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Pros and Cons of Group Insurance vs. Individual Insurance

Health insurance provided to an employee, and often times their family members, is called Group Health Insurance Coverage.  Having group coverage through an employer can be an integral part of any employee benefit package.  Employees that have group health coverage may be used to several different benefits.  Here are a few: 

Your employer may:

  • Pay for some or all of your monthly plan premium
  • Your share of the premium may be deducted from your paycheck each pay period
  • Provide plan documents and help to answer questions about the plan
  • Often times you may even get to chose between several different plans
  • An eligible employee cannot be denied coverage based on preexisting condition
  • The plans are often uniform in nature and offer the same benefit to all employees.
  • Premium amount and coverage will remain the same for all employees regardless of age or other factors

While group health care plans may be tempting to some, there are some individuals that may find private health insurance plans that are more suited to their needs.  

Cons to Consider for Group Coverage

  • Often times private insurance can provide lower rates to those employees that have a lesser need of coverage than that of the majority.  
  • Another con of an employer based group health plan is that the employer gets to make all the decisions regarding which options will cover their employees.  For some individuals this could mean they no longer can see certain trusted physicians, or retain services from facilities that are not covered under the group health plan. 
  • It can even mean steep out of pocket cost if there are services that are not covered under a group plan such as vision and dental.  

Unlike traditional employer sponsored insurance, when dealing with looking for an individual insurance policy:

  • You will be able to shop around and chose the plan that would be well suited for you and/or your family
  • You will be the purchaser on the plan, and you will make all of your monthly plan premium payments
  • You will be the one managing and controlling all of your health care coverage and benefits. 

There are many different things to consider when choosing between employee based health care coverage and individual health care plans.  It is always favorable to make sure that you are well informed of all your options before you make your final decisions regarding you or your family’s health care needs.  You want to make sure that you are making the best decision possible when it comes to your, or your family’s, health care needs as well as making sure it is a good fit for your finances.

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