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Medical Plans
Health Plan Types and Characteristics:
Fee-for-Service:
Health coverage that reimburses health care providers for services for employees. Tends to be the most costly for employers.
Health Maintenance Organization (HMO)
Covers services performed solely by providers in a network. This tends to be a low cost system, but is more restrictive than other plans.
Preferred Provider Organization (PPO)
Has a network of providers, but also allows use of medical providers outside of the plan’s network (typically with greater employee cost-sharing). Referrals may not be required. Is more flexible than an HMO, but also more expensive generally.
Point-of-Service Plan (POS)
Plan combines elements of an HMO and PPO. Each time employees need health care, they can choose how it will be received. If an employee initially sees a PCP and stays in-network, then more substantial benefits will be received versus not seeing a PCP first.
Consumer-Directed Health Plan (CDHP)
A high deductible health plan paired with a tax-advantaged account to pay for medical expenses. The most prominent options are Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) used in conjunction with savings accounts.
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