In a group insurance the employees are provided insurance coverage by their employers. Insurance policies are very affordable these days and providing coverage is easier than ever. Insurance policies are provided at a discount and its cost is spread out among all of the employees in the company. Mostly group coverage is less expensive when compared to individual health insurance policy. Some of the benefits of this type of insurance is it can boost the morale among the employees. Two types of Group health insurance are comprehensive and consumer directed. Comprehensive group Health plans are Preferred provider organization, Health Maintenance organization and Point of service plan. Consumer directed group health plans include Health savings account (HSA) plan and Cafeteria plan.
Preferred Provider Organization encourages you to use a family doctor, specialist or other provider from within Preferred Health care’s network of providers. Members can also choose from non-network provider. If you choose a network provider, you will receive the maximum level of coverage. But if you choose to use a non- network provider, you are responsible for the portion of the provider’s charges which exceeds the plan’s allowed amounts, plus the deductibles and coinsurance. The benefits that it includes are inpatient and outpatient hospital services, Maternity care, Infertility treatment etc.
In a Health Maintenance Organization one must choose a primary care physician from a list of participating doctors. You can visit doctors only within the HMO network. HMO health plans have lower health premiums for both the employee and the employer. Because of the lower cost, these plans are very attractive and a large amount of employees will choose them. Another monetary advantage is there is no deductible for the patient. The only thing that is required is the prescribed co-payment for services that may run between $15 and $20 a visit.
Point of service (POS) plan is a combination of HMO and PPO. These are called as ‘open ended HMO’ or ‘open ended PPO. A point of service plan is a managed care program that provides different benefit levels for in-network and out-of-network services. All services must be rendered or referred by a primary care physician (PCP) to be considered in-network, except specified self referral services, such as routine eye examinations, routine maternity services and annual gynecological exams. Each participant must select a network primary care physician to act as the patient’s medical care manager. In this way, PCP can direct the patient to the most appropriate type of service for a given condition.
In a group insurance all the policies cover emergency and routine medical procedures such as regular doctor’s appointments and hospital treatment for accidents. But group insurance may or not cover employee’s spouse or dependents. Some other benefits include vision care or dental work, and mental health. Prescription drug expenses often fall under group insurance benefits. Many employees see group insurance coverage as a major perk for faithful company service.
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