| Here are
a few of the popular types of group health insurance
plans:
Preferred Provider Organizations (PPO)
- In this type of plan, the plan provider has
arrangements with hospitals and physicians (the
network) to provide coverage for the employee
at a reduced cost. A co-pay is usually required,
and even if an employee chooses to see a physician
out of the network, the plan will usually cover
a portion of the cost.
Health Maintenance Organization (HMO)
- This plan provides a network of hospitals
and physicians similar to the PPO, but this
plan is different when it comes to the amount
employees are required to pay. Often, there
is no co-payment required (or a very minimal
payment required). However, if an employee sees
a physician out of the network provided by the
HMO, the employee would likely pay 100% of the
cost.
Fee-for-Service Coverage -
These plans allow the employee to see any physician
or hospital and receive partial payment. Most
companies offer an 80/20 plan which translates
to the plan paying 80% of the bill and the employee
paying 20%. Like with most plans, only services
that are considered medically necessary and
specified in the plan are covered.
The most important point to remember when considering
these plans is to work with an experienced agent
that can provide options from several different
insurance companies. And don't forget to ask
about the financial strength of the companies
you're considering. While the benefits provided
by the plan are important, if the company providing
the plan is financially distressed, it might
not be able to meet its obligations when you
need them.
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