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