Health · Chapter 14 · Group Health

Community Rating (Small Groups)

Definition

Premiums for small groups (2–50 employees) are based on the claims experience and costs of the surrounding community, not the group's own history. Also the traditional Blue Cross/Blue Shield approach and required for employer HMO plans.

Easy to confuse with

These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.

Experience Rating (Large Groups)Blue Cross & Blue Shield (Service Providers)Small Employer Group Rules

Drill this term Chapter lesson