Group Health Insurance

"I have been working with BenefitsMart for the past two years and during this time I have never been dissatisfied with the level of service I have received. The staff at BenefitsMart has a strong command of the insurance industry and has always been available to my staff and myself for any questions or concerns we may have. They actively keep me up to date with changes in the insurance industry and work hard to secure us with the best rates possible."

Karen S. Rossi
Director of Finance and Administration
CMARC Industries

Health Insurance is the most popular benefit plan offered by employers. There are many insurance companies who offer these plans. There are also many different types of plans.

These are the most popular plan designs:: Health Maintenance Organization (HMO); In this type of plan, you are a member of a network and have to go to a doctor or hospital in that network. You DO have a primary care physician. You will generally make a co-payment for your visit (amount varies by plan).; Point of Service (POS); In this type of plan, you are a member of a network and can go to doctors or hospitals in the network OR out of the network. You DO have a primary care physician (PCP) so you must go to the PCP for referrals in the network. If you go out of the network your out of pocket costs will increase substantially.; Preferred Provider Organization (PPO); In this type of plan, you are a member of a network and can go to doctors or hospitals in the network OR out of the network. You DO NOT have a primary care physician so you are responsible for knowing if your choices are in or out of the network. You basically make your own referrals. If you go out of the network your out of pocket costs will increase substantially.; Indemnity; Traditional insurance plan. Go wherever you want and pay a deductible.

There are different ways for your company to fund it's health insurance programs.: Partially self funded; Your company is responsible for paying claims up to a certain point and then the insurance carrier pays claims beyond that point. Your company must maintain a reserve to pay the initial claims.; Self funded; Your company insures all of its own claims; there is no insurance company. You may hire a third-party administrator to administer the plan.; Fully funded; Your company has no risk. All of the risk is taken by the insurer.

BenefitsMart can help your company choose the right kind
of plan design and the funding arrangements.

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