duty Nursing-$_____co-payment


Chiropractor Services-$_____co-payment

Durable Medical Equipment-$_____co-payment

Prescription Drugs-$_____co-payment

How rich an employees health plan is mostly related to how much co-pay the employee pays toward each coverages received and what medical help received. Many employers compete with each other and the unions through the type of medical plan they provide to their employees. Also Businesses in states that don't have any union shops will have very good health insurance to encourage employees to relocate to their businesses and purchase real estate listings.

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