(01) Insurance covering the members of a group such as the employees of a single employer. The benefits are not tailor-made to the needs of each member. If the group is acceptable to the Insurer, all members are covered. (02) Any insurance plan under which a number of persons and their dependents are insured under a single policy, issued to their employer or to an association with which they are affiliated, with individual certificates given to each insured person
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UK: Insurance of a number of persons under a single contract or, if agreed, under individual contracts. Usually the persons are in the same employment or all employed or members of the same association. Group cover can be applied to various kinds of insurance, e.g. group life, group accident, group legal expenses, etc.
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US: Insurance written on a number of people under a single master policy, issued to their employer or to an association with which they are affiliated.
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Policy protecting a group of persons—usually employees of a firm.
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MEDICAL,USA,REFERENCE: See: Group Health Plan.
Insurance Encyclopedia
Group insurance number
See: Group Number.
Group leader
Member of a group insurance plan that is responsible for administration of the group’s contract.
Group life insurance
Type of life insurance on a group of individuals under a master policy that is issued without requiring a medical examination. It is issued to an employer, and each employee is given a certificate as verification of his or her insurance.
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UK: Policy covering a group of lives as distinct from individuals. The group must exist for some purpose other than the insurance, e.g. employees in a firm or members of an association. The cover is often ancillary to a pension scheme but can stand alone. Policies are written as one-year term insurances with the automatic right of renewal each year subject to the terms of the contract. See ACTIVELY AT WORK; FREE COVER.
Group life insurance (Life Insurance)
Life insurance coverage provided to a group of people, most often employees of the same company. These policies carry a lower cost than the policies offered to individuals, due to the tax cuts offered to the insurer, the use of adverse selection, and the sharing of expenses.
Group medical plan
See: Group Health Plan.
Group medicine
See: Group Practice .
Group model
Type of managed care organization (MCO) that contracts with a group of providers to give medical care to its members. The providers work out of their own office facilities. A group model may or may not give medical services exclusively for the MCO’s members. Also called network model .
group model health maintenance organization (HMO)
Type of managed care plan (HMO) that contracts with one or more medical groups to give medical services to members. Usually all services, except hospital care, are provided under one roof and physicians share equipment, records, and personnel. Physicians are paid a predetermined per member, per month amount called capitation . From the capitation fund, the physicians’ group pays its own physician members according to a prearranged schedule such as salary plus incentives. Also known as a prepaid group practice plan . Also see staff model .
Group model HMO (Health Insurance)
An HMO that contracts with certain provider groups, with whom rates for medical care are negotiated. The HMO then pays the negotiated rate for care provided to the policyholders. Contracts are also made with hospitals for care provided to the policyholders.