A health insurance policy is a binding contract issued by an insurance company to an individual or group which promises to pay for health care reasonably required by the “insured” or “policy holder” or “certificate holder” to treat illness or injury. If the insurance policy is issued to an individual, the individual applies for the policy and pays the premiums either directly or through payroll deduction. Typically, in individual health insurance the individual policyholder is insured and also, in exchange for a higher premium, the insurance covers a spouse and dependent family members.
In the circumstance where the health insurance is obtained by an employer or a group or an association, the entity is the “group policyholder” and the covered individuals receive “certificates” of insurance. Generally, in addition to payment of premiums by the policyholder, the insured is also responsible for payment of deductibles and co-pays (a percentage of actual charges or a fixed amount per visit) which are predetermined in the policy at set amounts or rates.
NOTE: The answers to coverage questions are primarily based on ISO forms generally used in Florida by most companies. However, please keep in mind that all companies’ forms are NOT necessarily the same. Some companies may provide broader coverage and some may be more restrictive.
IN ALL CASES, THE CONSUMER MUST REFER TO HIS OR HER OWN POLICY FOR SPECIFIC COVERAGE INFORMATION.
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Information contained within this site is the property of Hoffman and Associates Insurance Company and is provided for consumers looking to purchase insurance. Any other use is prohibited. We are not responsible for errors and omissions on this web site. All information contained herein should be deemed reliable but not guaranteed, all representations are approximate, and individual verification is required. Please contact Hoffman Insurance Company at 321-751-2511 before making any purchase decisions based on information contained on this web site to check for validity. This content is copyrighted by Hoffman and Associates Insurance Company and will bring legal action on to anyone who copies the information contained here. PLEASE NOTE THAT COMPLETION OF A REQUEST FOR INFORMATION DOES NOT CONSTITUTE THE PURCHASE OF INSURANCE. NO COVERAGE MAY BE ADDED, CHANGED OR BOUND AS A RESULT OF SUBMITTING A REQUEST FOR INFORMATION. ALL COVERAGE MUST BE CONFIRMED BY THE AGENCY IN WRITING SUBJECT TO AN ACCEPTABLE SIG NED APPLICATION MEETING THE UNDERWRITING GUIDELINES OF THE INSURANCE COMPANY. Please read your policy carefully for your terms of coverage. No information in this website alters the terms of coverage in your individual policy. If you do not agree to these terms please exit this website