Employers with 50 or more full-time employees are required to offer a group health insurance plan or pay a penalty of $2,500 per employee per year under the Affordable Care Act. Offering group health insurance to your employees is an integral part of running your business. NIBC can help you understand ACA laws and provide affordable health insurance for you and your employees from top US providers.
Navigating all of the group health insurance options and ACA laws can be overwhelming. Benefits and pricing vary depending on the insurance provider. You can trust the experts at NIBC to help you select the best plan for your employees at an affordable cost.
Health Maintenance Organizations (HMOs)
HMOs give you a local network of providers to choose from. You will select an in-network provider, and they coordinate your care and give you a referral to another in-network specialist if needed. The copays and coinsurance are typically lower than other health plans as long as you stay in-network.
Exclusive Provider Organization (EPOs)
EPOs offer a network of participating providers, but they do not include coverage for out-of-network care except for emergencies. If you visit a provider outside of the local network, you will most likely have to pay the full cost of service. However, you do not need a referral from a primary care provider to see a specialist.
Point of Service Plan (POS)
These plans combine HMO and PPO plans. The provider network is generally smaller than a PPO plan, and the costs for in-network care are usually lower, like an HMO. With a POS plan, you have to choose a primary care provider. You are required to get a referral for a specialist. However, you can also see specialists in-network and out-of-network, but if you see an out-of-network provider the costs are higher and you must file any claims yourself.
Preferred Provider Organizations (PPOs)
PPOs offer a large network of providers, including doctors, hospitals, and other providers. You can also see providers out of the plan’s network, but you will pay more out of pocket. You are not required to have a primary care provider, and you can see specialists without a referral.
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If you have any questions regarding insurance options for yourself, your loved ones, or your employees give us a call today, or contact us to receive a free insurance quote!