| Types Of Plans
'Preferred Provider Organization' (PPO) plans help reduce insurance premiums by reducing medical costs. Physicians and hospitals join a PPO Network and agree to accept reduced fees for their services.
'Health Maintenance Organizations' (HMO's) help reduce medical costs by providing a select group of physicians and hospitals for patient use; use of the providers in an HMO's network results in quality services at minimum costs. Some HMO's (like Kaiser) provide their services at fixed locations; their patients have the convenience of 'one-stop service' for all of their medical needs.
P. O. S. Plan is a combination of the PPO & HMO Plans.
HSA - Health Savings Account is a compatible plan that can be used in conjunction with HDHP (High Deductible Health Plans) as defined by the I.R.S. These allow great savings in premium, flexibility for employers to fund HSA account considering the savings and tax savings for both employer and employees, while purchasing comprehensive medical insurance.
Recent Changes in Health Plans
Composite vs. Age-Rated Plans: As the result of many new laws, most health plan providers have changed from a 'composite' premium system to 'age-rated' or 'age-banded' plans for firms with less than 50 employees. Under the old composite system, all insured were charged the same premium rate, regardless of age. Under the new age-rated plans, premiums are charged according to the insured's age.
Primary Care Physician Concept: To help reduce ever-increasing medical costs, most HMO providers now ask their insured's to designate a 'primary care physician' (a 'PCP') for each member of their family.
Standard Risk Rates & Surcharges: California health plan providers are now required to designate the 'standard risk rates' ('SRR') they charge for various health plans. These rates may be decreased or increased ('surcharged') up to 20% depending on an insured's medical history, an employer's business classification, and other factors.
|
