Yes. Group insurance is medically underwritten. The entire gr0up, including the individual are reviewed by underwriting for group health insurance.
Let’s take a look at why one might ask this question. Most often we hear this due to a concern about being denied for coverage.
The good news for those concerned is this. Health Insurance companies in Michigan underwrite individuals to determine your rate. The amount you pay monthly for health insurance.
When small group plans are medically underwritten, employees are asked to provide health information about themselves and their covered family members when they apply for coverage. When determining rates, insurance companies use the medical information on these applications. Sometimes they will request additional information from an applicant’s physician or ask the applicants for clarification. If a company is unable to obtain information necessary to accurately determine the risk of a particular applicant, it will underwrite more conservatively, meaning that the assumption relative to the missing information will be negative rather than positive.
Example: A person has a history of diabetes but it is controlled with medication and he is not overweight. If the company is unable to determine if that individual smokes or if he has normal cholesterol, it will assume that the missing information is negative and rate accordingly.
In most states the amount a company can vary a group’s premium rates based on medical underwriting factors is limited to a certain percentage of the average small group insurance rate. This is known as a rating band requirement, and the specifics vary by state.
If you have a pre-existing condition, a new insurance company can review your medical records for the last six months only and apply an exclusion of that condition from coverage for varying times according to the type of group plan you have. If you have maintained coverage of your pre-existing condition, without a break of more than 63 days, you are entitled to creditable coverage.
Please contact us at 888.320.5388 to answer specific questions not addressed here. Or ask anonymously at http://www.formspring.me/michiganhealth
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