GROUP HEALTH INSURANCE
Comparison Table, HMO, POS, and PPO
The table below compares the three types of insurance discussed in this section on several important and distinguishing features. However, it should be noted that the lines between these plans have begun to blur in recent years. For example, your provider may offer an HMO plan with fewer restrictions, so that it resembles a POS plan. This table is simply meant to be a guideline of the features generally considered typical for each type of plan.
|Choice of Health Care Providers||Typically more restrictive than other plans, with no coverage for out-of-network providers or specialists seen without referral from primary care physician.||Financial incentives to use primary care physician and get referrals to other network providers.||Financial incentives to use network providers. Usually no primary care physician needs to be selected|
|Preventive Care||Typically covered.||Typically covered.||Sometimes covered.|
|Prescriptions||Typically covered.||Typically covered.||Sometimes covered. Often available as coverage for a higher premium.|
|Out-of-Pocket Expenses||Typically lower than other plans, but no coverage for out-of-network providers or providers seen without a referral.||Mid-range. More expensive when an out-of-network or self-referred network provider is used.||Typically higher than HMO or POS, but lower than traditional fee-for-service plans. More expensive when an out-of-network provider is used.|
|Premiums||Typically lower than other plans.||Typically higher than HMO plans.||Typically higher than HMO or POS, but lower than traditional fee-for-service plans.|
|Paperwork||Relatively insignificant.||May be more significant when an out-of-network or self-referred network provider is used.||May be more significant when an out-of-network provider is used.|
Want to know how to reduce your company's taxable income?
Employers can now reduce their FICA payroll by allocating money to a flexible spending account. There are numerous plans offered, allowing its members to set money aside on a pretax basis to reimburse various expenses, ranging from uninsured medical expenses to reimbursing work-related parking expenses. These flexible spending accounts, which are available upon request from J & S Coverage, Inc., are a great benefit in terms of pretax savings.
Here is a partial list of the health care providers we offer at J & S Coverage, Inc.: Oxford Healthcare, Blue Cross Blue Shield, Horizon Healthcare of New York, HIP, Health Plus...etc