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Monday, 21 November 2022 00:39

Employee Guide to the Major Types of Health Plans

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You have many choices when selecting a health insurance plan, which can make the process feel overwhelming. Health plans vary and have their own benefits and drawbacks related to coverage, primary care providers (PCPs), copays, premiums and more.

Here are some common types of health plans:

  • Health maintenance organization (HMO) plans cover services performed solely by in-network providers. HMO plans tend to be lower-cost but more restrictive than other plans.
  • Preferred provider organization (PPO) plans include a network of providers but also allow you to seek out-of-network services. These plans are more flexible than HMO plans but typically more expensive.
  • Point-of-service (POS) plans combine elements of HMO and PPO plans. Under POS plans, you can choose how care will be received each time it’s needed.
  • Exclusive provider organization (EPO) plans allow you to seek care from a predetermined list of in-network providers without having to obtain a referral from a PCP.
  • High deductible health plans (HDHPs) have a lower premium, but you pay more before hitting your deductible. An HDHP is typically paired with a tax-advantaged account to pay for qualified medical expenses.

The most suitable plan will depend on your health, unique needs and financial situation. Contact HR if you have questions about available health plans.

CLICK HERE to download our Benefits & Me guide for the month. 

Read 216 times Last modified on Wednesday, 04 January 2023 16:01
Kristen Russell

Kristen founded Fall River Employee Benefits as the culmination of her insurance industry career as an actuary, underwriting executive & consultant. As an Assistant Vice President at Great-West Healthcare (now part of CIGNA), she managed a $1 Billion block of health insurance. She also worked as a Senior Consultant at Reden & Anders, consulting to insurance companies and large employers throughout the country. Ms. Russell received a Bachelor of Science, Business Administration in Actuarial Science, is a member of the American Academy of Actuaries and achieved Fellowship in the Society of Actuaries through a rigorous nine-year series of exams.

Kristen grew up in Iowa but has lived in Colorado since 1993, currently living near our office in the Lower Highlands neighborhood near downtown Denver.  She enjoys bicycling, hiking, traveling and has a special passion for non-profit volunteering. She is married to an incredibly talented photojournalist, has two adult stepdaughters and an adorable Border Collie/Lab mix named Chaco.