Health Coverage Options
for the Entire Family

Preventative Plans

At every stage of life, preventive health services hold the promise of improving American lives, making us healthier and more productive. The promise of prevention stems directly from medical results. It is a proven fact that many types of disabilities and diseases which lead to premature deaths in the United States could have been potentially avoided or controlled through early detection. Adults with multiple risk factors for disease (high blood pressure, smoking, and sedentary habits ) are more likely to experience higher healthcare use, absenteeism, disability and lose their overall productivity. On the other hand, healthy employees – and especially those with healthy families – are likely to incur lower medical costs and be more productive.

HMO Plans

With most HMO plans, all of your healthcare services will be coordinated between you and your designated Primary Care Physician (PCP). As an example, with an HMO, if you have severe allergies and need to see an allergist, you will first schedule a visit with your PCP. Your doctor will then provide you with a referral for an in-network specialist. Since HMOs only allow you to see in-network providers, it’s likely you’ll never have to file a claim. This is because your insurance company pays the provider directly.HMO plans typically have lower monthly premiums and you can expect to pay less for out-of-pocket medical services. Both plans work on a combination of deductibles, cost-share or co-insurance and co-pays to pay for services.

PPO Plans

A PPO plan does not require you to select a PCP. You can receive care from any doctor you choose, however you will save more money by choosing a doctor, specialist or hospital that is within your network. PPO plans do not require you to get a referral in order to see a specialist. With a PPO, you have the flexibility to visit providers, hospitals and facilities outside of your network. Keep in mind that visiting an out-of-network provider includes a higher fee and a separate deductible. In some cases with a PPO, you will have to pay a doctor for services directly and then file a claim to get reimbursed. This is most common when you seek a service from an out-of-network provider. PPOs tend to have higher monthly premiums in exchange for the flexibility to choose providers both in- and out-of-network and without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

High Deductible Health Plan (HDHP)

A plan with a higher deductible than a traditional insurance plan. Usually the monthly premium is lower, but you have to pay more health care costs yourself (your deductible) before the insurance company starts to pay its share. A high deductible plan can be combined with a health savings account or a health reimbursement arrangement. This allows you to pay for certain medical expenses with untaxed dollars.
The IRS defines a high deductible health plan as any plan with a deductible of at least $1,300 for an individual or $2,600 for a family.

Avoid The Penalty​​

Make sure you are covered in 2017 to avoid a fine. The penalty for not having health insurance in 2017 will be $695 per person or 2.5% of your household income, whichever is greater. Open enrollment begins November 1, 2017 and ends December 15, 2017.