November 2017 Volume 15, Number 11 | |||||
What Type of Group Health Plan is Right for Your Company?These days there are a lot of group health plans to choose from. To pick the right one for your employees it’s important to know the advantages and disadvantages of each.
Before your annual enrollment period, you must choose a group health plan that will fit your employees’ needs and budgets, as well as your own. But what’s best? HMO, PPO, POS, HDHP? Wading through this alphabet soup of acronyms can be daunting. Health Maintenance Organization (HMO)
A Health Maintenance Organization (HMO) is a managed care plan that provides cost savings and structure. Members only choose hospitals and providers in the network and must have a primary care provider who will manage all of their care and provide referrals. Preferred Provider Organization (PPO)
A Preferred Provider Organization (PPO) also is a managed care plan. Members choose a doctor, hospital or other health care provider from the PPO network to get a discount, but the network is usually large so members have a lot of choices. Members also can see providers who are out of network, but they will pay a higher cost. Some PPOs also have a deductible. Exclusive Provider Organization (EPO) An Exclusive Provider Organization (EPO) plan gives members the flexibility of a PPO with the cost-savings of an HMO. Point-of-Service (POS)
A Point of Service plan is an HMO/PPO hybrid. Members have more in-network choices similar to a PPO, and they can see physicians and hospitals out of network if they’re willing to pay more. However, they must designate a primary care physician, as with an HMO. That physician will make referrals to network specialists if necessary. High-Deductible Health Plan (HDHP) A High-Deductible Health Plan (HDHP) is similar to catastrophic coverage. Members pay a low premium. An HDHP is combined with one of the health plans — HMO, PPO, EPO or POS — and the choice of providers is dependent on the plan. Because HDHP members have higher out-of-pocket costs, employees are encouraged to have Health Savings Accounts (HSA) to help pay for care. The maximum contribution to an HSA in 2017 is $3,400 for individuals and $6,750 for families, and for 2018 rises to $3,450 for individuals and $6,900 for families, but the money is not taxed |
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Your EEOC Responsibilities as an Employer What to Look for Before Signing a Group Health Plan Contract What Type of Group Health Plan is Right for Your Company? Why You Should Consider Re-Enrolling Your Employees in Their 401(k)
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