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Preferred Provider Organizations (PPOs)

The PPO plan is designed to offer the generally lower cost of managed care and the greater flexibility of traditional health insurance plans. You might think of a PPO plan as resting somewhere between an HMO and a traditional fee-for-service plan.

In exchange for a fixed monthly premium, your PPO will offer health care within its own network of physicians. However, unlike an HMO, you have the option to select primary care physician and specialists from outside the network. Of course, going outside the network will cost you and your covered employees higher copayments or coinsurance.

Request a Small Business PPO Quote from a carrier in your area >>

Many small-business owners and their employees appreciate the advantages of a PPO health insurance plan. These include:

• Costs are lower when using the PPO's own network of providers.
  
  
• The covered individual has the freedom to consult any specialist, including specialists who are not members of the PPO's network.
  
  
• There is no requirement to select a primary care physician from within the PPO's network.
  
  
• Out-of-pocket expenses per year are limited, and lifetime
  
  
• Some high-deductible PPO plans are eligible for Health Savings Accounts (HSAs), which allow you and your employees to make tax-advantaged payments into personal accounts that may be accessed for non-covered and major medical expenses.

If you are considering a PPO plan, it is important to ask a number of questions, such as:

• How many physicians and hospitals are in the PPO network, and where are they located?
  
  
• What health care service and preventative health care services are covered?
  
  
• Are there limits on certain services?
  
  
• What are the copayments for specific services?
  
  
• Does the plan charge an annual coinsurance payment?
  
  
• How much more will it cost to use out-of-network physicians?
  
  
• Does the PPO plan charge a deductible before the plan contributes to out-of-network services?

PPO health insurance plans are often the plan-of-choice for small businesses because of their combination of flexibility and relatively low cost to the business and to its employees.  Counterbalancing freedom of choice is the fact that PPO plans, after factoring in other charges, are typically more expensive overall than other forms of managed care.

Request a Small Business PPO Quote from a carrier in your area >>