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

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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.

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Anonymous 0 Comments

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!)

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