The regulation of group health plans in Virginia

Posted by admin on Jul 21st, 2010 in Uncategorized | 0 comments

Put simply, a group health plan is one purchased from an insurance company by a firm for its employees. Many firms include group health plans in their compensation packages as part of fringe benefits. Group health plans became popular during World War II as a means to get around wage controls. With the war effort in full-blown mode, the federal government imposed wage controls on employers. The effect of this was that employers could not offer attractive remuneration packages to recruit enough workers. As ‘fringe benefits’ such as sick leave and private health insurance were not included in wage controls, employers started to offer these instead in order to keep their companies moving. In Virginia, business health insurance administration, oversight and regulation is undertaken by the Virginia State Corporation Commission’s Bureau of Insurance. Several private health insurance providers operate in Virginia, including Anthem Blue Cross Blue Shield, a publicly-traded company, and CareFirst, both members of the national Blue Cross Blue Shield federation of private health insurers.

In Virginia, private health insurance providers are permitted to terminate your coverage or refuse coverage to you, provided that information regarding why the adverse underwriting decision was made is provided to you on request. Small employers are permitted to be charged higher premiums by private health insurers on the basis of the health of the group as a whole. In Virginia, private health insurers must offer small employers standardized plans with standardized features, allowing small employers to compare the cost of plans over a range of different insurers. The standardized plans available are named ‘Standard’ and ‘Essential’, both of which include a range of compulsory benefits. Insurers may also offer your business a non-standardized plan, and it is this option that most small employers choose to take up. Remember, when making a purchasing decision, it is always important to conduct your own research and find out which plan will serve your business the best and provide the most benefit for your situation. Every business is different, and as such it is important to keep your individual needs in mind when selecting a private health insurer.