Group vs. Blanket Health Policy. Understand The Difference

March 17, 2020by Alex Strautman

If you’re a small business owner and you’ve spent some time shopping for health insurance for your employees, you’ve likely encountered the terms “Group Health  Insurance Policy” and “Blanket Health Insurance  Policy.” Here’s an overview to help you understand how each type of coverage works and how they apply to your business.


What is a Group Health Insurance Policy?

A Group Health Insurance policy offers health benefits to your employees as well as spouses or other eligible dependents. It provides employees with medical benefits when they visit a health care provider like a doctor, urgent care facility, or hospital. A Group Health Insurance policy may also include coverage for prescription drugs and other health and wellness benefits – like discounts on Vision, Dental, or the option to purchase Life Insurance.


What is a Blanket Health Insurance Policy?

Despite its name, a Blanket Health insurance policy is less comprehensive than a Group Health policy. In fact, it is most often an accident-only policy issued to cover a group of individuals engaged in a specific activity. For example, school districts, colleges and universities, and sports teams can purchase Blanket Health coverage to provide health benefits to athletes and cheerleaders. These policies may also be issued to civic, non-profit, or religious organizations for participants in (or employees of) ongoing or one-time events or camps. Volunteer firefighters may be covered by a Blanket Health policy for medical treatment in connection with accidental injury related to their fire-fighting roles.


Most importantly, a Blanket Health insurance policy typically has limits on the types of covered tests, procedures, and services. There may also be a maximum covered benefit – ranging from $5,000 to $50,000 of eligible expenses – for treatment of individuals under this type of policy.


More on How the Policies Differ

In contrast to a Blanket Health insurance policy, a Group Health insurance policy – particularly one that includes the Essential Health Benefits (EHBs) mandated by the Affordable Care Act (ACA) – does not have a dollar limit on what it will pay for care received by you and your employees while you are insured. The ACA actually prohibits health insurers from limiting your annual or lifetime coverage expenses for EHBs under a Group Health plan.


In addition, a Group Health policy typically covers you for a full plan year (12 months). If you want coverage long-term, a Group Health policy may be a better choice for you, since a Blanket Health policy may have a limited term duration.


Choosing What’s Right for You

Taking the time to educate yourself on the differences between Group Health insurance and Blanket Health insurance policies is an important step in choosing coverage that’s right for you. To find out if your business qualifies for Group Health insurance, click here or talk with your employee benefits agent. To explore this subject further, consider reading 7 Things to Know About Offering Group Health Insurance.


Your employee benefits agent can also provide you with a quote for health insurance for your employees. If you’re not currently working with an agent, go here to find a licensed expert in your area.

Shopping for group health insurance?

This guide compiles a list of common questions you may have before you start offering health insurance coverage.