As a small business owner, you can choose to offer a few different options. Whether you only plan to offer one type of insurance plan, or if you're thinking about offering a few, it's important to know the specifics of each plan. Offering a few different plans is a valuable benefit for your employees, since health insurance is not "one size fits all". Some employees may enjoy the low premiums of a high deductible plan, while others are more interested in plans with few copayments and a low deductible.
It's important to keep an open mind, and consider all of your employees when looking at what type of group health insurance is right for your medical practice office. You should also pay close attention to the details of each plan you're considering. Each plan has its own terms and limitations, so be sure to check the official plan documents to understand how that specific plan works. This guide is only for general education, so be sure to look at the official plan documentation for any specific plan you may consider.
Health Maintenance Organization (HMO) plans offer a wide range of health care services through a network of providers that usually have a contract to work with the HMO. These providers are called "in-network". Some important details about an HMO include:
A Preferred Provider Organization (PPO) is an organization that works with a set of preferred healthcare professionals. When you visit preferred doctors or hospitals, your services will likely be paid at the highest level of coverage. With this plan, you may also have more flexibility with going out-of-network as long as you don't mind paying a little extra out-of-pocket. Some important details of a PPO plan include:
EPO stands for "Exclusive Provider Organization." EPO plans are similar to PPO plans but may be somewhat more restrictive when it comes to your network of doctors and hospitals. EPO plans typically do not provide you with coverage outside your network, except in emergencies. EPO plans are becoming more popular with health insurance shoppers, and health insurance companies are offering more of them as well. You're generally not required to select a single primary care doctor with an EPO plan.
HDHP plans are usually similar to PPO plans, but with higher deductibles, designed especially for use with Health Savings Accounts ("HSAs"). An HSA is a special bank account that allows you to save pre-taxed money to be used specifically for medical expenses. Money that you and your employer contribute to an HSA rolls over every year and can also earn interest, so if you end up not spending the money put in your HSA, you get to save it. By pairing a qualifying high-deductible health plan with an HSA, participants can save money on health care and earn a tax write-off.
Each plan has its own terms and limitations, so be sure to check the official plan documents to understand how that specific plan works. This article is only for general education.