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What Coverage Levels/Groups are Most Common (EE only, EE+!, etc.)

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I know that this is a very basic question, but can anyone explain what coverage groups are typical for an insured group health plan?

We have always used a) EE only, b) EE and 1 dep., and c) EE and 2+ deps, but I understand that other employers have different categories that may work better. Does the insurance company dictate which one is used or it is all negotiable?

Any help would be appreciated. Thanks.

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You can have a variety of categories, but you may be constrained by the carrier. Just ask your carrier/agent/consultant and they can provide you with the options. Under a self-funded, you can do whatever you want, but your question references a carrier, so I am assuming your insured.

Keep in mind, changing this may have negative consequences, depending on the demographics of your group. For example, let's use a two category level, single $100 per month, and family $400 per month. If you were to add a middle category, say ee+sp, it might be a $250 rate, and may increase the family.

Good luck.

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Depends on your group size, demographics, and contribution strategy. First thing I would do is determine how your group matches up to the categories. For example, how many singles, how many ee+sp, how many ee+child, and how many families. This will give you a better feel for what makes sense for your group.

Also, as for what is average, it is hard to say. I would say 3 to 4 is about maximum.

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Guest Stepper

I am more familiar with groups containing all levels: the EE and EE+SP are all in the same group. Rather, the different groups are separated by unionized, nonunion, retiree post Medicare, retiree pre Medicare, PPO -POS - HMO, and regional groups.

Also, the number of levels is effectively restricted by the tax consequences of including anyone other than a EE SP or Dep.

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