In this era of creative financing and cost management tools, many employers are looking for new ways to help employees
finance their health care expenses.
As an employer, you want to provide good coverage, but the cost increases in recent years have been tough to handle. A typical response to these increases may be to select a high-deductible insurance product that lowers your cost. However, there
is a better solution.
Think HMO. That's right — health maintenance organizations. The HMOs of today offer a whole new generation of health
care financing tools that every employer should consider.
It's not your father's HMO.
You may have heard bad stories or had a rough experience in the past. However, times have changed. HMO plans today offerextensive provider networks, excellent coverage for preventive care, the ability to frequently change a primary care physician
and outstanding prescription drug coverage through broad pharmacy networks.
HMOs take the surprise out of the bill.
With most health insurance plans, an employee is responsible for a percentage of the cost of care, often 20 percent or 25
percent. This can add up very quickly, and employees can't predict what their expense is going to be.
With an HMO structured co-pay plan, an employee knows up front the expenses associated with most covered services. For example, an employee may have a $20 copay for a primary care physician (PCP) visit, which will include all services provided in that visit. Each time employees go to their PCP, they can expect to pay $20 — no surprises there.
Higher co-pays offer savings.
The days of nickel sodas and 25-cent phone calls are long gone — and so are $5 and $10 co-pay plans. It's time to rethink the value of co-pays. New HMO plans have higher co-pays, some as high as $30 for a primary care visit and $50 for a specialist.But that covers all services provided during that
visit. That's a valuable cost limit these days.
HMOs offer bold new designs.
New HMO plans have fresh cost-sharing strategies that provide low employee out-ofpocket expenses in some areas while controlling your costs by increasing employee expenses through deductibles in other areas.
In most deductible-based plans, employees have a high deductible that applies to all services. However, with these new focused-deductible HMO plans, the deductible is limited to specific services, such as hospital care or prescription drugs. After the deductible is satisfied, a co-pay also applies to that service.
Furthermore, with these plans, employees continue to have a co-pay instead of a deductible for highly utilized areas such as
physician or specialist visits.
HMOs are FSA and HRA compatible.
Many HMO plans can be used with flexible spending and health reimbursement accounts, enabling employees to decide
how some of their health care dollars are used. Many carriers are also developing health spending account-compatible HMO plans.
HMOs offer more than health insurance.
Today's HMO plans offer health improvement programs such as discounted fitness club memberships and valueadded options that let employees take charge of their own health.
There are two primary reasons to revisit today's HMO — savings to you and savings to your employees. Rediscover today's HMO — you'll be pleased with what you find.
STEPHEN RUSSELL, a health care industry veteran with more
than 35 years of experience, joined VISTA in 2002. As vicepresident of product development, he is responsible for product design and implementation, and contract compliance
activities for all lines of business, including Medicare, Medicaid, large and small employer groups, and individual. Reach him at stephen.russell@vistahealthplan.com
Move On! No matter how worse it seems, just move on.
Finding Vacation Rentals in North Lake Tahoe The main difference between North and South Lake Tahoe is that most people who live on the lake year around tend to own houses on the northern end. Here you'll ...
Affiliate Marketing Pros and Cons Want an online business with a win-win opportunity for both the merchant and the publisher? Try investing your money, time and effort in affiliate marketing bus...
The Power of the A-Z Presentation When someone asked me, 'John, what is the #1 reason why people fail in their own Network Marketing business?', I said with 110% confidence, "It is because they ...
Eight Ways to Generate More Ideas in Groups We know that if we generate more ideas we have a better chance of finding better ideas. Your goals should be to have a variety of approaches to help stimulate ...
Old Habits Die Hard in the Third Age Years I spent a lifetime in retailing and I'm still at it in retirement; albeit virtually. You know how it goes. You put up a web page and throw in some stock.
Universal Thought Systems/Forgiveness Thoughts of forgiveness have a great impact within especially for the person doing the forgiving. The thought of forgiveness becomes part of universal energy an...
Italian Interior Design Italy is taking over the design world according to my friend, Al. He himself lives in a 3-floor condo that is designed with much that is Italian. The arches in ...
Common SENSS Stress Control Stress is something that we all grapple with at one time or another, and that can get out of hand before we know it. The common SENSS stress control approach ca...
Music, the Spiritual Connection All through the age's music and spirituality as served hand in hand. As for instruments, the earliest is presumed to be, percussions from noisemakers to drums.
Tippers Crusade The union was formed two hundred and twenty six years ago by the forefathers of this nation out of spite for a foreign oppressive government that not only dicta...
Unravelling The Real Estate Buying Process in Canada If you're a foreign national thinking about investing in the real estate market in Canada here's a run down of the typical buying process you should expect to e...
Short Term Savings Products When you invest, it simply means that you are putting your funds in products, in this case short-term savings vehicles, which will allow you to reap high financ...
The Benefits of Massage Recliner Chairs Massage recliner chairs are different than traditional home recliners. These innovative chairs offer a wide range of options for massages and comfort. Although ...
How to Make Your Wildest Dreams a Reality According to Bill Gates there are 3 keys to success in any new venture: 1) Being in the right place at the right time. (You could well be already there!) 2) Ha...
Did You Know Everything In Your Dream Is About YOU? Are your dreams full of weird and wonderful people, places and events? What does it all mean, and how does this relate to your life? Well, it's all about YOU. S...
To Love or Not to Love? Have you ever fallen in love with two different persons at the same time? Falling in love with two different persons whom both have the same feeling for you too...
Print this page