What
is an HMO? |
A
Health Maintenance Organization (HMO) is a benefit
plan that has one benefit level: in-network; it
allows enrolled members, who live in a defined
service area, to use participating HMO providers
in order to receive benefits. HMO members must
have all care authorized by their Primary Care
Physician (PCP). There are minimal copayments,
but no deductibles and virtually no claim forms.
There aren't any out-of-network benefits.
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What
is a POS? |
A
Point-of-Service (POS) is a benefit plan that
has two benefit levels: in-network and
out-of-network. In-network benefits provide the
maximum benefit to members and provide the same
cost and quality controls of the HMO product with
minimal co-payments. To maximize in-network
benefits, members are required to select a PCP
from the insurer's directory of participating
providers; the member's PCP will coordinate
all of the members' health care needs. Members
can choose, at the time services are needed, to
seek care from an in-network provider and receive
the highest benefit level possible or go out-of-network
and receive benefits that are subject to deductibles
and coinsurance.
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| What
is the advantage of using Electronic Debiting? |
Electronic
debiting brings electronic funds transfer technology
to the health insurance bill payment process.
Electronic debiting is the simplest and most worry-free
way to pay your monthly health insurance bills.
On or about the 15th day of each month, you will
receive an itemized bill from the LIA Enterprise
Enrollment Processing Center. The bill details
the premium dollars that are due the first day
of the following month. On the last business day
of the month, a debit request will be sent to
the bank you have designated and the payment due
will be electronically transferred to the Enterprise.
You won't have to worry about making late payments.
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