Tier Levels Of Group Health Insurance

Tier Levels Of Group Health Insurance

Group Health Insurance Greenwood Village, CODifferent group health plans will offer different amounts of coverage.

Group health insurance is a policy that an employer purchases and offers to eligible employees as a benefit of working for the company. Group health insurance is a vital part of many employee benefits packages. One of the biggest advantages for employees on a group health plan is the contribution that most employers make to help cover a portion of the cost of the premiums.

With the passing of the Affordable Care Act (ACA), the federal government works with state government to regulate health insurance plans. Under the ACA, small group health plans that are offered by employers are required to meet certain benchmarks. The benchmarks are represented by levels of platinum, gold, silver, and bronze. Each level tier plan is designed to provide around the same average level of benefits.

The level tiers are based on the percentage that the plan will cover in the overall cost.

  • Platinum – are more expensive but are the most generous. They are designed to cover up to 90 percent of medical expenses.
  • Gold – will pay up to 80 percent of medical expenses.
  • Silver – are expected to pay up to 70 percent of medical expenses.
  • Bronze – which will pay up to 60 percent of medical expenses.

Keep in mind that the tiers show what each plan will pay on average. The percentages are not the same as coinsurance, which requires the individuals to pay a specific percentage of the cost for each specific service.

ACA and federal HIPPA laws require that no individual can be turned down by an insurance company for group coverage due to a pre-existing condition.

For help navigating the world of group health insurance, contact Employee Benefit Plans Inc. in Greenwood Village,  Colorado. We will help you find the right amount of coverage for your specific needs, all at the right price.