GROUP HEALTH INSURANCE OPTIONS
If you have 50 or more full-time employees, it’s crucial to comply with the Affordable Care Act by offering a group health insurance plan or risk facing a penalty of $2,500 per employee per year. Providing group health insurance not only helps you meet your legal obligations but also demonstrates your commitment to the well-being of your employees.
At Jayroe & Associates, we understand that navigating the complexities of the ACA can be challenging. That’s why we offer comprehensive support to help you understand the regulations and choose the best health insurance plans for your business and your employees. Our team of experts works with top US insurance providers to offer affordable and customizable coverage options that meet the unique needs of your workforce.
With our help, you can ensure that you are providing the best possible group health insurance for your employees, fostering a more productive and satisfied workforce.
TYPES OF INSURANCE PLANS
HEALTH MAINTENANCE ORGANIZATION (HMO)
HMOs give you a local network of providers to choose from. You will select an in-network provider, and they coordinate your care and give you a referral to another in-network specialist if needed. The copays and coinsurance are typically lower than other health plans as long as you stay in-network.
EXCLUSIVE PROVIDER ORGANIZATION (EMO)
EPOs offer a network of participating providers, but they do not include coverage for out-of-network care except for emergencies. If you visit a provider outside of the local network, you will most likely have to pay the full cost of service. However, you do not need a referral from a primary care provider to see a specialist.
POINT OF SERVICE PLAN (POS)
These plans combine HMO and PPO plans. The provider network is generally smaller than a PPO plan, and the costs for in-network care are usually lower, like an HMO. With a POS plan, you have to choose a primary care provider. You are required to get a referral for a specialist. However, you can also see specialists in-network and out-of-network, but if you see an out-of-network provider the costs are higher and you must file any claims yourself.
PREFERRED PROVIDER ORGANIZATION (PPO)
PPOs offer a large network of providers, including doctors, hospitals, and other providers. You can also see providers out of the plan’s network, but you will pay more out of pocket. You are not required to have a primary care provider, and you can see specialists without a referral.