Benefits and PlanningWhat does the term PPO mean? Preferred Provider OrganizationWhat are the features of the PPO? Tends to be used in two ways. A way to apply for health care providers who contract with employers, insurance companies, union trust funds, third-party administrators, or others to provide medical care services at a discounted rate. PPOs can be organized by the Service Providers themselves or by other organizations, such as Les Bleus insurance companies. Like HMOs, they may take the form of group practices or separate individual practices, they provide a wide range of medical services such as physician services, hospital care, laboratory fees or they may be limited to hospitalization or under the care of a doctor. services. Benefit plans that contract with PPO to obtain lower-cost care for plan members. How do PPO+HMO differ? First, preferred providers are paid on a per-unit basis as their services are used. Second employees and their dependents are not required to use PPO contracted practitioners or facilities; instead, an election can be made each time medical care is needed, and benefits are also paid by out-of-network providers, but employees are incentivized to use in-network providers; they include lower or reduced deductibles and co-payments as well as increased benefits. Most PPOs do not use a primary care physician as a gatekeeper; employees do not need references to consult specialists. Third party PPOs do not monitor their preferred providers as closely as HMOs do. However, those that operate like traditional HMOs typically offer medical expense coverage at a slightly lower cost than traditional PPOs. Chapter 13. Do you know what HSAs are? Established Improvement and Modernization Act (HSA) = savings are accounted for in the middle of paper...... take responsibility for their child's health care expenses, and this parent's plan has actual knowledge of the terms of the court decision, then this plan is primary „X If the court grants joint custody without specification, the plan of the parent whose birthday falls on the first of the calendar year is primary „X If none of the above rules applies the plan covering the person for the longest period is primary. If the parents of the dependent children are not married, the following priorities apply: a- the project of the parent with custody is primary b- the project of the step-parent who is the spouse of the parent with custody is secondary. c- the plan of the parent without custody is tertiary d- the plan of the step-parent who is the parent without custody pays last. Know Ok has an extension of coverage of 30 days + an extension of benefits up to 6 months Know what COBRA