Overview: Health care insurance provides protection against the risk of medical expenses and generally provides coverage for doctor visits, hospital stays, medicines and other medical expenses defined in the contract. Issuers of group health insurance can assess the risk associated with an employer's group and develop a financial arrangement typically in the form of a monthly insurance premium.
A health insurance policy or contract is a written document that defines the type and amount of health care services covered, and, if both parties agree, are renewable on a periodic basis, usually annually. In employer group health plans, employees usually share the cost of their health plan with their employer by paying their share of premium contributions and by paying deductibles, co-payments and co-insurance.
Author: Tracy Morley, SPHR, Legal Editor
Updated to reflect the minimum value percentage and pay or play penalties for 2020; the extended deadline for providing 2019 employee statements; and the rules regarding HRA options, effective January 1, 2020.
Updated to reflect the extended deadline for providing 2019 employee statements.
Updated to reflect final documents and deadline extension for ACA information reporting.
Enhanced with additional details and resources.
Updated to reflect IRS guidance issued on the expanded determination letter program.
HR guidance on the importance of understanding health care insurance.