Group Health Insurance
Group heath Insurance | heath Insurance | medical Insurance | Obama Care | Dallas Tx
Group insurance is a health care coverage plan in which individual employees or members are included under one ‘master policy’ owned by their employers. Because the group insurance plan has so many contributors, the policy often provides coverage for more services at a much lower cost per participant. Group insurance may be provided by other organizations besides for-profit companies. Labor unions, churches and other service groups can also obtain group insurance for recognized members and possibly their dependents.
Three main types of group health insurance plans and a number of other plans with smaller following are on the market. These plans include the health maintenance organization (HMO), preferred provider option (PPO) and point of service plans (POS). Each has some advantages and disadvantages, many of which come down to a personal preference.
Individual members of a group insurance plan receive insurance certificates which demonstrate their eligibility for benefits. If the master policy held by the employer requires participation in a Health Maintenance Organization (HMO), then individuals are also registered as members. Other group insurance policies may be associated with major medical groups such as Blue Cross/Blue Shield. A major medical policy may or may not restrict an individual’s choice of primary physician and specialists. HMO policies often require a patient to use a specified physician, who must approve any visits to eligible specialists.
PPO group health insurance plans have network restrictions, but also allow the patient to go outside the network. In such cases, the patient usually pays a higher rate than he would normally pay if services were provided inside the network. Also, PPO plans usually do not require designating a primary care physician or receiving a referral before seeing a specialist.
Point of Service plans try to provide a middle ground between the HMO and PPO. The overall goal is to keep the patient in the network by providing incentives. These incentives may be better benefits or convenience. Often, people seeking service out of the network will have to submit their own paperwork and may even have to pay up front for the services and get reimbursed by the insurance company.
So, what plan should you chose? Overall, any health plan is generally considered better than not having one at all. Can you afford to pay out-of-pocket for a hospital visit? Call Choice Plus Benefits today.