What is a “Community Rated” Health Plan?

A community rated health plan may be right for your business – especially if you have fewer than 100 employees.

By Krista Latimer

We get a lot of questions about community rated health plans. For many businesses, a community rated plan is the way to go. Small business owners most frequently run into community rated plans when they shop for group health insurance options. In New York State, companies with fewer than 100 employees are subject to community rated plans.

Being community rated means that every company in a given geographic area pays the same premium rate for the same plan – regardless of the age, residence or gender of its participating employees. The premium rates and plan designs are established and cannot be modified, since the plans and rates are approved by New York State Department of Financial Services.

Though it may sound like it limits your options, community rating can be a benefit to a business. Insurance carriers are unable to raise rates on plans subject to community rating. That keeps your rates at a predictable level and puts you on the same playing field as the businesses around your size in your community.

OneGroup’s consultants can help you sort through the many plan designs and recommend a plan that will fit your needs. If you’ve run into community ratings in your employee benefits package search, don’t hesitate to reach out.

Krista Latimer is an Employee Benefits Consultant at OneGroup. She can be reached at 315-413-4426 or KLatimer@OneGroup.com.

This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.

Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.

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