ATHENS, Pa. — There are lots of options (and lots of letters) available to employers who want to offer health insurance benefits to their staff. These include HMOs, PPOs, EPOs, HDHPs, HSAs, and STM Plans Health Plan. With all these options, Agri-Services Agency thought it would be helpful to briefly explain each of these plans:
- Health Maintenance Organizations (HMO) – HMO’s generally have a more limited number of providers who are considered “participating” or “in network”. Each person is required to choose a Primary Care Physician (PCP) from the available participating providers and all care is coordinated through the PCP. HMO’s do not include coverage for care received from non-participating (or “out of network”) providers.
- Preferred Provider Organizations (PPO) – PPO’s provide the most choice in where to receive care. The participating provider network is generally the largest and coverage is also available for care received from out of network providers. A Primary Care Physician is not required. Care received from in network providers generally costs much less than care received from out of network providers.
- Exclusive Provider Organizations (EPO) – EPO’s are similar to PPOs but they do not cover care received from out of network providers.
- High Deductible Health Plans (HDHP) – These plans typically have higher deductibles and total out of pocket costs than other plan designs. Most benefits are subject to the deductible, including office care and prescription drugs. Certain preventive (wellness visits) services are covered in full and not subject to the deductible. HDHPs can also be coupled with Health Savings Accounts (HSAs).
- Health Savings Accounts (HSA) – HSA’s are savings accounts that are owned by the employee and can be used to pay for out-of-pocket medical expenses. Dollars deposited into the HSA may be made “pre-tax.” Dollars withdrawn from the HSA to be used to pay for qualified medical expenses are generally not subject to taxation.
- Short Term Medical Plans (STM) – STM’s are like PPOs in coverage and networks. A key difference is that coverage is available only for a short, defined period of time (typically 60 days). These types of plans can generally be purchased at any time during the year. Importantly, these plans may not meet Affordable Care Act rules and therefore an individual enrolled in one of these type plans may be subject to health care reform individual mandate penalty.
- Agri-Services Agency also administers their own plans for the agriculture industry that meet healthcare reform rules. Availability of these plans is limited.
Offering health insurance is a great way to attract and keep the best employees. With that said, health insurance is a complex topic, that’s where an agent from Agri-Services Agency can help. We’ve been offering health insurance to the agriculture industry for 50 years. We understand the industry and share your values. Give us a call today at 1-877-466-9089 or visit our website at www.agri-servicesagency.com for more information on what we can offer. You can also click here to fill out a form and request additional information.
–Agri-Services Agency
