Hmo ↝ Life insurance

HMO Licensure and Modification Filings, NC DOI

HMO Licensure and Modification Filings N.C.G.S. § 58-67-50 defines a Health Maintenance Organization (HMO). The North Carolina Department of Insurance is the only agency in North Carolina responsible for regulating HMOs. Several Divisions within the Department, including the Life and Health Division, play a role in the Initial Certification of Authority application and the ongoing regulation of the licensed entity. The Department also regulates other Pre-Paid Health Plans. The North Carolina Department of Insurance is also the North Carolina agency responsible for the licensing and financial regulation of a Prepaid Health Plan (“PHP”), as defined in N.C.G.S. § 58-93-5. HMO Licensing,...

The HMO Act of 1973: Objectives Finally Met through ACOs?

The HMO Act of 1973: Objectives Finally Met through ACOs? Signed into law by President Richard M. Nixon on December 29th, the HMO Act of 1973 was ambitious legislation that initiated a long, bumpy, and unsatisfying endeavor to establish a comprehensive healthcare delivery system that lowered medical costs and provided quality care to every American. Senator Edward M. Kennedy favorably described the proposed legislation as “a drastic overhaul of [the] entire way of doing business in the healthcare field” (Brase). The legislation obligated the Federal Government to support the implementation of prepaid group practices, or Health Maintenance Organizations (HMOs), as alternatives to the...

HMO vs PPO: What s Right for Your Small Business?

Health insurance plans use a provider network system to determine which doctors your employees can see and at what cost. Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are two of the more popular options. We cover HMO vs PPO, so you can find the right choice for your small business. An HMO looks to reduce costs by having a more restricted provider network. Your premiums on these plans will typically be less expensive. In 2016, the average annual premium for an employer-sponsored HMO family plan was $17,978, according to the Kaiser Family Foundation. A PPO plan cost $19,003, more than $1,000 higher per year. Your employees will also have lower out-of-...

HMO Plans

HMO Plans Large Employers 51+ employees HMO – Full Network Options Health Net has been setting the standard for HMO care for decades. From our high-quality full network HMO options to flexible options such as our EOA plans, we have the right full-network HMO options for your clients. We know HMOs! Health Net has a variety of plan designs for businesses of all sizes. Our full-network HMO gives your clients and their employees access to thousands of physicians and pharmacies across the state. More Elect Open Access (EOA) plans Elect Open Access (EOA) is an HMO plan with set copayments, unlimited lifetime benefits, and a primary doctor to coordinate members' care. However, an EOA also...

Excerpt 7: Know Your Opponent - HMO or PPO? - Carcinoid Cancer Foundation

The HMO is a vanishing breed. The only surviving HMO of any size is Kaiser Permanente. Plus, there are a few small local HMOs. Since most of us have PPOs, it behooves us to know what this means, and how the PPO set-up plays out in real life. What is an HMO? The HMO concept originated in the early 1970s. Prior to 1970, doctors had their own practices. Insurance companies were their own businesses, separate from doctors. All of a sudden, new and expensive tests and treatments were being developed, and doctors were ordering them for their patients. Doctors were also prescribing drugs for their patients, and the cost of prescription drugs was going through the roof. The insurance companies got...

DIFS - Health Maintenance Organizations (HMOs)

You are here Health Maintenance Organizations (HMOs) Health Maintenance Organizations (HMOs) provide preventive care and other services that are basic to good health. It is a health care system that joins together the financing and delivery of health care services to covered individuals by arrangement with selected providers who furnish a broad set of health care services. If you have health care coverage through an HMO, there is a provider network to provide covered health services. Be sure to follow your HMO's network rules when you need care. The HMO must employ or contract with health care providers who undertake a continuing responsibility to provide health care to enrollees. If...