Group Health Insurance
Our goal at Georgia Health Insurance is to provide your company with the best possible
plan to fit your specific needs and budget while at the same time making it as easy to administer
as possible. We have a tool we call our
Health Benefit Portal that we will create specifically
for your company. This tool will make your plan “user friendly” which means your employees will
be more self-sufficient in handling their own insurance. Be sure to take a look at our
demo of this portal.
In looking for a group health insurance plan there are many things to take into
consideration. An employer can take several steps to help control their company’s health care
cost. CoPays and Type of Plan are major
areas of interest when buying insurance.
CoPays - This is one area where mistakes
are often made. How low of a CoPay should you buy?
If you purchase a plan with a low office visit CoPay you run the risk of encouraging
unnecessary trips to the doctor. The
renewal rate of a group health plan is based partially on usage of the plan. It is only human nature that people
will tend to overuse doctors if they know it will only cost them a small amount
($20, for example). However, if they
had to pay more for that same trip to the doctor, they may be more likely to avoid
unnecessary office visits.
Type of Plans - (Your service area may
dictate what types of plans are available in your area.)
PPO (Preferred Provider Organization) - This type of plan gives you the strongest
benefits in a large network of doctors, but will cost more in premiums. In many instances
you can use that same large network of physicians plus the smaller HMO network in
a less expensive POS plan with dual benefits.
POS (Point Of Service) - This type of plan is a cross between an HMO plan and a
PPO plan with the best of both worlds combined. A POS plan utilizes two different networks
of physicians with two sets of benefits.
There is a smaller network, which is really the HMO network and then there is the
PPO network. With these plans, the
member is encouraged to see a physician in the smaller network by providing stronger
benefits such as a CoPay and possibly 100% co-insurance. A referral is usually required to see a doctor other than your primary care
physician, gynecologist or dermatologist.
But now, many health insurance carriers offer plans that do not require a referral
as long as you still see a doctor that is in the HMO/POS network. In a POS plan, you have the option to use the larger PPO network,
but the benefits are not as strong because there is no CoPay for office visits (it
is deductible instead) and co-insurance applies (which is often 60%).
HMO (Health Maintenance Organization) – This is the most restrictive type of plan. It is important
to note that coverage is only provided if you use a doctor in the HMO network, unless
you are in a life or limb-threatening emergency.
Referrals are required in most cases to see a doctor besides your primary
care physician. |
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