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Health Insurance Plans

Group health insurance is the employee benefit most valued by your employees. Most health plans cover doctor office visits, hospitalization, emergency room care, prescription drugs and a number of other medical conditions. Coverage is available to companies and individuals.

How to Choose a Health Plan that's Right for You?

First, determine what your needs and preferences are. Here is a list of questions you may want to ask yourself:

Do I want a high, low or no deductible plan?
Do I want a plan with prescription drug service?
Do I want the freedom to choose my own doctors and hospitals?
Do I want to be covered when and where I travel?
Once you have decided what you want in a plan, you may pick and choose what plan best suits you. There are basically three kinds of plans:


Indemnity -- The traditional plan also known as fee-for-service. It allows you to choose your own doctors and hospitals. After a deductible, the plan usually pays a certain percentage (e.g. 80%) of your claims until a maximum out-of-pocket expense is reach (e.g. $2,000). It then pays 100% up to the plan's maximum.


PPO -- Preferred Provider Organizations have negotiated special rates with doctors and hospitals. This allows them to pass on the savings to the insured in the form of lower premiums. The insured may also benefit by virtue of paying smaller co-insurance amounts if they use in-network doctors and hospitals. You may still choose your own doctors and hospitals. Your benefits will, however, be greater if you use "in-network" doctors and hospitals.


HMO -- Health Maintenance Organizations provide a wide range of comprehensive health care services using a network of doctors and hospitals. Care is provided often without a deductible and a low doctor visit co-pay. Unlike PPO's, however, they do not allow out-of-network services except in the case of an emergency. A primary care physician will determine the necessity to refer the patient to a specialist.

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