For Employers

When selecting a plan for your company, it's important to understand what you're getting. Insurance carriers will always sell you on the discount they provide. These discounts are based on the size of that provider's membership. At times, the discount their plan offers may not be as different from another carrier as it presented to be. The article below from Health Insurance Underwriter magazine explains a little more about how providers calculate discounts on services

As an employer or benefits manager, it's also important to understand the different types of plans. Below are some basic definitions for these plans. You can find out more at the North Carolina Department of Insurance website.

Common Terms:

Traditional insurance provides individuals with the most freedom of choice, and offers the most control over your health care. Traditional insurance, also known as indemnity or fee-for-service, allows members to select any provider.

A preferred provider organization (PPO) is a healthcare benefit arrangement designed to supply services at a discounted cost by providing incentives for members to use designated healthcare providers who contract with the PPO at a discount. Members enrolled in PPO coverage can also receive coverage for services by healthcare providers who are not part of the PPO network.

Point-of-service (POS) coverage is a healthcare option that allows members to choose medical services that are needed and whether they will go to a provider within the BCBS plan's network or seek medical care outside of the network.

A Health Maintenance Organization (HMO), is a health care system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee.