What’s the difference between individual health insurance and health insurance provided by employer?


Like is it cheaper to get health insurance with your job and how does it work or how is it different than getting it on your own.

In: 3

insurance through emploiyer – your employer often splits the cost of premiums with you

individual insurance – you do all that on your own

employer health insurance is always cheaper than buying it on your own, it’s a job benefit that better jobs offer more of. Pretty much no one would choose to buy individual health insurance if their job offers employee coverage.

This is a general statement and may not be universal

a) Insurance works by “grouping” risk class and charging a premium to insure that risk class. A lower risk class can be insured by low premiums and vice versa.

b) The second insurance cost factor is coverage. The greater the coverage, the greater the costs.

In broad terms, for public individual health insurance, the “group” that the person belongs to might be very broad (eg. every one in the state between x and y age). This is quite often mandated by legislation so insurance companies have to charge premiums based on the risk profile of the entire group – this can be expensive. It is also common to see adverse selection – those who know that they will need insurance will purchase while the younger and healthier won’t purchase insurance at the same rate.

Employer provided insurance is self selected. People who are employees are generally of working age, of reasonable ability and are able to hold down a job (ie they can be assumed to be somewhat responsible etc) Broadly speaking, this is a lower risk class.

Many large employers negotiate with the insurance companies and also subsidizes the employee insurance plan (US centric). It is common for employers to pay for the majority of the insurance premium and only charge a small percentage to the employee (80% employer/20% employee is not uncommon) (Actual details are far more complicated!)

Employer provided health insurance is cheaper for a couple of reasons.

First off, because your employer pays a portion of the monthly premiums. This lowers what you have to pay.

Secondly, they get a group discount. Because they are providing insurance for a bunch of people, they get charged a lower rate. Similar to when you buy something in bulk as opposed to buying a single amount of something.

As a single person, paying for your own health insurance, you foot the entire bill. And because you are only covering yourself, you don’t get the group discount.