What is Point of Service Health Insurance Coverage?

A brief summary Powerpoint presentation of POS

1. Tell Me About… POS
POINT OF SERVICE (POS) HEALTH INSURANCE PLANS

2. It’s a combo…
Combination
POSplans combine
features of an HMOand a
PPOplan.
Requirements
✓POS plans may require
employees to choose a
Primary Care Physician
(PCP) from the plan's
network providers.
Services
Services rendered by
the PCP aren't subject
to the policy's
deductible.

3. Utilizing Covered
Services…
IF EMPLOYEES UTILIZE
COVERED SERVICES THAT
ARE RENDERED OR REFERRED
BY THEIR PCP, THEY MAY
RECEIVE THE HIGHER LEVEL
OF COVERAGE.

4. Non-Network Providers
If you utilize services by a non-network provider,
you may be subject to a deductible and lower
level of coverage.
You may also have to pay up-frontand submit
a claim for reimbursement.

5. What you’ll get…
Freedom
A moderate amount of
freedom to choose
your health care
providers --more than
an HMO; you do not
have to get a referral
from a primary care
doctor to see a
specialist.
Higher Costs
What doctors you can
see? Any in the PPO's
network; you can see
out-of-network doctors,
but you'll pay more out-
of-pocket doctors vs. in-
network providers.
More Paperwork
More paperwork than
with other plans ifyou
see out-of-network
providers

6. A POS may be a
good option for
small business if
your employees:
✓NEED FLEXIBILITY WHEN
CHOOSING PHYSICIANS
AND OTHER PROVIDERS
✓DESIRE PRIMARY CARE
PHYSICIANS TO
COORDINATE CARE
✓LIKE THE BALANCE OF
GREATER PROVIDER
CHOICE VERSUS LOWER
PREMIUMS

7. Ask me a question…
Message me: LinkedIn
Email me: [email protected]
Call me: 724-941-8772 (cell)