What is group health insurance?

Group health insurance is a group insurance with various social groups as the insured and its employees as the insured (including retired employees in the group). When the insured is hospitalized due to illness or childbirth, the insurer is responsible for the treatment expenses, hospitalization expenses and nursing expenses during hospitalization, and when the insured is disabled due to illness or childbirth, the insurer is responsible for paying disability insurance benefits.

In group health insurance, the group refers to the relative person of insurance relationship, that is, the insured. In addition to the general attributes of groups, groups in group insurance also need to meet certain conditions. The group participating in group insurance cannot be a group established for group insurance, but must be an existing formal legal person group with specific business activities and independent accounting.

Group insurance generally requires that the absolute number of people insured by the group is not less than 50. In recent years, the demand for the number of insured persons has gradually decreased, and groups with 10 or even lower than 10 can also underwrite; The participation rate of the insured group is required to be 75% of the total number of eligible employees. If all the premiums are borne by the employer, all employees must participate in 100%.

In order to control the claim cost and management expenses reasonably and avoid adverse selection, the membership of insurance groups is usually restricted. First, group insurance is only for full-time or full-time employees in the group, and part-time employees cannot become the insured of group insurance. Second, group members who participate in group insurance should be normal on-the-job employees, and retirees, sick employees and temporary workers generally cannot be the insured of group insurance. Third, the members of the group should have certain mobility, so that the average age of the group will always remain at a relatively stable level. Fourth, for new employees, it is required to participate in group insurance after the probation period.