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LIFE INSURANCE

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HEALTH INSURANCE

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There are numerous plans, coverages and options you can tailor to your needs. The sections below outline the common types of policies and policy options. It's a good idea to work with your agent to help you create a benefits package that's right for you and your employees.

Indemnity (Fee-for-Service)
Allows you to go to any hospital or doctor. You submit a claim and pay the invoice (to be reimbursed later) or authorize the hospital or doctor to collect their fees directly from your insurance company. Although this plan is very flexible in who provides your care, the premiums are higher than other types of health insurance. Also, indemnity plans usually do not provide any coverage until the deductible has been satisfied.

PPO (Preferred Provider Organization)
The insurance company has a network of "preferred providers" (hospitals, doctors, clinics, etc.) These providers discount their service fees to your insurance company in exchange for being part of the network. If you use a provider from outside the network, you'll have to submit a claim and likely to pay a higher deductible. This is usually less expensive but not as flexible as the indemnity plan.

Exclusive Provider Organizations (EPO)
Similar to an HMO, a managed health care program that requires members to use doctors within the network. However, EPO's are not governed by most state and federal HMO regulations. As a result, certain conditions may not be covered by an EPO.

HMO (Health Maintenance Organization)
All your medical services are provided by the organization of doctors, hospitals, etc. The HMO is much like a strict PPO: you must use the providers they authorize (except for emergencies as defined by your plan). Your doctor refers you to other doctors within the HMO as necessary. The HMO's advantage is that it has no deductibles and usually requires only a small co-payment for each service. There may also be a maximum to what you pay annually "out-of-pocket".

POS (Point of Service)
This is an option of HMO with greater flexibility. Your primary doctor may refer you to someone outside of the HMO with a minimal or no additional cost. You may also refer yourself to a non-HMO provider, but you'll have to pay co-insurance.

VISION
May include visual benefits, ranging from co-payment eye exams and discounted glasses or contact lenses. Most policies contain a maximum annual benefit per member or family.

DENTAL CARE
General cleaning and other basic dental care. Often co-payment is required for extractions, crowns and other advanced procedures. Most policies contain a maximum annual benefit per member or family.

PRESCRIPTION COVERAGE
Enables your insurance carrier to pay most of your prescription costs. Usually presented at the drugstore, you'll pa only a fraction of what it normally costs depending on your policy and type of prescription (i.e. brand name or generic).