1. Any insurance plan by which a number of employees of an employer (and their dependents), or members of a similar homogeneous group, are insured under a single policy (master contract), issued to their employer or the group with individual certificates of insurance given to each insured individual or family. Usually, group insurance has lower monthly premiums compared with individual insurance. Group insurance is usually experience rated. Also called group insurance or blanket insurance . 2. Under the Health Insurance Portability and Accountability Act (HIPAA), an employee welfare benefit plan (as defined by ERISA) including any insured or self-insured plan that provides medical care including items and services paid for as medical care to employees or dependents either directly or through insurance, reimbursement, or otherwise if (a) the plan has 50 or more participants or (b) is administered by an entity other than the employer that established and maintains the plan. Also called group health coverage .

Managed care organization that contracts with two or more groups of practices to provide health services.

Member of a group insurance plan that is responsible for administration of the group’s contract.

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.

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 .

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 .