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T RADITIONAL OR PPO H EALTH P LAN W HAT IS A PPO P LAN A Preferred Provider Organization (PPO) is a health plan with an established provider network.

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Presentation on theme: "T RADITIONAL OR PPO H EALTH P LAN W HAT IS A PPO P LAN A Preferred Provider Organization (PPO) is a health plan with an established provider network."— Presentation transcript:

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2 T RADITIONAL OR PPO H EALTH P LAN

3 W HAT IS A PPO P LAN A Preferred Provider Organization (PPO) is a health plan with an established provider network (physicians, hospitals, labs, etc.) that has agreed to accept specific payment levels for specific services.

4 PPO IS NOT A H EALTH M AINTENANCE O RGANIZATION PPO plan does not require you to select a PCP Referrals are not required You are free to choose your own healthcare provider. One benefit to having a PPO plan is that patients can refer themselves to specialist.

5 FY2012 P LAN FOR BOTH T RADITIONAL AND PPO Pharmacy, Dental, and Vision benefits are unchanged The flexible spending account (FSA) limit has been increased from $2,500 to $3,000. The Integrated Behavioral Health Plan In-Patient Co-pay increased to $15 Outpatient Co-pay increased to $25

6 T RADITIONAL P LAN Employee Premium’s will increase by 15%, and benefits will be unchanged. The co-insurance is unchanged at 80/20 of allowable charges. The Employee will pay the remaining 20%.

7 PPO P LAN Monthly premiums and deductibles are less than the FY ‘11 traditional insurance plan. The co-payment is $20 for exams with in- network physicians. The co-payment is 85/15 of allowable charges and 70/30 out-of-network.

8 H EALTH P LAN ’ S The Misfits


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