Who is considered the policyholder in a group health benefit plan?

In a group health benefit plan, the policyholder is the entity that purchases the insurance coverage for the group, which in the vast majority of cases is the employer. The employer maintains the master policy and holds the contractual obligations with the insurance carrier. This means that the employer is responsible for paying premiums and managing the overall benefits provided to employees under the group policy.

While individual employees may receive benefits and are considered insured persons, they do not hold the policy; rather, they are covered under the employer's purchased group policy. Similarly, the insurance carrier does not hold the contract; instead, it provides the coverage and services outlined in the group health plan. A union representative, while possibly involved in negotiating or administering some benefits for union members, does not serve as the policyholder in this context. Thus, the employer distinctly qualifies as the policyholder, responsible for the policy itself and interacting with the insurer.