What's the Difference Between Group and Individual Coverage?
Health insurance provided to employees by an employer or by an association to its members is called group coverage.
Health insurance you buy on your own—not through an employer or association—is called individual coverage.
Those are the basics. But what does it mean for you if you're changing from group coverage to individual? What will be different for you?
If you've had employer-sponsored coverage, you're probably used to certain things. Your employer may:
If for some reason you can't get coverage through your employer anymore, you'll still need a health plan. For many people, that means buying individual health insurance. To learn more, see Is individual insurance right for me?
Unlike traditional employer-sponsored insurance, now you'll:
Depending on how many employees there are, benefits covered by group and individual plans may be different. All health plans for individuals and businesses with fewer than 50 full-time equivalent employees cover the same 10 essential health benefits. But if your employer has 51 or more full-time equivalent employees, they have more say in what your plan does and doesn't cover.