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Select a healthcare plan that fits your business

Here's a breakdown of what various plan types typically feature. As you read about each type, just remember that today's health coverage market often offers "blends" of these traditional types. *Monthly premiums represent the total cost for a single employee (both employer and employee contributions). If you share premium costs with the employee, your business costs will be less. Price ranges reflect national averages for 2023; premiums for your business may differ depending on your location, employees' age and other factors.

What is covered? Whom can you see? Cost-sharing at time of service Monthly premium* Summary
Health maintenance organizations (HMO)

Usually comprehensive.

Limited network; no benefits for services outside network. Generally, services must be referred by primary care physician (some exceptions such as preventive gynecological exams, emergency services, etc.).

Typically low copayments at time of service ($10 to $40); no co-insurance.

Typically medium range; averages roughly $575.

Makes sense when employees are willing to give up flexibility in provider choice and accept greater management of their care. Also offers benefits in terms of ease of administration. Less attractive if some or many employees feel strongly about having access to a wide selection of providers.

Preferred provider organizations (PPO)

Usually comprehensive

Any doctor, but benefits reduced for services outside the network.

Typically have copayments between $10 and $50, co-insurance up to a deductible.

Depends on cost-sharing: High deductibles usually mean lower premiums and low deductibles mean higher monthly premiums. The national monthly average is roughly $600. 

Good option if choice of providers is important to employees. Employees should be willing to assume responsibility for some administrative duties (such as obtaining referrals or submitting claims).

Health Savings Accounts (HSA)

Comprehensive up to savings account limit, and usually comprehensive above deductible. Employee is responsible for share of deductible after savings account funds are spent.

Below deductible: any doctor. Above deductible: benefits generally reduced for services outside the network.

Employee pays with spending account funds, and then out-of-pocket, up to a high deductible (for example, $4,000). Copayments and/or co-insurance apply after deductible.

Usually a low-cost option (monthly premiums for high-deductible plans average $550). Policies with higher deductibles typically have lower premiums.

Good option if employers and employees share an interest in keeping monthly premiums low. Employer must be willing to set up and administer savings accounts; insurance carriers, financial institutions, brokers and other advisers can help. HSAs may be less attractive to older and sicker employees, whose health needs may use up their savings account and require additional out-of-pocket payments.

Point of service plans (POS)

Usually comprehensive

Any doctor referred by primary care physician; benefits reduced for services outside the network if not referred by PCP.

Contact a broker for detailed information on costs.

Contact a broker for premium quotes, but the national average is roughly $600/month. 

Offers more flexibility than HMOs but less than PPOs. Employees should be willing to assume responsibility for some administrative duties (such as obtaining referrals or submitting claims).