Health insurance

It is kind of hard to understand all these medical plans without reading their statements carefully. This year, company is changing the plan offers again to save cost, so next year's per-pay-check contribution will increase about 40%. Given that, I have to read the flyers carefully and attended one session to understand them better before make elections within enrollment period.

As I said, it is kind of confusing to engineers with so many acronyms. However, 10 minutes explanation will work well. Here I try to write down my understanding as a memo for future reference. For medical insurance plan, we need understand 3 categories, namely health plan, health account, and health service provider.

Health plan:

1. PPO – Preferred provider organization.  A health plan that uses network and out-of-network providers.  Examples are Choice Plus (UHC) and Open Access Plus (CIGNA).
2. EPO – Exclusive provider organization.  A health plan that uses network only providers.  Examples are Choice (UHC) and Open Access (CIGNA).
3. OOA – Out of area plan.  Medical coverage for employees outside major network and metropolitan areas.
4. HPSP – Health Plus Savings Plan.  Usually tax qualified high deductible health plan.
5. HMO – Health maintenance organization.  A legally qualified health care organization that provides medical services in a geographic area.  Examples are Kaiser and Harvard Pilgrim Healthcare.

Health account:

1. FSA - Flexible Spending Account (employee owes, use it or lose it)
2. LPFSA - Limited Purpose Flexible Spending Account (employee owes, limited for vision and dental)
3. HSA - Health Savings Account (employee owes, carry over with possible interest rate)
4. HIA - Health Incentive Account (company owes, a.k.a Health Reimbursement Account)

Health service provider:

1. CIGNA
2. UHC(UnitedHealthCare)
3. Kaiser
4. Harvard Pilgrim

Notes:

1. Tax laws prohibit the rollover of HIA funds into an HSA.
2. New medical reforms requires dependents up to 26 years old be covered in medical plan, disregarding employment/martial status.