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Up to this point we have discussed “basic” benefits that are designed to cover some hospital, medical and surgical costs that are primarily considered to be minor. When purchased individually, these benefits can be substantially less than actual costs incurred.
Disability income insurance is available individually or sometimes as a portion of a group benefit provided by an employer in their group package.
In sharp contrast, the HMO provides both the health care services AND the health care coverage.
Exclusions: Specific conditions or circumstances for which the policy will not provide benefits.
This same concept also applies to determining who receives specific benefits. For example, an employer may choose to offer certain groups of people within the total employee group, a different set of benefits.
COBRA requires that some group health plans offer a continuation of coverage at group rates or slightly higher to departing employees for up to 18 months. For dependents of deceased employees and in some other special cases, continuation of coverage can last for up to 36 months.
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