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The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status.
Companies that have 50 or more full-time employees are required to offer employer-sponsored insurance. The window to purchase a plan for their staff lasts only two weeks. The window to purchase a ...
But POS health insurance does differ from other managed care plans. Enrollees in a POS plan are required to choose a primary care physician (PCP) from within the health care network; this PCP becomes their "point of service". The PCP may make referrals outside the network, but with lesser compensation offered by the patient's health insurance ...
An HMO Point-of-Service (HMO-POS) plan is a type of HMO plan. With an HMO-POS plan, an individual must choose a PCP, but they can use out-of-network services at a higher cost, similar to a PPO plan.
Employee benefits in the United States include relocation assistance; medical, prescription, vision and dental plans; health and dependent care flexible spending accounts; retirement benefit plans (pension, 401(k), 403(b)); group term life insurance and accidental death and dismemberment insurance plans; income protection plans (also known as ...
Despite a perception that IPAs have been formed to negotiate as a group with insurance companies in an attempt to improve rates of compensation, under the Federal Trade Commission Act, they cannot negotiate as a group with insurance companies for the providers' other insurance reimbursement. The IPA can only negotiate for the IPA members those ...
The Federal Employees Health Benefits (FEHB) Program is a system of "managed competition" through which employee health benefits are provided to civilian government employees and annuitants of the United States government. The government contributes 72% of the weighted average premium of all plans, not to exceed 75% of the premium for any one ...