The group of physicians, hospitals, facilities, and other providers of medical care who are in contract with a health insurance company to offer discounted rates for their services. Networks of providers can offer a broad range of services or extend over a large geographical region.
A prerequisite that group health coverage under an employer cannot withhold coverage or charge more for a plan due to an individual’s health status. The employer is not legally allowed to discriminate against an employee for any health condition or being a high risk individual. Employer plans are able to limit coverage on the basis of non-health-status related factors, such as being a part time employee.
Refers to the Affordable Care Act, a plan that has been created after the health care reform laws were enacted in March 2010, therefore these “new plans” must follow health reform regulations. For individual health insurance, a plan you or your family is buying for the first time is a new plan. For group health insurance, a plan that the employer is offering for the first time is a new plan. If an employer is operating under a grandfathered plan (or plan that was created before the ACA was enacted), and you are new to the employer, you will be offered a grandfathered plan, which is not subject to all regulations of health reform. All health plans must indicate whether they are “new” or “grandfathered” in its plan materials.
1. HealthInsurance.org, “Health insurance glossary”. http://www.healthinsurance.org/glossary/
2. HealthCare.gov, “Glossary – N”. http://www.healthcare.gov/glossary/n/index.html