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Types of health insurance for small businesses

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Types of health insurance for

small businesses


• There are 4 key types of health insurance that

small businesses can choose from:

o PPO plans,

o HMO plans,

o HSA-qualified plans and

o Indemnity plans.

• Here are some of the pros and cons of each

type of plan.

thebenefitadvisors.com


PPO (preferred provider organization)

plans

• PPO plans are the foremost common sort

of insurance .

• Employees covered under a PPO plan can

choose either in-network or out-of-network

doctors or hospitals, but selecting from

the insurance firm 's list of preferred providers

leads to the insurance company covering a

bigger percentage of every claim.

thebenefitadvisors.com


• Pros:

o A PPO plan allows participants to hunt care

from doctors, hospitals and specialists both

within and out of doors the network, and

participants aren't required to settle on a PCP.

o PPOs cover a good range of services, including

preventive care, hospitalization and emergency

care, medications, outpatient surgery and

specialist treatments.

o These plans follow participants wherever they

are going , meaning they will seek medical

aid albeit they're traveling and be covered.

thebenefitadvisors.com


• Cons:

o With a PPO plan, participants are liable for a copayment

of around $10 to $15 any time they visit

an in-network doctor, and co-pays are higher if

they visit a doctor outside the network.

o For some categories of service, participants must

also meet an annual deductible before the plan

pays for those services.

o Plan participants are liable for filing their own

claim paperwork if they visit a doctor outside

their network, which may be a hassle.

thebenefitadvisors.com


HMO (health maintenance

organization) plans

• HMO plans offer a wide range of healthcare

services through a network of providers that

are exclusively contracted with the HMO or

that agree to provide services to members.

• Employees who are on this type of plan

generally must select a primary care physician

who will provide the majority of their care and

will refer them to a specialist if needed.

thebenefitadvisors.com


• Pros:

o A primary care physician can be an excellent

medical resource, since they get to know the

plan participant, their medical history and

their health goals through consistent care.

o HMOs tend to offer lower-cost healthcare

because they only cover in-network

treatment and can negotiate lower prices

with their provider networks.

thebenefitadvisors.com


• Cons:

o You must choose doctors and facilities

within the HMO network.

o Participants must get a referral from their

primary care physician before seeing

another doctor, even for routine care.

thebenefitadvisors.com


HSA-qualified plans

• HSA-qualified plans are PPO plans designed

specifically to be used with health savings

accounts (HSAs).

• An HSA is a bank account that allows

participants to save pre-tax money specifically

to be used for future medical expenses.

thebenefitadvisors.com


• Pros:

o The No. 1 advantage of an HSA is its triple tax

benefits: Participants contribute to their HSA

with pre-tax dollars, pay medical expenses

with pre-tax dollars and earn compound

profits tax-free.

o Any unused balance in an HSA automatically

rolls over year to year, so participants don't

lose their money if they don't use it in a given

year.

thebenefitadvisors.com


• Cons:

o To be eligible for an HSA, participants must

have a high deductible health plan (HDHP)

with a deductible of at least $1,350 for single

coverage or $2,700 for group coverage.

o The high deductible of HSAs may lead

participants not to seek medical care when

they need it.

thebenefitadvisors.com


Indemnity plans

• Indemnity plans allow members to direct their

own healthcare and visit any doctor or

hospital they want.

• The insurance company pays a set portion of

the total medical charges.

• Employees may be required to pay for some

services up front and then apply for

reimbursement from the insurance company.

thebenefitadvisors.com


• Pros:

o Indemnity plans give a cash payment to the

member in the event of a qualifying incident,

like an accident or a critical illness, which

means quick and easy money to cover

medical costs.

o Some indemnity plans may include additional

wellness benefits, such as telemedicine, so

that members can access medical care 24/7

at no additional cost.

thebenefitadvisors.com


• Cons:

o Members with pre-existing conditions

likely won't be covered within the first 12

months of coverage.

o Indemnity plan benefits are tied to

particular incidents, such as admission to

the hospital or a doctor visit, so they don't

provide comprehensive coverage.

thebenefitadvisors.com


Independent Benefit Advisors

• The Independent Benefit Advisors are here to listen

and help you find the right group employer health

insurance plan for your small, mid-size, or large

company that is headquartered in NC.

• We serve the entire state including, but not limited

to: Raleigh, Charlotte, Greensboro, Wilmington,

Asheville, Fayetteville, and everywhere in between.

• Contact us today to find out how we can help

make employer health insurance NC plan benefits

uncomplicated and straightforward for your

company.

thebenefitadvisors.com


Contact Us

Address: 1121 Pemberton Hill Rd,

Apex, NC 27502

Phone: (919) 303-9690

Toll Free: (888) 303-9690

Fax: (919) 303-9691

ID: john@thebenefitadvisors.com

Website : Thebenefitadvisors.com

thebenefitadvisors.com


(919) 303-9690

(888) 303-9690

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