Group Health Benefits that Protect Your People and Help Your Company Thrive
Providing health benefits to your employees is vital to the success of your company. However, with today’s economy and ever-changing employee needs it can be challenging. That’s where we come in. JPA offers employer sponsored health coverage with innovative funding arrangements that means you and your employees pay less for healthcare, but it doesn’t mean you get less healthcare. Learn More
At JPA, we leverage our experience and relationships, supported by data insights, to help design a strategic benefit plan to fit the varying needs of our clients.
Types of group health plans available:
Preferred Provider Organization (PPO)
PPO members have the flexibility to choose between vast network of quality healthcare providers and facilities. While they are not required to use providers within the network, they will save the most money if they do, as some services may be only partially covered or not even covered at all when outside providers are used. Also, many services may not be covered if deductibles are not first met, however, the plan includes important wellness and preventative services provided outside of the deductible with a small co-pay.
Health Maintenance Organizations (HMO)
An HMO may be more cost-effective for your employees. This plan requires members to appoint a primary care physician who directs treatment utilizing service providers affiliated with the HMO. Some services may be only partially covered or often, not covered at all when outside providers are used. HMOs offer access to a comprehensive package of health care for a low monthly premium. A small co-payment is often required for services, depending upon the type provided.
High Deductible Health Plan (HDHP)
An HDHP can be any type of health insurance plan, including a preferred provider organization (PPO) or health maintenance organization (HMO) plan. While not for everyone, the HDHP plan will save you a significant amount of money on monthly premiums but comes with a very high deductible, in addition to higher maximum out- of-pocket costs. Simply put, you will have higher out-of-pocket costs when you need care if you have an HDHP, however, depending on the specific plan, preventive care may be covered before the deductible is met with no out-of-pocket costs.
Point of Service (POS)
POS plans combine features of HMOs and PPOs. Most POS plans require members to choose a primary care physician from within the POS network, but allow them to use out-of-network specialists with a referral from a primary care physician. Co-payments will be higher for out-of-network services.
Exclusive Provider Organization (EPO)
EPOs only cover services from providers within its network, offering no benefits for out-of-network care, except in emergencies. EPO plans are known for offering direct access to specialists without needing referrals and generally lower out-of-pocket costs than Preferred Provider Organization (PPO) plans.
Wellness Benefits
As mandated by the Affordable Care Act, most group health plans include wellness benefits in their comprehensive coverage at no additional cost. These benefits are designed to improve lives and keep members healthy. These are preventative health services such as preventative medical screenings, free or discounted gym memberships, diet advice, disease management, telehealth, mental health services and much more.
Fully Funded Plans vs. Level Funded Plans
In a fully funded plan, the insurance company assumes all the risk of employee healthcare costs for a fixed monthly premium. In a level funded plan, the employer shares some risk by funding part of the claims. JPA specializes in transitioning Georgia companies to Level Funded Plans proven to significantly lower healthcare costs for both the employer and employee. Learn More
