Understanding Group POS Plans
If you own a business and are looking for an affordable group insurance plan that has versatile coverage, then a group point-of-service (POS) plan could be an option for you. POS plans are a form of managed care hybrid plans, and are similar to group HMO plans or group PPO plans.
A basic principle governs POS plans: employees get lower medical costs in exchange for restricting their health care choices. A group POS plan will give your employees the option to decide when, where, and how they receive benefits and will give them control over their out-of-pocket expenses.
Group POS plans operate using a “two-level” benefits system: in-plan and out-of-plan. In-plan refers to the care received from a list of doctors who are in the plan’s pre-approved network. Out-of-plan refers to care received from doctors who have not been pre-approved and are thus not in the network. In-plan care provides employees with savings, while out-of-plan care can provide flexibility and freedom in choosing the right healthcare provider.
Group POS plans are not the right choice for all employers and employees, so employers must carefully weigh the benefits and disadvantages of the plan before making a choice.
Some advantages of group POS plans are:
- Employees will not be limited to network care providers.
For in-network care, co-payments will be low and the plan’s deductible will not be applied.
Out-of-pocket costs for employees will be limited.
Employees will have more freedom than members of other managed care plans.
Employees will not need a referral from their primary caregiver for any necessary, emergency services.
Some disadvantages of group POS plans are:
Co-payments for any out-of-network care employees receive will be high.
The plan deductible will be applied to employees’ out-of-network care.
Employees may experience problems getting a referral to a specialist.
If employees are traveling outside of the plan’s network-area or have a dependent living outside of it, benefits will cost more out-of-pocket.
Choosing a group POS plan may be the right choice for your employees. A licensed Florida insurance agent can help you decide if this type of plan is right for your employees.
Bradley Palmer is with Grouphealthflorida.com offering Florida Group Health Insurance. To learn more about group health insurance, visit http://www.grouphealthflorida.com.
