Plan Types

Articles

What are my plan options?
A high-level explanation of plan types (PPO, HMO, POS, and EPO)
High vs Low Deductible Plan
Which health plan is best, and how much will it cost?
How to Compare Plans
When you have multiple health plans to choose from, most decisions are driven by three questions.
Who can I add to my health plan?
Generally, coverage is offered to an employee's legal spouse and dependent children. The ACA extends coverage until a child turns 26.
Do I have to enroll in healthcare benefits?
Through the end of the 2018 tax year, all Americans are required to have medical insurance. This is commonly called the "individual mandate".
Open Enrollment: Active vs Passive
Open enrollment is an annual period when you can sign up for or change your health insurance plan or benefit program.
The Importance of Staying In-Network
Using "in-network" doctors and service providers will keep your costs down.
10 Tips to Reduce Your Healthcare Costs
Consider the following tips--they could reduce your out-of-pocket expenses.
Choosing a Primary Care Physician
Tips for choosing a new primary care doctor.
Prior Authorization for Prescription Drugs
Health plans may require “prior authorization” before covering some prescriptions. It's a doctor-insurance matter, not your pharmacy.
Precertification for Medical Services
A precertification means an insurance carrier has deemed a treatment as "medically appropriate." It is not a guarantee that it will be covered.
What is an Explanation of Benefits?
An EOB breaks down your share of medical costs. You should keep it for your records.
What is a Qualifying Life Event?
A change in your situation can make you eligible for a special enrollment period.
Emergency vs Urgent Care
It's good to familiarize yourself with your options—before you need them.
Appealing a Claim Denial
Insurance carriers have to tell you why they’ve denied your claim, and they have to let you know how you can dispute their decisions.
COBRA Coverage
COBRA allows the temporary continuation of group health insurance after losing coverage through an employer.
Embedded vs Aggregate Deductible
For family coverage, your deductible may be classified as either embedded or aggregate (non-embedded).

Rate this article:
Thank you for your feedback!

Clear ROI. Better Outcomes. Engaged Employees.

Learn more about our partnership approach to help you achieve your benefits goals