Large Group Health Insurance Plans | What is the Large Group Health Plan?

health plans for your business

Health plans for your business, whether you run a local shop or a larger corporation, can make a real difference in the well-being of your employees and the contentment within your workforce.

How to Qualify for Large Group Coverage?

In the context of health insurance in the U.S., the distinction between small and large groups can have important implications for coverage options, regulations, and pricing. Typically, the Affordable Care Act (ACA) defines a "small employer" as one with 1 to 50 employees, and a "large employer" as one with 51 or more employees. However, some states might define a small employer as one with up to 100 employees. This is where things might get a little complex, especially if you're conducting business in español and dealing with translation nuances.

Here's how a business might qualify for large group coverage, which is a specialty of certain insurance companies:

  1.  Employee Count: To qualify for large group coverage, a business typically needs to have more than 50 (or in some cases, more than 100) full-time equivalent (FTE) employees. The method for calculating the number of FTE employees can vary, but it generally involves adding up the number of full-time employees and the equivalent number of part-time employees. For example, two half-time employees might count as one FTE.
  2.  Offer Coverage to Full-Time Employees: For certain large employers, particularly those with 50 or more full-time equivalent employees, there might be a mandate to offer health insurance to at least 95% of full-time workers under the ACA's employer mandate. If they don't, they might face penalties.
  3.  Minimum Essential Coverage: Large employers are generally required to offer "minimum essential coverage" that meets the minimum value standard and is affordable, as defined by the ACA.
  4.  Consistent Renewal: To maintain large group coverage, the employer typically needs to renew the policy annually and ensure it remains compliant with any relevant regulations.
  5.  Geographic Considerations: Regulations and definitions can vary by state. For instance, some states might classify businesses with up to 100 employees as small groups, thus changing the threshold for large group coverage. It's crucial to understand local regulations and definitions.
  6.  Documentation and Reporting: Large employers often have additional reporting requirements under the ACA. This includes providing information about the coverage offered to employees and ensuring that the necessary forms (like Form 1095-C) are filled out and provided to both the IRS and employees.
  7.  Waiting Periods: Under the ACA, employers cannot impose a waiting period of more than 90 days before new employees are eligible for health insurance coverage.
  8.  Nondiscrimination Rules: Large group plans are typically subject to nondiscrimination rules, meaning that they can't offer better benefits to higher-paid employees than to lower-paid ones.
  9.  Communication with Employees: Ensure that all eligible employees are properly informed about their health insurance options, the benefits offered, and any changes that might occur.
  10.  Broker or Consultant Assistance: Due to the complexity of large group coverage, many businesses opt to work with insurance brokers or consultants who can help navigate the process, ensure compliance, and find the best rates.

Remember, the distinction - the difference - between small and large group health plans might vary based on state laws and specific insurance carriers. It's always recommended to consult with legal counsel, a health insurance broker, or a benefits consultant to ensure that a business meets all requirements for large group coverage.

Comparison of Small and Large Health Plans

Small-group health plans are offered by insurance companies to businesses with 2 to 50 employees. They are typically more expensive than large-group health plans, but they offer more flexibility and customization options. Small group plans can be specifically tailored to the specific needs of your business and its employees, similar to how a local shop individualizes its content to cater to its specific clientele. They also may come with a potential tax credit and offer additional benefits, such as dental and vision coverage.

Large-group health plans are offered by insurance companies to businesses with 51 or more employees. They are typically less expensive than small-group health plans but offer less flexibility and customization options compared to the small-group health plans. Large-group plans are standardized and must meet certain requirements set by the government. These plans might not offer the same level of additional benefits as small-group plans due to their standardized content.

Here is a table summarizing the key differences between small and large health plans:

Feature Small-group health plans Large-group health plans
Number of employees 2-50 51 or more
Cost More expensive Less expensive
Flexibility More flexible Less flexible
Customization options More customization options Less customization options
Additional benefits May offer additional benefits, such as dental and vision coverage May not offer additional benefits
Government regulations Less regulated More regulated

The best type of health plan for your business will largely depend on several factors, including the number of employees you have, your budget, and the specific needs and health concerns of your employees. If you're running a small business with tightly held purse strings, a small-group health plan may just be an ideal option for you. On the contrary, if your ledger swells with the names of numerous employees, a large-group health plan may make more sense.

Here are some additional things to consider when choosing between small and large health plans:

  • The age and health of your employees.
  • The type of coverage you need.
  • The cost of the premiums.
  • The level of deductibles and copays.
  • The availability of doctor's offices and hospitals in your area.
  • The customer service offered by the insurance company.

It is important to compare quotes from multiple insurance companies before making a decision. This is where a health insurance broker can make a significant difference by helping you navigate the complex landscape.

Today’s insurance market consists of many companies competing for a fixed number of customers, ranging from small shop owners to large corporations.

The Affordable Care Act (ACA) changed the way many individuals and employers approach healthcare. Most of these changes are positive, including an improvement in many individuals' ability to obtain healthcare. It also prompted changes to the operations of existing health plans, and introduced the potential for some businesses to benefit from a health insurance tax credit.

The demand for excellent health insurance is rising for many reasons, a key difference being that more employees now recognize the value of comprehensive health coverage.

  • Federal and state laws require employers to provide coverage.
  • Members of the post-boomer generations are starting to seek health insurance for their families as they "age out" of parental coverage.
  • Healthcare costs are on the rise across the country.
  • Established health plan providers are always on the lookout for new customers to remain in business.

But individual insurance coverage often falls short of affordability due to high premiums.

Some insurance providers started offering cheap coverage through the state and federal exchanges as required by the ACA. However, it later emerged that this coverage was not sustainable at competitive rates, and these companies ended up withdrawing from the exchanges or raising their premiums, leaving some subscribers without reliable and affordable coverage. Established insurance providers are not always reliable over the long-term. As an employer, you are looking to set up a health insurance plan that your employees can rely on, and you are conscious of income considerations, too. The advantage of this approach is that knowing the group size helps you tailor the benefits as per your team's needs, which makes a valuable contribution to your workforce's satisfaction and morale.

The best option today is to get help from an independent agency like Taylor Benefits Insurance. We can help you build a group health plan that suits your employee health coverage needs, including things like choosing the right payment plans and products.

Our goal is to reduce your out of pocket costs by working with you to build the right group health plan. We know that insurance isn’t one-size-fits-all, and group size plays a crucial role in this. That’s why we take the time to get it right for small group market and group market, considering every contribution that can be made to reach the best plan possible.

Offering Employer Sponsored Health Insurance Plans In All 50 States

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Why You Should Work With Taylor Benefits Insurance

Large Group Insurance Options For The Best Health Plans

A health insurance plan is an insurance plan that covers a group of over 50 employees. The income derived from such a sizeable group allows for a mutual payment system that benefits all involved.

  • Access to essential healthcare and health maintenance services.
  • Affordable monthly premiums that will keep your insurance costs down.
  • Fully insured for employees and medical insurance coverage for major risk procedures.
  • Coverage for dental, vision, and prescription drugs for employees.

There is no maximum number of employees that can be covered. Whether you run a local business or a Fortune 500 firm, you can find group health insurance that will meet your employees' needs. The advantage of such wide coverage pertinent to group size is the variety of products available to cater to diverse requirements.

What Is a Large Group Health Insurance Plan?

This coverage tends to be comprehensive and flexible enough to accommodate the needs of subscribers with divergent requirements. Often, a group plan offers people with special health needs complete confidence in their coverage. This advantage results from the contribution of every member of that particular group, spreading out the payment and thus, reducing the burden on individuals.

Coverage can be flexible and comprehensive. The payment structure can be adjusted to match the income levels across the group, thus offering products that cater to everyone's needs.

Group health insurance is easy to work with and provide coverage for all employees. Every employee covered by the policy receives the same benefits package, so employee enrollment can be quick and efficient. The advantage lies in the uniformity of the products offered and the convenience of a single payment plan.

This health plan is often the best option if you are running a business with at least 50 employees. A group coverage plan is a good deal and provides insurance at lower costs down by providing you with a discount based on the larger number of potential subscribers. The contribution of every individual, in terms of payment, enables you to leverage this advantage, making it ideal for everyone, irrespective of their income.

Do you have questions about what Taylor Benefits Insurance can do for you, regarding group insurance plans, health products, or the potential advantage of a cooperative payment scheme?

There are several types of coverage you can choose from for your group insurance plan. Each of them have unique pros and cons based on the coverage, payment options, and resources you require for you and your employees.

Group health plan provides a streamlined way to link all of your employees with the same benefits and offer coverage at minimal value. It’s perfect for employers with many employees, each of which needs to be insured with proper resources. The uniformity of the products and the collective contribution work to everyone's advantage here.

The average group health premium for each employee is between $1,500 to $4,000 per employee. But you can split these costs with your employee based on the percentage of the monthly premium that they pay. This way, the income generated by the group insurance plan will help keep the payment system manageable for everyone involved.

Costs associated with your employees’ insured group health insurance premiums are amicably divided between you and each employee. These costs often depend on numerous aspects, including the employee's dependents and financial power. Both you and your employee will save money when you implement a group health plan, thereby protecting their rights to affordable care.

We can help you find the right group insurance plan

Get in touch with us today

What Types of Large Group Plans Exist?

Learn About Large Group Benefits

Employers will bear the responsibility of paying between 70 and 90 percent of the group health insurance premium for the insured large group coverage, depending on the financial capability of the employee. Subsidized coverage is also available in various locations for employees who can’t pay for their healthcare by themselves, strengthening the association between employers, employees, and their health.

The Most Popular Large Group Health Plans

  • Fully-Insured Plans: This is the traditional group health plan option that is risk-free for both large employers and small employers. Fully-insured plans offer full coverage for a minimum value annual premium. Premiums cost in this place are partially shared with your employees. Premiums are calculated by looking at factors like the size of the large employer group, average age of employees, claim’s history, type of business work, and what employee coverage and add-ons are needed.
  • Self-Funded Plans: Self-funded plans place the burden of risk on the employer. Large employers charge premiums from their employees, pool the money, and use it to cover medical costs as they occur. They do not purchase coverage for group health plans.
  • Level-Funded Plans: This plan includes paying set rates based on census data for your group. Payments are made monthly, and rates are adjusted at the end of the year based on group performance.
  • Health Maintenance Organization (HMO): An HMO requires large group health plans group members to pay monthly premiums for medical services. However, employees will only have access to a specific in network care of healthcare providers and facilities. Receiving care out of network can result in significant extra costs for the individual employee.
  • Preferred Provider Organization (PPO): A PPO plan functions much like an HMO, but members are able to use healthcare services outside of their in network care hospitals. Out of network visits will require a higher co-pay from employees.
  • High-Deductible Health Plan with a Savings Option (HDHD/SO): The HDHD/SO is a flexible and accessible group health plan option that provides health plan for a lower monthly cost. Employees will pay for medical expenses out of pocket and get a portion of them reimbursed by the company. Members can also pay into a savings account (tax free) and use this pool of money to pay for health costs.

How Does Group Health Insurance Work?

Employees that want to engage in your group health insurance plan but can’t afford it themselves can still apply for enrollment with the largest English-speaking companies such as Anthem. The government provides subsidies and financial assistance to individuals who are below a certain level of poverty, ensuring that no one is left behind.

These subsidies apply to large group plans just as much as to an individual market plan. The ACA, also known as the Affordable Care Act, demands that everyone have some level of health insurance. Government grants and subsidies have been created to empower these rights.

How Much Does Group Health Insurance Cost?

In terms of health plans,

If your company has a large crowd, the health plan will provide inclusive coverage to all of the employees at a competitive price. Employees will also get the needed resources to file claims.

How Do the Insurance Costs Get Split?

Typical health care coverage varies significantly when it comes to large group health insurance and small group health plans. Most group health plans will cover the basics, like life insurance and disability coverage, and may provide numerous coverage options based on your group’s unique needs. Coverage may extend to an employee's family, leaving no dependents uninsured.

It isn’t easy to find affordable group health insurance plans that also cover all the health benefits and coverage that your employees need. Independent insurance agencies, with their association with several insurers, serve as a vital ingredient in providing you with the necessary employee insurance policy. They can suggest large group health plans that you may not find elsewhere.

Financial Assistance

Since Obamacare, or the Affordable Care Act (ACA), was enacted, you are entitled to essential health benefits in your group health insurance plans. The Affordable Care Act covers most basic medical necessities. However, it’s crucial to understand what services you need your insurance policy to cover in English.

The benefits that the Affordable Care Act provides include:

What Does Group Insurance Cover?

health plans

Being outside of the network can drastically increase insurance costs for employees. The individuals who rely on your group health insurance might face unexpected, out-of-pocket expenses. This can immensely add to the financial burden, sometimes costing your employees tens of thousands of dollars.

Taylor Benefits Insurance offers centralized access to all of the most significant insurance networks, giving your employees the power to access affordable care in various locations on the large group market.

Here are just a few of the health benefits that a group insurance plan provides:

  • Pre-existing conditions
  • Deductibles
  • Coinsurance
  • Employer-sponsored (funded) Medicare/Medicaid enrollment
  • Dental plans and dental coverage for employees
  • Health Savings Accounts (HSAs)
  • Vision insurance and vision care for employees
  • Drug coverage for employees
  • Co-pay
  • Comprehensive health plan
  • Major medical expenses for employees
  • Out of pocket expenses
  • Wellness programs for employees
  • Other services including registered massage therapists (RMTs), physiotherapists, and more
  • Medical devices

Typical Health Care Coverage

Your group health plan members can’t always control where or when an injury occurs. The right to essential medical care during an emergency is vital. But sometimes that means your employees get treated out of your network.

We assure that your employees are covered by a large group coverage no matter where they happen to be.

Essential Health Benefits (Affordable Care Act)

Need assistance finding the perfect group insurance plan?

Different insurers specialize in various types of group health plans. It's essential to understand how these various plans could better serve your employees' rights to quality, affordable healthcare.Some companies may offer excellent dental insurance, while others specialize in handling major employee life events, including the provision of coverage for children. Determining which large group company is the right fit for you and your employees can often feel like navigating a bustling marketplace such as healthcare.gov.

  • Inpatient and outpatient hospital care costs for the insurer
  • Pregnancy and childbirth
  • Mental health service
  • Hospitalization
  • Emergency services
  • Low deductible
  • Prescription drugs

Don’t Get Caught Out of Network

The answer to this question depends on what you need in a group health plan. Most insurers are primarily interested in closing a deal, so you might not be able to rely on their benefits and premiums information. You want a person-focused approach that understands your needs. That’s why it’s best to have an insurance broker like us choose your health insurance company for you, ensuring you get the right amount of coverage.

Taylor Benefits Insurance connects you with several of the large group health insurance providers in the country. Whether you are an individual person or a company owner, you can always rely on us to negotiate you a favorable deal on your large group coverage plans.

As your insurance broker, we take care of all the details for you, leaving you with more time to focus on running your business or managing your personal needs. With our full range of insurance providers – from those catering to children to services for adults, as featured on healthcare.gov – you can be sure you’re getting the best deal on the large group and small group markets.

The market for group health insurance is a complex matter for large employers. With so many large group health providers competing for the same clientele, it can be difficult to find a large group market company that serves your own needs well enough. Moreover, the amount of coverage each company provides may vary, affecting the overall value they offer.

Here’s a breakdown of some of the most popular health insurance providers out there, including their enrollment advantages and drawbacks.

We can help you find the right group insurance plan

Get in touch with us today

Which Health Insurance Company Is Best For You?

Kaiser Permanente is one of the largest provider network options for large group coverage. As of 2021, Kaiser Permanente provided health insurance coverage to more than 12.5 million health plan members, including adults and children. It also has more than 724 medical facilities spread throughout the United States for managed care services, preventive care and more, making it a prominent player even on platforms like healthcare.gov.

An experienced company for large group coverage, Kaiser boasts over 12.5 million members and 724 medical facilities around the country. These facilities offer various services, with the amount of care given reflecting their dedication to providing comprehensive coverage for employees at nominal premiums.

Insurance Companies In Taylor Benefits’ Network

United Healthcare provides large group health coverage to a huge number of Americans. It offers everything from basic health plans to prescription drug coverage, eHealth service, HSA (health savings account)-eligible plans and more. It has more than 49.5 million customers across the world, mostly located in the United States, and has many large group plan options available for employees.

This insurance company serves over 49.5 million clients worldwide, though most of them reside in the United States. It offers large group health plan benefits option as well in an effort to cater to the diverse needs of each person.

Here are some of the insurance companies we work with:

  • Blue Cross
  • Blue Shield
  • eHealthInsurance
  • Humana Group
  • Kaiser Foundation Group
  • Unitedhealth Group
  • State Farm
  • Coventry Corp. Group
  • HIP Insurance Group
  • Carefirst Inc. Group
  • UHC of California
  • Metropolitan Group
  • HCSC Group

Relevant Statistics

  • Over 80% of large enterprises in the United States offer health insurance coverage to their employees.
  • Large group health insurance plans typically cover an average of 90% of medical expenses incurred by policyholders.
  • More than 95% of employees covered by large group health insurance plans have access to preventive care services.
  • On average, large group health insurance premiums have increased by 4.5% annually over the past five years.
  • Studies show that companies offering large group health insurance experience 20% lower employee turnover rates compared to those that don't provide such coverage.

General Facts

  • Large group health insurance plans are typically offered by employers to provide coverage for a large number of employees.
  • These plans often have lower premiums due to the larger risk pool and the bargaining power of the employer.
  • Large group health insurance plans usually provide comprehensive coverage, including hospitalization, prescription drugs, and preventive care.
  • Employers may contribute a portion of the premium cost, making it more affordable for employees.
  • Large group health insurance plans typically offer more extensive network options, allowing employees to access a wide range of healthcare providers.

List of Major Group Health Insurance Providers

Aetna is a very popular provider of business health insurance. It’s a subsidiary of CVS health, and offers a wide variety of small group health plans including health insurance for employees and family members, dental benefits, vision insurance Medicare plans and more. Its comprehensive coverage options, suitable for both adults and children, have made it a preferred choice on platforms such as Healthcare.gov.

Here’s a breakdown of some of the most popular health insurance providers out there, including their enrollment advantages and drawbacks.

Kaiser Permanente

Kaiser Permanente is one of the largest provider network options for large group coverage. As of 2021, Kaiser Permanente provided health insurance coverage to more than 12.5 million health plan members. It also has more than 724 medical facilities spread throughout the United States for managed care services, preventive care and more.

An experienced company for large group coverage, Kaiser boasts over 12.5 million members and 724 medical facilities around the country. They have a dedicated team in most states to offer coverage for employees at nominal premiums.

Pros

  • Low premiums for employee
  • High number of large group health plan options for customized coverage
  • Resources such as live classes, open enrollment, and other medical contact information

Cons

  • Employee must use the company’s own contact systems and doctors
  • Coverage only available in 8 states, while other states not covered

United Healthcare

United Healthcare provides large group health coverage to a huge number of Americans. It offers everything from basic health plans to prescription drug coverage, eHealth service, HSA (health savings account)-eligible plans and more. It has more than 49.5 million customers across the world, mostly located in the United States, and has many large group plan options available for employees.

This insurance company serves over 49.5 million clients worldwide, though most of them live in the United States. It offers large group health plan benefits option as well.

Pros

  • Large healthcare network to work with
  • Many health plan options for customized coverage
  • Some health plans cover preventative care completely

Cons

  • Long wait times for certain medical procedures (4 to 6 week in some cases)
  • No coverage for pre-existing conditions of employees

Aetna

Aetna is a very popular provider of business health insurance. It’s a subsidiary of CVS health, and offers a wide variety of small group health plans including health insurance for employees and family members, dental benefits, vision insurance Medicare plans and more. There are also options to compare health plans and find a plan with tax credits and subsidy benefits, thanks to health care reform.

A popular and long-standing healthcare solution for large group and small group markets wanting coverage for their employees, Aetna serves as a subsidiary of CVS health.

Pros

  • Generally low prices to offer coverage at minimum value
  • Comes with extra benefits like dental, vision, student, and international insurance
  • Fewer employees can receive additional insurance to complement current health plans

Cons

  • No short-term coverage options for small group plans
  • Finding a small group premiums quote on the company’s website takes time

HCSC (Health Care Services Corporation)

Health Care Services Corporation is based in Illinois, but you can also get a quote in other states of the United States. It has more than 17 million members, with a wide variety of copay options and different large group health plans to fit organizations of any size, including indemnity health plans. Get a summary of benefits and a self insured quote now to learn more.

The HCSC, operating from Illinois, provides insurance to employees all around the nation. The company gives varied health plans to both small business and large business members.

Pros

  • Health plans for both families and individuals
  • Serves Medicare and small business employer

Cons

  • No dental or vision plans available

Anthem

With an Anthem ID card, you can get medical care just about anywhere. Anthem is one of the largest group health providers in the United States, and it’s part of the Blue Cross Blue Shield alliance, with more than 43 million members in the US alone. With a huge variety of group insurance options, Anthem is a good choice for small group plans and large group health plans.

Anthem is a member of the Blue Cross Blue Shield alliance, meaning that clients can receive care from many hospitals around the country including Ohio and Georgia. Small group or large group, businesses of all sizes can benefit from Anthe's health plans.

Pros

  • Easy to add insurance plans to your roster
  • Dental, vision, and other types of insurance benefits available
  • Affordable rates for employees at minimum value

Cons

  • Not enough family plans for an employee
  • Coverage limited to certain states

Cigna

Based in Pennsylvania and Connecticut, Cigna provides medical insurance, dental, disability, life and accident insurance. It has more than 86 million customers worldwide, and more than 37,000 employees. With a wide variety of small group and large group health plans available, you can easily find one that meets the needs of your organization.

The coverage Cigna provides runs in compliance with the Affordable Care Act, and the business’s offerings range from global coverage to dental plans.

Pros

  • Large number of available doctors
  • High-deductible plans and health savings accounts are available
  • Excellent website with various resources and information, including coverage status of various medications

Cons

  • Health plans only cover medical work in 12 states
  • No short-term large group or small group plans

Blue Cross Blue Shield Of Massachusetts

With more than 3.8 million policyholders, Blue Cross Blue Shield of Massachusetts is the largest single health care provider in Massachusetts. It’s a non-profit, and the majority of its customers are subscribed through large group and small group plans, though health care reform has made some self insured individual plans available.

The largest provider in its titular state, this company is a non-profit organization serving many Americans. It specializes in small group and large group health plans, but some individual ones are accessible as well.

Pros

  • A Great, friendly, and knowledgeable customer support team
  • Access to a nurse hotline that you can use to discuss basic medical issues

Cons

  • Their customer support team is busy and wait times can be long
  • Some basic procedures that other companies cover may not be covered

Blue Shield Of California

Blue Shield of California covers more than 4 million members in California, and is one of the largest insurers in the state. It works with nearly 65,000 physicians across the state, providing it with a very large and extensive network for California residents, and it works with more than 340 hospitals. It offers a wide variety of group health plans.

Employers use Blue Shield of California to provide large group health plans to their employees so that they get access to 65,000 physicians and 340 hospitals.

Pros

  • They are the second largest health insurance provider in California
  • Offer a mix of networks, including both PPO and HMO
  • Access a large network of doctors, hospitals, providers, and other specialists
  • You can refer yourself to a specialist if needed

Cons

  • Not as flexible as other insurance options on the market
  • You must stay within your HMO
  • Treatment options may be restricted based on cost constraints
  • PPO plans are costly

Blue Cross Blue Shield Of Michigan

Blue Cross Blue Shield of Michigan is one of the largest state insurance companies in Michigan, and offers large group plans, small group plans, individual employee plans, Medicare and Medicaid business plans, and more. It has more than 900,000 members and works with more than 6,000 doctors in the state of Michigan, making it a top choice for health care coverage in this state.

Blue Cross Blue Shield is the top choice for Michigan clients in the individual market group plans.

Pros

  • Options include small group plans and large group plans
  • Medicare and Medicaid supported
  • Access to Blue Cross Blue Shield’s broad network of physicians and hospitals

Cons

  • Customer service may be difficult to reach

Highmark

Highmark is a not-for-profit healthcare company based in Pittsburgh, and it primarily serves Western Pennsylvania, as well as some in Delaware and West Virginia, with a total of 4.5 million members. It offers individual plans as well as large group health plan options.

Highmark is a non-profit operating in Pittsburgh. It’s a relatively small company serving 4.5 million clients across Pennsylvania, West Virginia, and Delaware.

Pros

  • Many types of plans are available, including Medicare and Children’s Health
  • Great tools for human services to manage their accounts and find healthcare providers
  • Focus on quality customer service

Cons

  • Limited business service outside of those 3 states
  • Customer service is not 24/7

Blue Cross And Blue Shield Of Florida (Florida Blue)

One of the largest Blue Cross and Blue Shield affiliates, Blue Cross And Blue Shield Of Florida has more than 4.2 million members, providing it with a market share of nearly 30% in the state. It offers large group health plan, as well as individual, Medicare and Medicaid plans.

Florida’s division of Blue Cross Blue Shield is one of the alliance’s largest. 4.2 million clients make up 30% of the insurance market in the state.

Pros

  • Significant support for large group health plan and individual plans
  • Support for Medicare and Medicaid patients
  • Employers have many options for insurance

Cons

  • Limited service outside of the state

Independence Blue Cross

Based in Philadelphia, PA, Independence Blue Cross serves more than 2 million members in Pennsylvania and more than 7 million people nationwide, and it works with more than 160 area hospitals and 42,000 physicians in its network. It also has a number of subsidiary insurers.

42,000 physicians and 160 hospitals make up the network of Philadelphia’s Independence Blue Cross. The company serves 9 million policyholders, a decent percentage of whom come from Pennsylvania.

Pros

  • Clients can choose from multiple plan options, such as Medicare, Medicaid, and Children’s Insurance
  • Online accounts for clients to manage insurance and electronic payments
  • Support, resources, and advice regarding prescriptions and doctor’s visits

Cons

  • Not available in some states
  • Customer service is not 24/7

Blue Cross and Blue Shield of Kansas

Blue Cross And Blue Shield Of Kansas has been operating for more than 75 years, and covers more than 925,000 people in Kansas with large group health plan coverage, individual plans under health care reform, Medicare and Medicaid and more. It serves all of Kansas except for Johnson and Wyandotte counties.

Blue Cross Blue Shield of Kansas is a well-experienced organization in the individual market, having served for over 75 years. It currently has 925,000 users in its state.

Pros

  • Support for Medicare and Medicaid
  • Access to Blue Cross Blue Shield’s extensive healthcare network

Cons

  • No coverage for Johnson and Wyandotte counties in Kansas

Harvard Pilgrim Health Care

Harvard Pilgrim Health Care is based in Massachusetts and was founded in 1994. It offers large group health plan options. Harvard Pilgrim Health Care is a not-for-profit company that serves more than 2.4 million members in New England including Maine, Connecticut, New Hampshire, Massachusetts, and Rhode Island, making it one of the largest human services insurer in the area.

Known for its large group health plan coverage, Harvard Pilgrim is another non-profit organization with 2.4 million members. It’s most active in the New England area.

Pros

  • Many large group health plans to choose from, such as Medicare, student packages, and family coverage
  • Eligibility for certain discounts on dental care, fitness programs, and other additional perks
  • Excellent customer service

Cons

  • Not available in most states outside of the New England area

Centene Corporation

Based in Missouri, Centene Corporation provides Medicaid insurance, ACA health insurance marketplace coverage, large group health plans, small group plans, Tricare and Medicare. It has more than 15 million enrolled members, and is one of the largest providers of Medicare in the United States, but also offers traditional commercial insurance for companies.

From the standard commercial insurance for businesses to plans for individuals, Missouri’s Centene’s 15 million member count makes it one of the largest Medicare providers in the nation.

Pros

  • Wide variety of large group health plan options, including ACA marketplace coverage, Medicare, Medicaid, and Tricare
  • Publicly traded company with extensive resources

Cons

  • The company has a large business and the claims process can be slow (1 week)
  • You must follow their rigid rules if you want to maintain eligibility for employee coverage

Humana

Humana has over 13 million customers in the United States, making it one of the largest insurers in the country. It primarily offers large group plans and other types of employer-sponsored coverage, but also offers individual plans, Medicare, Medicaid and more. Thanks to its business size, it works with tens of thousands of doctors, healthcare facilities and hospitals across the United States.

Humana is a well-established health brand with companies and individual clients alike, bringing in 13 million customers in the United States.

Pros

  • Excellent options for business-sponsored coverage and other large group plans
  • Medicare and Medicaid support available
  • Network of many doctors and hospitals for health coverage
  • Relatively low rates for small group premiums

Cons

  • Restricted to 22 states
  • No short-term healthcare solutions

CareFirst Blue Cross Blue Shield

This Blue Cross Blue Shield subsidiary is located in Maryland and Washington D.C., and is one of the top insurers in the area. It covers more than 3.3 million people with large group plans and individual policies, and is part of the Federal Employees Health Benefits Program. It has a 75% market share in Maryland, making it the largest insurer in the state by far.

Blue Cross Blue Shield owns this division for over 3.3 million Maryland and Washington D.C. citizens, taking up the largest market share in the former.

Pros

  • Company is part of the Federal Employees Health Benefits Program
  • Policyholders can pay bills, view plan details, and download relevant forms through the company easily
  • Great customer service; voted “Most Ethical Company” for 3 years in a row

Cons

  • No Medicaid plans
  • No short-term insurance for employees

Excellus Blue Cross Blue Shield

Based in Rochester, NY, Excellus Blue Cross Blue Shield is the largest nonprofit health plan in Upstate New York. It’s been operating for more than 80 years, and offers small group and large group plans and other employer-sponsored plans, as well as individual coverage, with more than 1.5 million customers.

Few providers can boast the 80 years of operation that New York’s Excellus has. The company is a long-running non-profit with over 1.5 million customers.

Pros

  • Medicare support, group insurance, and HSA-compatible plans available
  • Company portal helps users find doctors, hospitals, plan details, and other resources
  • Rewards program that encourage healthful lifestyles

Cons

  • Large group health plan limited to New York
  • The business suffered a hack in 2013 that exposed the records of its business clients

HAP

HAP was founded in 1956 in Detroit, Michigan. It offers both small group plans and large group plans, as well as individual and family insurance. It’s available throughout the entire state of Michigan, with hundreds of thousands of customers in the area. It offers unique features like discounts for healthy lifestyles, digital ID cards and electronic benefits statements.

This Michigan-based provider specializes in business, group, and family insurance plans, having served the state for over 50 years.

Pros

  • Special-case coverage available, such as discounts for maintaining a healthy lifestyle
  • Offers electronic benefits and digital ID cards
  • Offers large group health plan along with small group market plan

Cons

  • Poor customer service
  • They are known to elongate the 30-day appeals process
Horizon logo

Horizon Blue Cross Blue Shield Of New Jersey

As the only licensed Blue Cross Blue Shield member in the state, Horizon Blue Cross Blue Shield Of New Jersey provides individual, large and small group coverage to more than 3.3 million people in the state. With thousands of doctors and a wide range of medical facilities, it remains the top choice for health care coverage for small group market in New Jersey.

Over 3.3 million residents of New Jersey are under an insurance plan from this provider. The network in question involves thousands of doctors across multiple hospitals in the state.

Pros

  • Access all essential forms and resources in one, convenient location
  • Wide range of employer coverage available

Cons

  • Ineffective customer service that is known to ping-pong customers around for a week
  • Poor administrative practices
  • No out of network employee coverage
Wellmark logo

Wellmark Blue Cross And Blue Shield Of Iowa

Based in Iowa, Wellmark Blue Cross And Blue Shield Of Iowa is the largest insurer in both Iowa and South Dakota, with more than two million members. It offers health insurance, dental insurance, life insurance and ACA insurance, and is a great option for large group health plan in Iowa and South Dakota.

2 million policyholders across Iowa and South Dakota enjoy health insurance from Wellmark. If you are an employer looking for large group plans, Wellmark should be on your list.

Pros

  • Varied individual market plans, including life, health, dental, and ACA insurance
  • Mobile app for keeping track of spending and managing employee insurance
  • Employee Rewards program that encourages healthful lifestyles

Cons

  • Limited to specific states, with little business support in other parts of the nation
  • No 24/7 contact for resources
Blue Cross Blue Shield logo

Blue Cross Blue Shield Of Tennessee

One of the dominant insurers in the state, Blue Cross Blue Shield of Tennessee offers large group plans, Medicare and ACA individual & family insurance. This not-for-profit company serves more than 3.5 million covered individuals in Tennessee, and is one of the best options for employer health insurance in the state.

A non-profit responsible for over 3.5 million individuals, Blue Cross Blue Shield’s Tennessee division remains as one of the best providers in the state.

Pros

  • Varied employee insurance plans, ranging from Medicare to ACA to family insurance
  • Access to Blue Cross Blue Shield’s extensive network of physicians, hospitals, and resources

Cons

  • Finding a main customer support line can be difficult
Priority Health logo

Priority Health

Priority Health is another top Michigan health insurance provider for large group plans, small group market plans, family & individual insurance, and Medicare and Medicaid, and it currently serves the entire Lower Peninsula of Michigan. It has more than 830,000 covered individuals and employees under its various employer plans.

Priority Health primarily serves 830,000 clients in the lower section of Michigan. It’s widely regarded as an excellent option for employee health insurance in the area.

Pros

  • Varied coverage options for both small and large employer groups, as well as families and individual employees
  • Medicare and Medicaid support
  • PPO and HMO plans are highly rated

Cons

  • Will not cover procedures that take place out of network for employees
  • Have a reputation of refusing to cover prescriptions recommended by doctors after a week
Premera Blue Cross logo

Premera Blue Cross

Premera Blue Cross is based in Washington, and it primarily operates in Washington, Oregon and Alaska. It serves a total of more than 2 million people with group insurance coverage, individual and family plans, and Medicare plans. In total, it has more than 38,000 partner physicians, hospitals and health care facilities in Alaska, Oregon and Washington.

This Washington-based provider serves not only the titular state but also Oregon and Alaska. Over 2 million clients enjoy the company’s many doctors and health care facilities.

Pros

  • Solutions for those looking for Medicare, individual, employer, or family plans
  • Membership comes with discounts on vision care, gym memberships, and other perks
  • Simple account management for employees through the app

Cons

  • No visible Medicaid support
  • No 24/7 customer support (only during business hours for employees and employers)
Tufts logo

Tufts Health Plan

Tufts Health Plan is based in Massachusetts, and is part of Tufts Associated Health Plans, Inc. It had more than 1 million members as of early 2019, with a network of 110 hospitals and 51,000+ health care providers, making it one of the largest providers in New England, along with Harvard Pilgrim Health Care.

Tufts owns a network of over 50,000 physicians and 110 hospitals, making it one of the largest New England health insurance companies.

Pros

  • HMO plans at low prices
  • Solid reputation with few employee complaints

Cons

  • Provider networks are limited, especially for traveling employees

Your Next Steps

Decide whether a large group health plan is right for you and your employees.

If you have no need for extended coverage for employees, and the essential health benefits required under Obamacare are enough, you may decide to go with a smaller employers plan.

Are you looking for broader and more comprehensive health care coverage for your employees? Consider contacting an independent agency that specializes in this marketplace.

Let Taylor Benefits be your broker, contact us today!

We can help you find the right group insurance plan

Get in touch with us today

Large Group Information & Resources

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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