Group Health Insurance
Most of this is a review from chapter 24. Group health insurance may be issued to eligible groups in Florida insuring more than one individual.
Eligible groups (employer based, fraternal, assoc., blanket)
Trustee group policy
A group of employees or employers or members of labor unions may be insured for the benefit of the individuals (and not the employers or unions) under a policy issued to the trustees of a fund as long as the following requirements are met:
Employer group policy
This is a standard group insurance plan issued to an employer for the benefit of individual employees (and their dependents). The employer is the policyholder and covered employees under the plan may also include the business owner(s).
A policy may only be issued if it will cover all eligible employees at the time of issuance. (No "carve outs" for sick employees.) A policy may insure the spouse or dependent children with or without the employee being insured and must include the definition of full-time employee as one who has a normal workweek of 25 or more hours. Temporary or substitute employees may be excluded.
Associations, labor unions, and small employer health alliances
A group of individuals may be insured under a policy issued to an association, including a labor union, if:
- the association has a constitution and bylaws;
- the association has at least 25 members;
- the association has been maintained for one year and is a natural group;
- the association is the policyholder; and
- at least 15 members of the association enroll in the plan.
Plans issued to associations must accept all individual members as eligible at the time of the policy issuance. A policy may insure the spouse or dependent children with or without the member being insured. A single master policy issued to an association may include more than one health plan from the same insurer.
Debtor group policy
A group of individual debtors of a creditor may be insured under a policy issued to a creditor to cover the respective debtors' loans due to disability. The creditor is the policyholder. Two types of insurance may be used:
Credit disability insurance is for all of the debtors of the creditor. However, a credit disability policy may be issued only if the creditor writes at least 100 new loans yearly, or may reasonably be expected to receive at least 100 new entrants during the first policy year. The insurer may require evidence of individual insurability only if less than 75% of the new entrants become insured.
Mortgage insurance is also for all of the debtors of the creditor. The term debtors includes borrowers of money in connection with an indebtedness of more than 10 year's duration, and is secured by a first real estate mortgage.
NOTE: In either case, the purpose of the insurance is to maintain the minimum loan repayment amount during the time that the borrower is disabled. If the borrower is disabled long enough this will pay the loan off; if not, then the borrower resumes loan payments when the disability ends.
Blanket health insurance
We've talked about this in detail back in chapter 24. Blanket health plans cover public places, where we don't know the names of everyone present. Examples include an airline insuring its passengers, or a football team insuring the spectators. This helps protect the owner of the public place against liability when something occurs. (The chart below provides more examples of when blanket insurance is used.)
