Hassle-Free Health Coverage: The Group Insurance Contract

A group insurance policy, or master policy is issued to the policyowner -- usually your employer, association, union, or trust, etc. And if you are covered under the group policy you are issued a certificate of insurance. The certificate lists what the policy covers, and explains such things as how to file a claim, the term of insurance, and the right to convert from group coverage to an individual policy.

Many of the group health insurance contracts features are similar to the contract features of group life insurance.

Group health insurance is generally subject to experience rating, under which the premium modification factor is determined by the experience of the group as a whole. In contrast, individual policies may be subject to community rating, under which the insurance company's overall experience is adjusted in different areas to reflect variations in local costs for doctor and hospital services.