Group Health Insurance


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Group Health Insurance Overview

A group plan is determined by your employer. Benefits are determined by the owner or HR department.

Health Coverage can vary based on the type of plan the company chooses to offer its employees.

Various Plan Options

  • PPO:  Large network plans that feature choice of deductible, coinsurance and copays.  Benefits are provided if you go out of network, however, usually at a lower rate.
  • HMO: Smaller Network plans that feature robust in-network coverage, but no out of network coverage.  Member usually only pays a copay.  There are no deductibles on HMO plans.
  • H.S.A.: Health Savings Account/ High Deductible Health Plan:  Usually uses the same large network as the PPO, this plan consists of deductible and coninsurance only, no copays.  Benefits are provided if you go out of network, however, usually at a lower rate.  Member is eligible to open a tax advantaged Health Savings Bank Account


Plan Structures

  • Generally, companies pay a percentage of the employee’s premiums and the employee will be responsible for their dependents.
  • If you or your family member leaves the job, you will lose your employer- supported group coverage. It may be possible to keep the same policy for a short period of time, but you will have to pay for it yourself.
  • Some companies choose to implement an HRA, or Health Reimbursement Arrangement, where they help employees pay a portion of their deductible on a reimbursement basis.

Click here to get more information about Group Health Insurance Options.

About Optimized Benefits

Optimized Benefits is a Boutique Firm dedicated to providing smart solutions to the small and mid-sized business owners and their Employee Benefits plans
we have a focus on Retirement (401K) and Group Health plans

Contact Us

55 W Wacker Dr 14th Floor
Chicago IL 60601

312 263 1590 X 101

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