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Group Health Insurance Options

HMO – Health Maintenance Organization

Group Health Insurance Photo

A health maintenance organization (HMO) provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals and other entities and acts as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. Some features of most HMO plans include:

  • Each member selects a Primary Care Physician
  • The PCP ‘manages’ the member’s healthcare and refers the member to a specialist within their contracted medical group
  • No out-of-network benefits except in the case of a true emergency

PPO – Preferred Provider Organization

A preferred provider organization (sometimes referred to as a participating provider organization) is a managed care organization of medical doctors, hospitals, and other health care providers who have contracted with an insurer or a third-party administrator to provide health care at reduced rates to the insurer’s or administrator’s clients. Some of the benefits of a PPO are:

  • Members do not select a Primary Care Physician
  • The PPO plan design has two levels of benefits
    • In-Network
    • Out-of-Network
  • The member can go to any provider within the health plan’s PPO directory of services
    • The member pays less when utilizing the health plan’s PPO directory for services
    • The member pays more when utilizing non-contracted physicians

HSA – Health Savings Account

A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. A health savings account works like this:

  • Works with high-deductible health plans that can reduce monthly insurance costs
  • Member owns the account
  • Money saved by the member is deposited into an HSA and used for qualified medical expenses
    • Member’s savings grow tax free
    • Compounds interest year after year

Whatever you group health insurance needs, let Amorosi Insurance develop an ideal plan for you.