Group Point-Of-Service Plans Explained

Who determines your company’s healthcare costs? Choosing the plan may be up to you, but the costs are mainly determined by your staff. Employees are looking for benefits other than basic health — such as life and dental coverage — and adding those benefits can get expensive.

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If you’re looking for an affordable plan with versatile coverage, a group point-of-service plan could work for you. POS plans are a managed care hybrid, similar in many ways to group HMO plans and group PPO plans .

Why People Are Choosing Group POS Plans

Group POS plans are based on basic managed care principles: your employees get lower medical costs in return for restricting their choices. A group POS plan allows your employees to decide when, where, and how they receive benefits and gives them control over their out-of-pocket expenses.

Group POS plans have a “two-level” benefits system: in-plan and out-of-plan. In-plan refers to care received from doctors in the plan’s pre-approved network. Out-of-plan refers to care from doctors not in the network. In-plan care provides savings, while out-of-plan care provides flexibility and freedom in choosing your healthcare provider.

The advantages of group POS plans:

• Your employees won’t be limited to network care providers.
• For in-network care, your employees’ co-payments will be low and the plan’s deductible won’t be applied.
• Your employees’ out-of-pocket costs will be limited.
• Your employees will have more freedom than members of other managed care plans.
• Your employees won’t need a referral from their primary care giver for emergency services.

The disadvantages of group POS plans:

• The co-payments for out-of-network care your employees receive will be high.
• The plan deductible will be applied to your employees’ out-of-network care.
• Your employees might have problems getting a referral to a specialist.
• If they’re traveling outside of the plan’s network-area or have a dependent living outside, benefits will cost them more out-of-pocket.

Want to learn more about your options? Talk with our network of agents to start comparing plans. Fill out an easy online form, and you’ll be contacted with free health insurance quotes.