Group Medical

Traditional Health Plans typically consist of the following:

Preferred Provider Organization (PPO)
When you or a family member need medical care, the PPO encourages you to use a family doctor, specialist or other provider from within their preferred network of providers. You also have the choice of using a non-network provider utilizing the out-of-network discounts.

Point of Service (POS)
Simular to a PPO, the POS also encourages you to use a family doctor, specialist or other provider from within their preferred network of providers. You also have the choice of using a non-network provider utilizing the out-of-network discounts.

Health Maintanence Organization (HMO)
With HMO coverage, you receive your health care from a network of health care providers. You typically do not have access to services outside of the network at a discount. Most HMOs no longer require a "referral" to see anyone outside of your primary doctor.

Alternatives to Controlling Costs:

Health Reimbursement Arrangements (HRAs) are funded with employer dollars to pay expenses not covered by another health plan. An employer can opt for its HRA to pay some or all of the health expenses allowed by the IRS. For example, an HRA could pay all eligible medical expenses, including premiums for health and long-term care insurance; or the HRA could be limited to cover only dental or vision expenses. Although an HRA can have an option to carry forward unused funds to the future or for retirement, an employee cannot take their HRA funds to a new employer. This is a unique way to fund health costs while controlling increases in cost to the employer.

Health Savings Accounts (HSAs) allow employees to set aside a portion of their paychecks (before taxes) into an "IRA-like" custodial account to pay expenses not covered by another health plan. To contribute to an HSA, the employee must also be covered by an IRS-qualified high-deductible health plan. Employers may contribute to employees' HSAs. Unlike FSAs, unused funds can be carried forward to the future. HSAs are also portable and can be taken to a new employer or used at retirement.

Flexible Spending Accounts (FSAs) allow employees to set aside a portion of their paychecks (before taxes) into an account to budget for expenses not covered by another health plan. The participant can use the account to pay for over-the-counter medicines, co-pays at the doctor or pharmacy, chiropractic, eyeglasses, contacts, LASIK, orthodontics and more.

 

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