Group Health Insurance Regulations

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    • Learn about group health insurance regulationshealthcare concept image by Stasys Eidiejus from Fotolia.com

      Group health insurance regulations provide certain benefits to you and your family. Health insurance in America is generally divided into two kinds: group health and private health insurance. The laws for both insurance plans are similar, but not always the same. Group health insurance offers unique benefits that private insurance does not, and group insurance is also offered through employers, so you cannot simply purchase a policy directly from an insurance company.

    Guaranteed Renewability

    • States generally mandate guaranteed renewability. This means that you cannot be turned down for coverage when you renew because of your health status. As long as there was no fraud committed on your part and all premiums are paid, your coverage is guaranteed to continue.

    Child Coverage

    • Most group health insurance plans that cover children will automatically cover newborn children without any action on your part. They will also cover adopted children. This typically lasts for 30 to 31 days and then you'll need to add the child to your policy. In many states, you can also include any disabled children beyond the maximum allowed age for coverage specified in the policy if the child is not self-sufficient due to their disability.

    Pre-Existing Conditions

    • Depending on what state you live in, your insurance company may be allowed to impose a pre-existing condition exclusion. This exclusion means that the pre-existing condition cannot be covered under your policy. Instead, you must wait until an amount of time, specified by the insurance company, has passed before you can be covered for your condition. Your state generally sets maximum exclusion limits on how long an insurance company can exclude your condition. Your insurer may also allow you to use any previous continuous coverage as a credit towards your new policy to eliminate any pre-existing condition exclusion.

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