Group vs. Individual

Group vs. individual plans apply to health insurance plans for self employed business owners:

They may purchase either a group policy on themselves and their families or,
individual health insurance that may be less expensive.
Those who are medically uninsurable can purchase a guaranteed-issue business group of one policy during a limited time each year;
otherwise, they can purchase any small group health policy available from any carrier in Colorado at any time, subject to medical underwriting.

Colorado does not allow, by law, marketing individual plans to employees through your place of business except in very narrowly defined situations (DOI Reg 4-6-8), because these plans do not meet requirements imposed by law. Even using a "group carve-out" as justification for individual planning is not allowed. If you are purchasing or contributing to a small business health plan for employees, Colorado requires that fully insured plans made available or sponsored through an employer meet all mandates for coverage, including maternity, and plans that don't provide these coverage's can leave the employer responsible for them.

If you have further questions about this issue, call us at 303-422-1660, or email us using the link below. Health care reform legislation will further blur the lines from now on - stay informed!