Health Maintenance Organization (HMO) - A form of health insurance combining a range of coverages in a group basis. A group of doctors and other medical professionals offer care through the HMO for a flat monthly rate with no deductibles. However, only visits to professionals within the HMO network are covered by the policy. All visits, prescriptions and other care must be cleared by the HMO in order to be covered. A primary physician within the HMO handles referrals.
Preferred Provider Organization (PPO) - A health care organization composed of physicians, hospitals, or other providers which provides health care services at a reduced fee. A PPO is similar to an HMO, but care is paid for as it is received instead of in advance in the form of a scheduled fee. PPOs may also offer more flexibility by allowing for visits to out-of-network professionals at a greater expense to the policy holder. Visits within the network require only the payment of a small fee. There is often a deductible for out-of-network expenses and a higher co-payment. A policy holder will have a primary physician within the network who will handle referrals to specialists that will be covered by the PPO. After any visit, the policy holder must submit a claim, and will be reimbursed for the visit minus his/her co-payment.
Point of Service - A feature of an insurance plan that allows a patient to choose between in-network care and out-of-network care every time he or she sees a doctor. The patient is allowed the freedom to go to whichever doctor is most convenient, although the cost will vary depending upon which option the patient chooses.
Life Insurance - Insurance to be paid to a beneficiary when the insured dies.
Dental Insurance - An insurance program which can be formatted HMO or PPO to pay for expenses relating to overall dental health and expenses.
Disability Insurance - (Short and Long Terms available) Insurance policy that pays benefits in the event that the policyholder becomes incapable of working.
Employee Assistance Program (EAP) - Offers counseling for family and marital problems, alcohol problems, drug abuse, legal problems, financial troubles, and depression or anxiety.
401k - A defined contribution plan offered by a corporation to its employees, which allows employees to set aside tax-deferred income for retirement purposes, and in some cases employers will match their contribution dollar-for-dollar. Taking a distribution of the funds before a certain specified age will trigger a penalty tax. The name 401(k) comes from the IRS section describing the program.
Voluntary Benefits - Company sponsored but employee funded benefit programs.
Health Savings Account (HSA) - The HSA was created recently by federal legislation. An HSA lets you set aside pre-tax dollars for future medical, retirement, or long-term care premium expenses. Invest these funds as you wish within a broad range of choices, then use them for qualified expenses. The funds can roll over from year to year. You take them with you when you change jobs.
The main difference between an HRA and an HSA is that HRA funds are provided only by an employer for an employee, and do not follow an employee to a new employer. The main difference between a FSA and an HSA is that FSA funds must be used within the calendar year; otherwise they are forfeited.
Cafeteria Plans - A benefits plan that allows employees to select from a pool of choices, some or all of which may be tax-advantaged. Potential choices include cash, retirement plan contributions, vacation days, and insurance.
