Plan Options
We’ve surveyed the insurance industry and selected the carriers and plans that fit businesses in Alaska, Oregon, and Washington best, allowing you to choose a plan that meets your specific coverage needs while helping you maintain control of your budget.
PPO - Preferred Provider Organization
What is a PPO plan?
PPO plans, or "Preferred Provider Organization" plans, are one of the most popular types of plans in the Individual and family market. PPO plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.
How does a PPO plan work?
As a member of a PPO plan, you'll be encouraged to use the insurance company's network of preferred doctors and you usually won't need to choose a primary care physician. No matter which healthcare provider you choose, in-network healthcare services will be covered at a higher benefit level than out-of-network services. It's important to check if you provider accepts your health plan so you receive the highest level of benefit coverage.
You will probably have an annual deductible to pay before the insurance company starts covering your medical bills. You may also have a co-payments for certain services or be required to cover a certain percentage of the total charges for your medical bills.
A PPO plan may be right for you if:
You want the freedom to choose almost any medical facility or provider for your healthcare needs.
You want a portion of out-of-network claims to be covered by your insurance company.
You don't want to get referrals before visiting a specialist.
Health Savings Accounts
A health savings account (HSA) is a tax-favored savings account created for the purpose of paying medical expenses.
Tax-Deductible
Contributions to the HSA are 100% deductible (up to the legal limit) — just like an IRA.
Tax-Free
Withdrawals to pay qualified medical expenses are never taxed.
Tax-Deferred
Interest earnings accumulate tax-deferred, and if used to pay qualified medical expenses, are tax-free.
HSA money is yours to keep!
Unlike a Flexible Spending Account, unused money in your HSA isn’t forfeited at the end of the year; it continues to grow, tax-deferred.
HMO - Health Maintenance Organizations
What is an HMO plan?
HMO means "Health Maintenance Organization." HMO plans offer a wide range of healthcare services through a network of providers who agree to supply services to members. With an HMO you'll likely have coverage for a broader range of preventive healthcare services than you would through another type of plan.
How does an HMO plan work?
As a member of an HMO, you'll be required to choose a primary care physician (PCP). Your PCP will take care of most of your healthcare needs. Before you can see a specialist, you'll need to obtain a referral from your PCP.
Though there are many variations, HMO plans typically enable members to have lower out-of-pocket healthcare expenses. You may not be required to pay a deductible before coverage starts and your co-payments will likely be minimal. You also typically won't have to submit any of your own claims to the insurance company. However, keep in mind that you'll likely have no coverage for services rendered by out-of-network providers or for services rendered without a proper referral from your PCP.
An HMO plan may be right for you if:
You're shopping for a plan with lower premiums.
You want a plan without a deductible and don't mind having an out-of-pocket limit.
You need preventive care services such as coverage for checkups and immunizations.
Return of Premium Plans
Health insurance plans that pay you back.
Are you overpaying for your business health insurance benefits?
With fully insured health plans, all of your premium is paid to the insurance company. You do not have control over how that money is spent and you won't see any of those premium dollars again, even in years when your group's claims are less than expected.
Our Self-Funded Programs are different. Some of your monthly premium is used to run the daily administration of your plan, but portions of it are also used to pay your stop-loss insurance premium and to build your claims funding account.
In years when claims are lower than expected, a portion of the difference between your group's anticipated and actual claims funding account are credited back to you and that adds up to significant savings.
Return of premium self-funded health insurance programs. Your premiums are split into three categories:
● Plan Administration
● Stop-loss insurance
● Your claims funding account
Receive MONEY back from your claims funding account when your claims are lower than expected.
