Employer-based Coverage
Hotel Associates, LLC can secure an individual or group health insurance policy issued by Aetna, Blue Cross Blue Shield, Humana and, Priority One. To request a quote
click here and you will be contacted within 24 hours.
If available, most people choose group health insurance coverage
through an employer because frequently the employer helps offset some of
the premiums costs. Some group plans may behave other benefits that are
not available with individual insurance, such as no waiting period, no
physical requirements, or lower rates. Employees contribute anywhere
from 10 to 60% of the premium cost.
Types
There are three main types of group health insurance plans: the
health maintenance organization (HMO), preferred provider option (PPO)
and point of service plans (POS).
- HMO Plans
In an HMO, each person must choose a physician from the network to serve
as a primary care physician. In order to meet with another physician or
specialist, the primary care physician must make the referral. In all
likelihood, those going out of network or failing to get prior approval
before seeing a specialist will not have any benefits paid. - PPO Plans
These group plans also have network restrictions, but do allow the
patient to go outside the network. If the patient goes out of network he
or she will usually pay a higher rate than if the 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. - POS Plans
Point of service plans fall in the middle between the HMO and PPO. The
patient is incentivized to stay in the network with better benefits or
convenience. For example, if a patient visits a doctor or receives a
service outside the network, he will have to submit his own paperwork
and might be required have to pay up for the services and then get
reimbursed by the insurance company.
Costs
Generally an HMO is the least expensive plan because it is the most
restrictive. At the other end of the spectrum is the PPO because it is
the most flexible. POS plans usually fall somewhere between HMOs and
PPOs in terms of overall cost.
Choice
In some cases, there will be no choice. An employer or group may only
offer one type of plan. In cases where both types of plans are offered –
usually HMO and PPO – the employer requires different premiums.
Overall, any health plan is generally considered better than not having
one at all.