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Prishtina, Republic of Kosovo

What Is Health Insurance?

Health insurance is a contract that requires an insurer to pay some or all of a person’s healthcare costs in exchange for a premium. More specifically, health insurance typically pays for medical, surgical, prescription drug, and sometimes dental expenses incurred by the insured. Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly. It is often included in employer benefit packages as a means of enticing quality employees, with premiums partially covered by the employer but often also deducted from employee paychecks. The cost of health insurance premiums is deductible to the payer, and the benefits received are tax-free, with certain exceptions for corporation employees.


  • Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured.
  • Choosing a health insurance plan can be tricky because of plan rules regarding in- and out-of-network services, deductibles, co pays, and more.

How Health Insurance Works

Health insurance can be tricky to navigate. Managed care insurance plans require policyholders to receive care from a network of designated healthcare providers for the highest level of coverage. If patients seek care outside the network, they must pay a higher percentage of the cost. In some cases, the insurance company may even refuse payment outright for services obtained out of network.

Insurance companies may also deny coverage for certain services that were obtained without pre-authorization. In addition, insurers may refuse payment for name-brand drugs if a generic version or comparable medication is available at a lower cost. All these rules should be stated in the material provided by the insurance company and should be carefully reviewed. It’s worth checking with employers or the company directly before incurring a major expense.

Insurance plans with higher out-of-pocket costs generally have smaller monthly premiums than plans with low deductibles. When shopping for plans, individuals must weigh the benefits of lower monthly costs against the potential risk of large out of pocket expenses in the case of a major illness or accident.

What Is Health Insurance and Why Do You Need It?

Health insurance is an agreement you make with an insurer to have them pay for some or all of your medical expenses in exchange for a premium. Having health insurance can keep you from incurring medical bills you can’t afford to pay out of pocket.

Who Needs Health Insurance?

The simple answer is everyone. Health insurance can help to offset the costs of minor medical issues or major ones, including surgeries or treatment for life-threatening illnesses. But if you don’t have health insurance, you won’t be penalized for it under the terms of the Affordable Care Act.

How Do You Get Health Insurance?

If your employer offers health insurance as part of an employee benefits package, you may be covered by it. You can also purchase health insurance through the Health Insurance Brokers.

How Much Does Health Insurance Cost?

Your costs for health insurance can vary based on the scope of coverage, the type of plan you have, and your deductibles. Co pays and coinsurance can also add to the cost, so it’s important to consider what you’ll pay before enrolling in a healthcare plan.

Group Health Insurance

What Is a Group Health Insurance Plan?

Group Insurance health plans provide coverage to a group of members, usually comprised of company employees or members of an organization. Group health members usually receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders. There are plans such as these offered by Blue Brokers International.


  • Group members receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders.
  • Plans usually require at least 70% participation in the plan to be valid.
  • Premiums are split between the organization and its members, and coverage may be extended to members’ families and/or other dependents for an extra cost.
  • Employers can enjoy favorable tax benefits for offering group health insurance to their employees.

How Group Health Insurance Works

Group health insurance plans are purchased by companies and organizations and then offered to their members or employees. Plans can only be purchased by groups. Which means individuals cannot purchase coverage through these plans. Plans usually require at least 70% participation in the plan to be valid. Because of the many differences—insurers, plan types, costs, and terms and conditions—between plans, no two are ever the same.

Once the organization chooses a plan, group members are given the option to accept or decline coverage. In certain areas, plans may come in tiers, where insured parties have the option of taking basic coverage or advanced insurance with add-on`s. The premiums are split between the organization and its members based on the plan. Health insurance coverage may also be extended to the immediate family and/or other dependents of group members for an extra cost.

The cost of group health insurance is usually much lower than individual plans because the risk is spread across a higher number of people. Simply put, this type of insurance is cheaper and more affordable than individual plans available on the market because more people buy into the plan.

Benefits of a Group Health Insurance Plan

The primary advantage of a group plan is that it spreads risk across a pool of insured individuals. This benefits the group members by keeping premiums low, and insurers can better manage risk when they have a clearer idea of who they are covering.

What Is a Group Health Plan?

Group health plans are employer- or group-sponsored plans that provide healthcare to members and their families. The most common type of group health plan is group health insurance, which is health insurance extended to members, such as employees of a company or members of an organization.

What Is a Group Health Cooperative?

A group health cooperative, also known as mutual insurance, is a health insurance plan owned by the insured members. Insurance is offered at a reduced cost, and what they collect from members is based on claims paid. The cost of care is spread out across the insured population.

How Many Employees Do You Need to Qualify for Group Health Insurance?

Many group health insurers offer plans to companies with ten or more employees. The type of plans available, however, may vary according to the size of the business. For example, Blue Brokers International provides various plans for small businesses with 10-99 employees, midsize businesses with 100-2,999, and large employers with 3,000 or more employees.

What Are Group Health Insurance Benefits?

Group health insurance plans offer medical coverage to members of an organization or employees of a company. They may also provide supplemental health plans—such as dental, vision, and pharmacy—separately or as a bundle. Risk is spread across the insured population, which allows the insurer to charge low premiums. And members enjoy low-cost insurance, which protects them from unexpected costs arising from medical events.

How Much Does Group Health Insurance Cost?

The average group health insurance policy costs a little more than 15.00€ for an individual monthly, with employers paying approximately 80% and employees paying the difference.

The Bottom Line

Group health insurance plans are one of the most affordable types of health insurance plans available. Because risk is spread among insured persons, premiums are considerably lower than traditional individual health insurance plans. This is possible because the insurer assumes less risk as more people participate in the plan. For employees who ordinarily would not be able to afford individual health insurance, it is an attractive benefit.