Understand your options and make the right choices
Medical insurance is complicated. That's why it's best to have an agent in your corner to help maximize your benefits investment when it comes to plan types including:
Fully insured plan - The employer contracts with another organization to assume financial responsibility for the enrollees' medical claims and all incurred administrative costs.
Partially self-funded plan - The employer assumes some of the financial risk for providing medical insurance benefits to employees. These plans will have an administrator and a reinsurer to reduce the risk to the company.
Managed-care plans - Provide comprehensive health services to their members. Employees are offered financial incentives to use the providers who belong to the plan. Managed-care plans include:
- Preferred provider organizations (PPO)
- Exclusive provider organizations (EPO)
- Health maintenance organizations (HMO)
- Point-of-services (POS)
- Physician-hospital organizations (PHO)
Financial tools to help employees control costs
With some policies, a premium only plan (POP) can provide provide tax advantages to help employees make the most of their health care dollars.
Offering medical insurance helps your business, too
As part of a comprehensive benefits package, medical insurance can be critical to the success of your business.
Associated preventative and wellness programs help keep your workforce healthy and productive.
Plus, health benefits can be a huge selling point for potential employees and a key factor in attracting and retaining top talent.
Get the most out of your health insurance investment
Take the complexity out of choosing a medical plan by working with a partner that knows insurance. Automatic Data Processing Insurance Agency, Inc. (ADPIA) has a team of licensed agents ready to answer questions, help you build a strategy and find the best options for your business.
Your business will also be assigned a dedicated, knowledgeable Relationship Manager who will provide support throughout your group health policy lifecycle, helping to answer your questions and simplifying benefits administration.
Common questions about Group Health
- What additional services do many medical insurance carriers provide?
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In addition to healthcare coverage, many medical insurance programs also include:
- Prescription drug benefits give employees affordable access to the medications necessary to address immediate health concerns and manage chronic conditions.
- A mail-order medication option that enables prescriptions to be filled and delivered directly to an employee's home.
- Wellness programs to encourage healthy behaviors and identify medical conditions when they first develop.
- What is a flexible spending account/arrangement (FSA)?
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Administered by employers, FSA's allow employees to set aside pretax dollars to pay their share of medical insurance expenses not covered by the health plan.
- What is a health reimbursement account (HRA)?
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Established, owned and funded solely by employers, an HRA provides funds to pay for certain medical expenses. HRA's are administered by a vendor who handles reimbursement as claims are submitted.
- What is a health savings account (HSA)?
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An HSA is tax-advantaged medical savings account available to employees with a high deductible health plan. They are owned by the employee but can be funded by both employer or employee. Funds contribution are tax-free and can be used to pay for qualified health care expenses.