What is Group Coverage?
A group plan is insurance issued to a group, such as an employer, for the benefit of employees. Group policies provide coverage for individuals and often their dependants.
Am I eligible for Group Coverage?
- If you are employed, check with your human resources department for information about the benefits available to you. Some employers will not offer insurance benefits until you have been working a set amount of time.
- Group plans cannot reject you based upon your medical condition. You may also be able to enroll a spouse, domestic partner, and other dependants on your employer’s plan.
- If you are self employed and have at least one full-time employee, you may be eligible for a small group plan. For buying and coverage options please refer to the Washington State Office of the Insurance Commissioner.
Can Evergreen pay for my group plan?
Evergreen can pay for your group premiums if you are eligible to be an Evergreen client, and the group plan meets our cost-effective criteria. In addition the employer must provide Evergreen with the following on company letterhead:
- A statement of willingness to accept third-party payments from Evergreen for the employee's portion of the insurance premium.
- The monthly premium amount.
- When the premium is due.
- Who to make checks payable to.
- Where to mail payments.
We can assist you with your group premium even if you only pay for a portion of the premium cost. However, please note that since we will send checks to your employer, this means they may be able to determine your HIV status.
How do I apply for Group Coverage?
- Generally, the group's administrator will provide you with forms to enroll in health coverage when you become eligible. Complete the required documents.
- In order for Evergreen to pay your premium, you will need to ask the administrator of the group plan (often your HR department) if they are able to bill for your health coverage and if they are willing to accept third-party payments. Please have your employer provide this in writing on company letterhead.
- Submit your group plan information along with an application to Evergreen. Your group plan information should include a copy of your insurance card, the letter from your employer, the Summary of Benefits for the plan, documentation of the monthly premium amount, and contact information for either the health plan administrator or your HR department. If you are not a current Early Intervention Program client, you will need to enroll in EIP.
- We will process your application and contact your HR department to set up a payment system for your COBRA coverage.
Other important information about Group Plans
Not all group plans have the same coverage, so it is important to review the plan benefits information before you visit the doctor. Be sure you know which doctors you can visit, what is and isn't covered, and how much you will have to pay out of pocket.