ABOUT GROUP HEALTH PLANS
If you have questions and need additional assistance, please contact:
James Rodriguez, President & CEO
TexHealth Central Texas
TexHealth offers a variety of group major medical health insurance plans from some of the best carriers in the nation. Below are some of the most common insurance plans available to groups on the open market that we may recommend, depending on needs.
A Health Maintenance Organization (HMO) requires group members to obtain their health care services from doctors and hospitals affiliated with the HMO. Generally with an HMO members generally are required to designate a primary care physician who treats and directs health care decisions and who coordinates referrals to specialties within the HMO network. HMOs offer access to a comprehensive package of covered health care services in return for a prepaid monthly amount (or "premium"). Most HMOs charge a small co-payment depending upon the type of service provided.
A Preferred Provider Organization (PPO) does not require group members to designate a particular provider, however, if they use providers within their network, they will save the most money on their healthcare services. If providers outside of the network are used, it is possible that those services may not be covered at all, so it is a good idea to check first with your PPO. Keep in mind that deductibles must be met on this plan before some services will be covered. PPOs generally require a co-pay for physician visits.
A Health Reimbursement Account (HRA) combines high deductible/low premium health insurance with a tax favored savings account. Employers contribute to the savings account. Money in the savings account can help fund co-pays and other qualified expenses prior to the deductible being met. Money left in the savings account earns interest and can be carried to the next year.
A Health Savings Account (HSA) combines high deductible/lower premium health insurance with a tax favored savings account. Both employer and employee can contribute, tax-free to the savings account. Money in the savings account can help fund the deductible and other qualified medical expenses. Once the deductible is met, the insurance starts paying. Money left in the savings account earns interest and is yours to keep.