| PPO
- Preferred Provider Organization |
| This is a
network of doctors and hospitals
that has agreed to accept a
discounted fee for their services
from the plan. It just may be the
plan for you if you like the freedom
of choosing your own doctor and
hospital and are willing to pay some
of the costs. Some basics include: |
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You may go to any doctor in
the network at any time
without a referral,
including all specialists. |
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You may go out-of-network
"at will" to any top
specialist for your serious
problems. |
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A co-pay at doctor's office
of $15 - $45. |
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No claim forms or paperwork. |
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Prescription coverage is
included. |
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| HMO
- Health Maintenance Organization |
The
most controlled type of plan as you
must use the HMO's doctors and
facilities. Medical care outside the
system is not covered. Some
basics include:
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Lower out-of-pocket costs.
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Lower deductibles and plan
limits. |
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Low
cost doctor visit co-pays of
$15 - $45.
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No
paperwork or claim forms.
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POS
- Point Of Service
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| This plan
combines some of the features
offered by HMO and PPO plans. A
network of providers is included in
the plan. If you outside the network
only partial coverage is provided
and a deductible may apply.
Some basics include: |
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A primary care physician is
selected.
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Preventive care visits
are covered. |
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Non-network services cost
more. |
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| HSA - Health Savings Account |
Health
savings accounts or HSA's were
developed by the government to help
provide low cost health insurance
for both groups and self-employed
persons. HSA's are one of the most
favorite California health insurance plans
for those who are
self-employed.
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According to the IRA...an HSA is a
tax - exempt trust fund or some
refer to it as a custodial
account. Either way, they are
created simply and only for
the purpose of paying specified medical expenses
of the beneficiary who is at the
same time covered under a high
deductible health plan (HDHP).
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In simpler
language, a health savings account (HSA)
is like a bank account that works
with your health plan. As money is
added to your account, you can use
it to pay for most health care
expenses, as they are included
within the HSA as health savings
account eligible expenses.
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Examples of
what might be considered health
savings account eligible expenses
are the money you may need to pay
before your individual health plan
begins to make payments - called
deductible - or medical expenses not
covered by your health plan such as
dental, counseling, etc.
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If you
don't need all of the funds in your
(HSA) health savings account, what
is left over rolls over to the
following year acquiring tax-free
interest. No money is
lost.
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HSA
accounts belong to each employed or
self - employed individual. They are
not a plan that would be obtained
by an employer ... although employers may
add funds to an HSA.
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*Note: An
individual who contributes an
initial $1,000 each year and makes
catch-up contributions can
accumulate $23,000 after 10 years,
$47,000 after 20 years, $81,000
after 30 years, and $127,000
after 40 years.
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| HRA
- Health Reimbursement
Arrangement |
| A Health
Reimbursement Arrangement or HRA is
an employer funded account, not
pursuant to a salary reduction
election, that provides tax-free
reimbursement to employees for
qualified medical expenses.
The HRA Is Right For Employers: |
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Are their health priorities
on preventive care,
prescription coverage or
coverage in case of
emergencies? |
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Who wishes to establish a
bonus contribution for
participating in smoking
cessation programs. |
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Who wants the most control of
the plan. |
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Who want flexibility in plan
design. |
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Who can handle compliance
and issues of
substantiation. |
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Who wishes to save money and
improve employee retention
and health. |
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Who wants a lower cost plan. |
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Are they already covered
under a spouse's policy? |
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Insurance Advisors is here
to personally meet with you and
identify and implement the carrier
with the best California group
health insurance plan for both you,
the employer, and all of your
employees.
Companies
with employees are now able to offer
benefits that are competitive with
the larger companies. You can keep
great employees and attract new
talent to your small business with a
group health insurance plan tailored
for you.
you
have a California business, send us
a list of all your employees. We
will contact you with our group
insurance recommendations.
Click
Here For Census/Quote Form |
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