Group Health Insurance Plans Through Your Employers
2006-01-23
Group health insurance at one time was viewed as a perk to recruit highly skilled employees for a company. Now it has become a necessity in the work place and is considered a vital part of any hiring package.
There are three basic types of coverage to consider as an employer:
Preferred Provider Organization or PPO is a mix between the benefits of a Health Maintenance Organization and an Indemnity plan. In a PPO health plan, the patient is limited to a network of service providers and must pay a co-payment. Unlike a HMO, their primary care doctor or other specialist in the network may refer a patient to an out-of-network physician.
The well known HMO or Health Maintenance Organization. This type of medical insurance is based on a network of doctors who agree to accept the insurance at pre-determined billing rates. This type of medical coverage usually includes variable co-payments for office visits, hospital visits and prescriptions.
Indemnity. Indemnity insurance allows users to visit whichever health care provider they choose. Instead of a co-payment, visiting patients must pay the actual expense out of pocket until they have spent a total equal to their annual deductible. Once the deductible is reached, the indemnity insurance begins coverage. Most indemnity insurance limits what they will pay to what they consider ordinary and customary fees.
When considering a health insurance company it is important to review the information regarding their available plans. Be sure to review their monthly fees per plan for both individual coverage and family coverage, including co-payment fees.
You will want to ask about insurance pooling, where overall fees are based on the average expenses of the pool members. If your organization is placed in a pool that traditionally has below average medical coverage use, then the rates for that pool may be less than those in another insurance pool.
Also, inquire about what kind of discounts are available to your organization if you potentially have many employees that will subscribe to the coverage.
Many independent insurance representatives will be glad to do a value comparison of the major medical insurance companies and the plans they offer, helping you to make an informed decision. Utilizing the services of an insurance professional can save you time and money.
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