Every small business in Dallas, Houston and throughout Texas wants to attract high quality individual employees who will contribute to the growth and success of the company. In order to recruit and retain these people, many larger business owners offer health insurance coverage, specifically group health, as an employee benefit.If your company is small, especially if has ten or fewer employees, there are still ways to offer your employees health insurance coverage. In most states, insurance companies which offer small group health insurance plans are required to accept any employer group of two to 50 employees, provided the employer agrees to insure 100% of the eligible employees.Before you can offer any health insurance coverage, you must decide how much your employees will pay, as well as the kind of insurance that you wish to offer.It’s expensive. So who pays?Most businesses that offer their employees group health insurance plans contribute towards the cost of the coverage. Some pay for all of the employees’ premiums (for single coverage) and let the employees pay the premium if they need coverage for their families. Other businesses pay a percentage of the total cost.The amount you choose to pay will depend on your own situation. First, think about how your contribution will affect your budget. Second, think about how it affects the desirability of your plan to your present and future employees.Many businesses choose to have their employees make a contribution towards some of the cost, especially as health care costs and insurance premiums continue to increase.Plan designsThere are three major types of health plans — managed care, preferred provider, and fee-for-service. The plan that’s best for your business is determined largely by your business location, the physicians and hospitals available through the plan, the options offered by insurance companies, and the constraints of your budget.Managed careManaged care plans are agreements between certain doctors, hospitals, and health care providers, and are designed to offer a range of services to members at a reduced cost. Managed care plans are typically HMOs. They may also be referred to as an Individual Practice Association (IPA) or Point of Service (POS) plan.· Most HMOs minimize the out-of-pocket expenses members pay for medical care, as long as members use the HMO’s preferred providers and facilities. If members go outside of the network, they may be responsible for paying the entire bill.· In addition, members must choose a primary care physician, and see that person first whenever they need medical attention. The primary care physician will make necessary referrals to specialists.· With HMOs, the per-visit or annual deductibles are usually lower than with other plans.Preferred providerPreferred provider plans, known as PPOs, negotiate price discounts with health care providers. They refer to the health care providers that they have discounts with as “network” providers. PPOs pay a higher percentage of your employees’ claims if they use network providers.· Unlike HMOs members, PPOs members can see physicians without referral and can use physicians outside the network if they are willing to pay the non-network cost sharing.· PPOs generally require more cost sharing than HMOs, even for in network care. The per-visit or annual deductibles are usually higher than with HMO plans.· There may be some managed care elements with PPOs, but not as extensive as HMOs. For example, you may need pre-authorization for a hospital stay, surgery, or an expensive diagnostic test.Fee for ServiceFee-for-service plans, also known as indemnity plans, allow employees to choose health care providers themselves. This gives them a wide range of options that includes specialists such as cardiologists and surgeons. But because these plans do not give members incentives to use low cost providers, the plans are expensive. Some insurance companies limit the fee-for-service expense by imposing low maximum benefits and/or fee schedules. As with any insurance plan, carefully read the benefit description for a fee-for-service plan.Check out the insurance companyAlong with selecting the right group health plan, selecting an insurance company is important, because the service delivered will directly impact each of your employees. Look for an insurance company with a good network of health care providers, timely claims service, and relatively stable premiums.In addition, check with other small business owners in the area, or with your Small Business Association. The Texas Department of Insurance will also have information about the financial stability of the insurance companies that you are considering, as well as any history of customer complaints.Can I choose my own small business health insurance provider?Sure. Small business group health plans are available from reputable insurance companies who are using the Internet to help reduce administrative expenses.Do I need an agent to help me select a plan?No. Keep in mind that many agents only represent a small number of insurance companies. If you use an agent, you should expect him/her to ask questions about your goals and objectives and to learn about your business and employees before recommending a plan.Health insurance for your employees can be expensive. The following tips will help you ensure you’re offering the best option for employees and the most cost-effective option for you.Do your homework:* Survey your employees for their insurance needs. Do their families require insurance?* Consider insurance plans that require second opinions and include built-in cost containment features.Talk to your employees:* Design a plan that includes employee contributions towards cost and keeps employees informed of health care costs and rate changes.* Create a committee to investigate the group health insurance market.* Survey your employees to make sure you understand their needs and objectives before launching a plan.Educate your employees about the cost of appropriate health care:* Encourage employees to request second opinions and alternative, less invasive treatments.* Help employees understand what is and is not covered under the plan.Create a health-conscious work environment:* Limit smoking at work to designated areas or eliminate it entirely.* Offer healthy choices in vending machines and alternatives to pizza and beer at employee events.* Promote moderation in use of alcohol and establish a zero tolerance drug and alcohol abuse policy.If you’re a small business owner who would like to offer an affordable health insurance plans to your employees but can’t afford group health insurance, you should take a look at the revolutionary, comprehensive individual health insurance solutions created by Precedent specifically for young, healthy individuals. Precedent offers affordable, individual health plans with catastrophic coverage, but without a high deductible, and we’ll work with you to make these plans available to your employees at a discount. For more information, visit us at our website, [http://www.precedent.com]. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans and an unparalleled “real time” application and acceptance experience.
What is PPO Health InsurancePPO basically means Preferred Provider Organization. A PPO health insurance plan is offered by an organized health care plan that offer its member a limited choice of hospitals, doctors and specialists and also the ability to seek the services of a doctor or specialist outside the network. The health net PPO member will be reimbursing only 70% of the cost which the member will have to do all the paper work for his claims.The PPO health insurance plans is similar to an indemnity plan in that a PPO enters into an agreement with medical doctors and hospitals to provide medical care to their members which these doctor or hospitals will charge them for a lesser fee for the service they render. Another unique feature of a PPO is the freedom of the insured to consult with any doctor they wish, even from outside the network of the PPO. So if you consult a doctor outside the PPO network you stand to pay more than if you have consulted from within the network also the insured member can make referrals to doctors and also will need to meet the different in charge between what the health insurance plans offers and what the provider of this services charges.The PPO health network provides a wide network of doctors that is very similar to that of HMO. In order to enroll as a proffered provider organization health insurance plan, you will have to pay a monthly premium part of the annual membership expenses and for those who are in PPO health insurance plan through their employer would fund their premiums debited direct from their monthly salaries, and this kind of deduction is from their gross pay before the removal of taxes. Many employers also pay a small portion of their employee medical premium these is a part of the total compensation package offered to their employees, which help to off set the cost of the health insurance plan.Based on the geography location and the insurance company providing the health individual insurance PPO you will find that your own primary health care medical services provider is also a member of the PPO network Office visit and prescription made by the doctor is not as costly as hospital co payment because of hospital or emergencies associated.Why should I choose a PPO health care provider?PPO differ from Health maintenance organization (HMO’s) in the sense the insured who do not use participating health care providers receive little or no benefit from their health insurance plans.Being a Hybrid between traditional indemnity plans and health maintenance organizations, the PPO aims to strike a balance between the two.PPO can also create efficiencies in the health care business. However, PPO require insurance to pay a claim within a certain time frame in order to obtain the PPO discount, and calculating the PPO discount and the insurer paying the PPO’s access fee is an opportunity for delay and mistake in the already complex situation for paying for health care in the United State. PPO have more strength in their relationship with providers, and can still provide benefit to their insured members, but uninsured patient may not be able to obtain their discount even if they pay cash to the insurance company.What are the cost advantages and disadvantages of this plan?Some of the advantages of the PPO plans include the following:
Being a client of a PPO enables you to receive great savings due to the agreements entered between the PPO and the wide network of doctors and hospitals, these doctors and hospitals reduce their fees which is then passed on to insured.
Individuals also enjoy a tax cut; this is so because the premiums due to the PPO are deducted as source to the account of the PPO thereby reducing their taxable income.
Most times a PPO health care subscriber discovers that his own primary care health care provider is also a member of the PPO network.
Disadvantages of the PPO plans are listed below:
Although a PPO subscriber can use the services of any physician of his choice, he still is liable to pay a larger portion of the bill if he chooses to visit a doctor of his choice who is not a member of the PPO’s health insurance plan.
PPO’s create inefficiencies in the health care system.
There is great room for delays and mistakes in health care delivery due to the several steps involved in insurance payment process.
Irrespective of the few flaws of the health individual insurance PPO, the PPO health insurance plan is a good investment for those who care for their wellbeing and the well-being of their family and dependants. So avail yourself today to Health net PPO systems that enable individuals to select the best PPO health insurance plan well suited to their own unique circumstances.