Massachusetts Health & Accident Insurance Practice Exam

What does group health insurance generally offer compared to individual health plans?

1. Higher premiums but fewer benefits

2. More extensive benefits and higher maximums

3. More limited coverage options

4. Higher deductibles and copayments

The correct answer is: More extensive benefits and higher maximums

Group health insurance typically provides more extensive benefits and higher maximums compared to individual health plans. This is largely due to the larger risk pool created by insuring a group, which allows insurance companies to spread the risk across a greater number of individuals. As a result, group plans often negotiate better rates and coverage options that individual plans cannot match. In a group plan, the employer usually plays a significant role in the benefits structure, which can lead to enhancements in the level of coverage offered to employees. Furthermore, group health insurance often includes additional perks or comprehensive services that an individual policy might lack, such as wellness programs, preventive care options, and broader provider networks. Consequently, members of a group plan may benefit from higher per-visit maximums and overall coverage limits, contributing to a more extensive safety net for healthcare expenses. Other choices might suggest potential trade-offs such as higher costs or limitations in coverage, which are generally not the case with group health insurance when compared to individual plans.