Spring offers Health Maintenance Organizations (HMOs) and Preferred Provider Organization (PPO) plans. All of these plans offer maximum benefits for services rendered by contracted providers and some also offer reduced benefits for services rendered by non-contracted providers. Additionally, all plans available through Spring Insurance Group, provide emergency coverage worldwide.
All of the health insurance plans offered by Spring are guarantee-issue plans. Groups can implement a policy on the first day of each month with no medical questionnaires and no pre-existing condition clauses. New groups, however, are required to show plan specific business documentation, such as tax returns, to verify that they are eligible for group coverage.
How do you know which plan is best for your office? Here are some key points to keep in mind:
Health Maintenance Organization (HMO)
An HMO is generally the most popular and the least expensive healthcare option of the three major types of plans. With an HMO, members are required to select a primary care physician (PCP) from a network of contracted physicians. A PCP is one who takes care of routine medical needs, such as checkups and basic prescriptions. In addition, a PCP issues referrals to specialists, who are also contracted physicians. Members of an HMO will not receive any benefit for services received from a non-contracted physician. Members of an HMO have nationwide emergency coverage; however, they must notify their HMO within 48 hours of their situation.
Preferred Provider Organization (PPO)
PPO plans offer members more flexibility with slightly higher premiums than an HMO. They allow members to receive care from either contracted or non-contracted physicians at their discretion without the need for a referral from a PCP. PPO plans provide members with a financial incentive to receive care from contracted physicians by offering small co-payments for such services. Services from non-contracted physicians are typically subject to a deductible and coinsurance. Coinsurance does not typically begin until the member has satisfied any applicable deductibles.
Health Savings Accounts (HSA)
A high deductible HMO or PPO plan coupled with a tax-free savings account make up this increasingly popular consumer directed plan.